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Shahriarirad S, Asmarian N, Shahriarirad R, Moghadami M, Askarian M, Hashemizadeh Fard Haghighi L, Javadi P, Sabetian G. High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:247-258. [PMID: 38680224 PMCID: PMC11053253 DOI: 10.30476/ijms.2023.97708.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/01/2024]
Abstract
Background Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. Methods This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. Results A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).
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Affiliation(s)
- Sepehr Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Javadi
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Nguyen NN, Nguyen YN, Hoang VT, Million M, Gautret P. SARS-CoV-2 Reinfection and Severity of the Disease: A Systematic Review and Meta-Analysis. Viruses 2023; 15:v15040967. [PMID: 37112949 PMCID: PMC10145185 DOI: 10.3390/v15040967] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Since the discovery of SARS-CoV-2, changes in genotype and reinfection with different variants have been observed in COVID-19-recovered patients, raising questions around the clinical pattern and severity of primary infection and reinfection. In this systematic review, we summarize the results of 23 studies addressing SARS-CoV-2 reinfections. A total of 23,231 reinfected patients were included, with pooled estimated reinfection rates ranging from 0.1 to 6.8%. Reinfections were more prevalent during the Omicron variant period. The mean age of reinfected patients was 38.0 ± 6. years and females were predominant among reinfected patients (M/F = 0.8). The most common symptoms during the first and second infection were fever (41.1%), cough (35.7% and 44.6%), myalgia (34.5% and 33.3%), fatigue (23.8% and 25.6%), and headaches (24.4% and 21.4%). No significant differences of clinical pattern were observed between primary infection and reinfection. No significant differences in the severity of infection were observed between primary infection and reinfection. Being female, being a patient with comorbidities, lacking anti-nucleocapsid IgG after the first infection, being infected during the Delta and Omicron wave, and being unvaccinated were associated with a higher risk of reinfection. Conflicting age-related findings were found in two studies. Reinfection with SARS-CoV-2 suggests that natural immunity is not long-lasting in COVID-19 patients.
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Affiliation(s)
- Nhu Ngoc Nguyen
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | | | - Van Thuan Hoang
- Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
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Liu H, Aviszus K, Zelarney P, Liao SY, Gerber AN, Make B, Wechsler ME, Marrack P, Reinhardt RL. Vaccine-elicited B and T cell immunity to SARS-CoV-2 is impaired in chronic lung disease patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.25.23284971. [PMID: 36747750 PMCID: PMC9901055 DOI: 10.1101/2023.01.25.23284971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The protection afforded by vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to individuals with chronic lung disease is not well established. To understand how chronic lung disease impacts SARS-CoV-2 vaccine-elicited immunity we performed deep immunophenotyping of the humoral and cell mediated SARS-CoV-2 vaccine response in an investigative cohort of vaccinated patients with diverse pulmonary conditions including asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD). Compared to healthy controls, 48% of vaccinated patients with chronic lung diseases had reduced antibody titers to the SARS-CoV-2 vaccine antigen as early as 3-4 months after vaccination, correlating with decreased vaccine-specific memory B cells. Vaccine-specific CD4 and CD8 T cells were also significantly reduced in patients with asthma, COPD, and a subset of ILD patients compared to healthy controls. These findings reveal the complex nature of vaccine-elicited immunity in high-risk patients with chronic lung disease.
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Affiliation(s)
- Haolin Liu
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, 80206, USA
| | - Katja Aviszus
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, 80206, USA
| | - Pearlanne Zelarney
- Research Informatics Services, National Jewish Health, Denver, CO, 80206, USA
| | - Shu-Yi Liao
- Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver CO, 80206, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Anthony N Gerber
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, 80206, USA
- Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver CO, 80206, USA
| | - Barry Make
- Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver CO, 80206, USA
| | - Michael E Wechsler
- Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver CO, 80206, USA
| | - Philippa Marrack
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, 80206, USA
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - R Lee Reinhardt
- Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, 80206, USA
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
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Deng L, Li P, Zhang X, Jiang Q, Turner D, Zhou C, Gao Y, Qian F, Zhang C, Lu H, Zou H, Vermund SH, Qian HZ. Risk of SARS-CoV-2 reinfection: a systematic review and meta-analysis. Sci Rep 2022; 12:20763. [PMID: 36456577 PMCID: PMC9714387 DOI: 10.1038/s41598-022-24220-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/11/2022] [Indexed: 12/02/2022] Open
Abstract
This meta-analysis aims to synthesize global evidence on the risk of reinfection among people previously infected with SARS-CoV-2. We systematically searched PubMed, Scopus, Embase and Web of Science as of April 5, 2021. We conducted: (1) meta-analysis of cohort studies containing data sufficient for calculating the incidence rate of SARS-CoV-2 reinfection; (2) systematic review of case reports with confirmed SARS-CoV-2 reinfection cases. The reinfection incidence was pooled by zero-inflated beta distribution. The hazard ratio (HR) between reinfection incidence among previously infected individuals and new infection incidence among infection-naïve individuals was calculated using random-effects models. Of 906 records retrieved and reviewed, 11 studies and 11 case reports were included in the meta-analysis and the systematic review, respectively. The pooled SARS-CoV-2 reinfection incidence rate was 0.70 (standard deviation [SD] 0.33) per 10,000 person-days. The incidence of reinfection was lower than the incidence of new infection (HR = 0.12, 95% confidence interval 0.09-0.17). Our meta-analysis of studies conducted prior to the emergency of the more transmissible Omicron variant showed that people with a prior SARS-CoV-2 infection could be re-infected, and they have a lower risk of infection than those without prior infection. Continuing reviews are needed as the reinfection risk may change due to the rapid evolution of SARS-CoV-2 variants.
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Affiliation(s)
- Luojia Deng
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Peiqi Li
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuezhixing Zhang
- Yale School of Public Health, Yale University, 300 George Street, New Haven, CT, USA
| | - Qianxue Jiang
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | | | - Chao Zhou
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Frank Qian
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ci Zhang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hui Lu
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, 300 George Street, New Haven, CT, USA
| | - Han-Zhu Qian
- Yale School of Public Health, Yale University, 300 George Street, New Haven, CT, USA.
- GSK plc, Rockville, MD, USA.
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Lee JS, Yun KW, Jeong H, Kim B, Kim MJ, Park JH, Shin HS, Oh HS, Sung H, Song MG, Cho SI, Kim SY, Kang CK, Choe PG, Park WB, Kim NJ, Oh MD, Choi EH, Park S, Kim TS, Lee JH, Sung H, Park SS, Seong MW. SARS-CoV-2 shedding dynamics and transmission in immunosuppressed patients. Virulence 2022; 13:1242-1251. [PMID: 35891618 PMCID: PMC9336477 DOI: 10.1080/21505594.2022.2101198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern have been emerging. However, knowledge of temporal and spatial dynamics of SARS-CoV-2 is limited. This study characterized SARS-CoV-2 evolution in immunosuppressed patients with long-term SARS-CoV-2 shedding for 73–250 days, without specific treatment. We conducted whole-genome sequencing of 27 serial samples, including 26 serial samples collected from various anatomic sites of two patients and the first positive sample from patient 2‘s mother. We analysed the intrahost temporal dynamics and genomic diversity of the viral population within different sample types. Intrahost variants emerging during infection showed diversity between individual hosts. Remarkably, N501Y, P681R, and E484K, key substitutions within spike protein, emerged in vivo during infection and became the dominant population. P681R, which had not yet been detected in the publicly available genome in Korea, appeared within patient 1 during infection. Mutually exclusive substitutions at residues R346 (R346S and R346I) and E484 (E484K and E484A) of spike protein and continuous turnover of these substitutions occurred. Unique genetic changes were observed in urine samples. A household transmission from patient 2 to his mother, at least 38 days after the diagnosis, was characterized. Viruses may differently mutate and adjust to the host selective pressure, which could enable the virus to replicate efficiently for fitness in each host. Intrahost variants could be candidate variants likely to spread to the population eventually. Our findings may provide new insights into the dynamics of SARS-CoV-2 in response to interactions between the virus and host.
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Affiliation(s)
- Jee-Soo Lee
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeonju Jeong
- Department of Internal Medicine, Gyeonggi Provincial Medical Center, Ansung Hospital, Anseong Gyeonggi-do, Republic of Korea
| | - Boram Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Man Jin Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Hyeon Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Seob Shin
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Sae Oh
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hobin Sung
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myung Gi Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Im Cho
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Republic of Korea
| | - Chang Kyung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Pyoeng Gyun Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myoung-Don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seungman Park
- Department of Laboratory Medicine, Seegene Medical Foundation, Seoul, Republic of Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-Hee Lee
- Department of Haematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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6
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Guevara R, Prado-Vivar B, Márquez S, Muñoz EB, Carvajal M, Guadalupe JJ, Becerra-Wong M, Proaño S, Bayas-Rea R, Coloma J, Grunauer M, Trueba G, Rojas-Silva P, Barragán V, Cárdenas P. Occurrence of SARS-CoV-2 reinfections at regular intervals in Ecuador. Front Cell Infect Microbiol 2022; 12:951383. [PMID: 36164552 PMCID: PMC9507970 DOI: 10.3389/fcimb.2022.951383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
SARS-CoV-2 reinfection is defined as a new infection with a different virus variant in an individual who has already recovered from a previous episode of COVID-19. The first case of reinfection in the world was described in August 2020, since then, reinfections have increased over time and their incidence has fluctuated with specific SARS-CoV-2 variant waves. Initially, reinfections were estimated to represent less than 1% of total COVID-19 infections. With the advent of the Omicron variant, reinfections became more frequent, representing up to 10% of cases (based on data from developed countries). The frequency of reinfections in Latin America has been scarcely reported. The current study shows that in Ecuador, the frequency of reinfections has increased 10-fold following the introduction of Omicron, after 22 months of surveillance in a single center of COVID-19 diagnostics. Suspected reinfections were identified retrospectively from a database of RT-qPCR-positive patients. Cases were confirmed by sequencing viral genomes from the first and second infections using the ONT MinION platform. Monthly surveillance showed that the main incidence peaks of reinfections were reached within four to five months, coinciding with the increase of COVID-19 cases in the country, suggesting that the emergence of reinfections is related to higher exposure to the virus during outbreaks. This study performed the longest monitoring of SARS-CoV-2 reinfections, showing an occurrence at regular intervals of 4-5 months and confirming a greater propensity of Omicron to cause reinfections.
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Affiliation(s)
- Rommel Guevara
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Belén Prado-Vivar
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Sully Márquez
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Erika B. Muñoz
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Mateo Carvajal
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Juan José Guadalupe
- Laboratorio de Biotecnología Vegetal, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Mónica Becerra-Wong
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Stefanie Proaño
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Rosa Bayas-Rea
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, CA, United States
| | - Michelle Grunauer
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Patricio Rojas-Silva
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Verónica Barragán
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Paúl Cárdenas
- Instituto de Microbiología, Universidad San Francisco de Quito USFQ, Quito, Ecuador
- *Correspondence: Paúl Cárdenas,
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A comparison between SARS-CoV-1 and SARS-CoV2: an update on current COVID-19 vaccines. Daru 2022; 30:379-406. [PMID: 36050585 PMCID: PMC9436716 DOI: 10.1007/s40199-022-00446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
Since the outbreak of the novel coronavirus disease 2019 (COVID-19) in Wuhan, China, many health care systems have been heavily engaged in treating and preventing the disease, and the year 2020 may be called as “historic COVID-19 vaccine breakthrough”. Due to the COVID-19 pandemic, many companies have initiated investigations on developing an efficient and safe vaccine against the virus. From Moderna and Pfizer in the United States to PastocoVac in Pasteur Institute of Iran and the University of Oxford in the United Kingdom, different candidates have been introduced to the market. COVID-19 vaccine research has been facilitated based on genome and structural information, bioinformatics predictions, epitope mapping, and data obtained from the previous developments of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) vaccine candidates. SARS-CoV genome sequence is highly homologous to the one in COVID-19 and both viruses use the same receptor, angiotensin-converting enzyme 2 (ACE2). Moreover, the immune system responds to these viruses, partially in the same way. Considering the on-going COVID-19 pandemic and previous attempts to manufacture SARS-CoV vaccines, this paper is going to discuss clinical cases as well as vaccine challenges, including those related to infrastructures, transportation, possible adverse reactions, utilized delivery systems (e.g., nanotechnology and electroporation) and probable vaccine-induced mutations.
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An Outbreak of SARS-CoV-2 Reinfection in a Long-Term Care Facility in South Korea. J Infect Public Health 2022; 15:966-969. [PMID: 35932619 PMCID: PMC9329134 DOI: 10.1016/j.jiph.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/03/2022] [Accepted: 07/23/2022] [Indexed: 11/20/2022] Open
Abstract
We report a cluster of 12 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection in a long-term care facility in South Korea. There were two outbreaks of SARS-CoV-2 infection in the facility at the beginning and end of October 2021, respectively. All residents in the facility were screened for SARS-CoV-2 infection using RT-PCR as part of the investigation of the second outbreak. Twelve residents, who had infection confirmed during the first outbreak, were found to be re-positive for RT-PCR test at the second outbreak. 8 Of 12 RT-PCR re-positive cases were confirmed as reinfections based on investigation through the whole genome sequencing, viral culture, and serological analysis, despite of the short interval between the first and second outbreaks (29–33 days) and a history of full vaccination for 7 of the 12 re-positive cases. This study suggests that decreased immunity and underlying health condition in older adults makes them susceptible to reinfection, highlighting the importance of prevention and control measures regardless of vaccination status in long-term care settings.
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Affiliation(s)
- Claire Johnston
- Infectious Diseases, Public Health Wales, Cardiff, UK
- Department of Microbiology, Morriston Hospital, Swansea, UK
| | | | - Sion Lingard
- Health Protection Team, Public Health Wales, Swansea
| | - Stephen Hailey
- Medical Directorate - General Practice & Revalidation, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff, UK
| | - Brendan Healy
- Cardiff and Vale University Health Board, Public Health Wales, Cardiff
- Department of Microbiology, Morriston Hospital, Swansea, UK
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Toro-Huamanchumo C, Hilario-Gomez M, Pinedo-Castillo L, Zumarán-Nuñez C, Espinoza-Gonzales F, Caballero-Alvarado J, Rodriguez-Morales A, Barboza J. Clinical and epidemiological features of patients with COVID-19 reinfection: a systematic review. New Microbes New Infect 2022; 48:101021. [PMID: 36060548 PMCID: PMC9420201 DOI: 10.1016/j.nmni.2022.101021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/29/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022] Open
Abstract
Recurrent positivity in a patient with COVID-19 may be due to various reasons, not necessarily reinfection. There is concern about the occurrence frequency of reinfection. Five databases and a preprint/preprint repository were searched. All case reports, case series, and observational studies were included. Bias was assessed for each study with the Newcastle-Ottawa Scale tool and reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA-2020). After eligibility, 77 studies were included for qualitative synthesis (52 case reports, 21 case series, and four case-controls; 1131 patients included). Of these, 16 studies described a second contact with the SARS-CoV-2 positive case, five studies described healthcare profession-related infection, ten studies described that the source of reinfection was likely to be from the community, one study described travel-related infection, nine studies described vulnerability-related infection due to comorbidity. The mean number of days from discharge or negative test to reinfection ranged from 23.3 to 57.6 days across the different included studies. The risk of bias for all case report/series studies was moderate/high. For observational studies, the risk of bias was low. Reinfection of patients with COVID-19 occurs between the first and second month after the first infection, but beyond, and 90 days have been proposed as a point to begin to consider it. The main factor for reinfection is contact with COVID-19 positive cases.
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Affiliation(s)
| | - M.M. Hilario-Gomez
- Sociedad científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - L. Pinedo-Castillo
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - C.J. Zumarán-Nuñez
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - F. Espinoza-Gonzales
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - J. Caballero-Alvarado
- Escuela de Medicina, Universidad Privada Antenor Orrego, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - A.J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
- Universidad Cientifica del Sur, Lima, Peru
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11
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Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis. Lancet 2022; 399:2351-2380. [PMID: 35405084 PMCID: PMC8993157 DOI: 10.1016/s0140-6736(22)00484-6] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Timely, accurate, and comprehensive estimates of SARS-CoV-2 daily infection rates, cumulative infections, the proportion of the population that has been infected at least once, and the effective reproductive number (Reffective) are essential for understanding the determinants of past infection, current transmission patterns, and a population's susceptibility to future infection with the same variant. Although several studies have estimated cumulative SARS-CoV-2 infections in select locations at specific points in time, all of these analyses have relied on biased data inputs that were not adequately corrected for. In this study, we aimed to provide a novel approach to estimating past SARS-CoV-2 daily infections, cumulative infections, and the proportion of the population infected, for 190 countries and territories from the start of the pandemic to Nov 14, 2021. This approach combines data from reported cases, reported deaths, excess deaths attributable to COVID-19, hospitalisations, and seroprevalence surveys to produce more robust estimates that minimise constituent biases. METHODS We produced a comprehensive set of global and location-specific estimates of daily and cumulative SARS-CoV-2 infections through Nov 14, 2021, using data largely from Johns Hopkins University (Baltimore, MD, USA) and national databases for reported cases, hospital admissions, and reported deaths, as well as seroprevalence surveys identified through previous reviews, SeroTracker, and governmental organisations. We corrected these data for known biases such as lags in reporting, accounted for under-reporting of deaths by use of a statistical model of the proportion of excess mortality attributable to SARS-CoV-2, and adjusted seroprevalence surveys for waning antibody sensitivity, vaccinations, and reinfection from SARS-CoV-2 escape variants. We then created an empirical database of infection-detection ratios (IDRs), infection-hospitalisation ratios (IHRs), and infection-fatality ratios (IFRs). To estimate a complete time series for each location, we developed statistical models to predict the IDR, IHR, and IFR by location and day, testing a set of predictors justified through published systematic reviews. Next, we combined three series of estimates of daily infections (cases divided by IDR, hospitalisations divided by IHR, and deaths divided by IFR), into a more robust estimate of daily infections. We then used daily infections to estimate cumulative infections and the cumulative proportion of the population with one or more infections, and we then calculated posterior estimates of cumulative IDR, IHR, and IFR using cumulative infections and the corrected data on reported cases, hospitalisations, and deaths. Finally, we converted daily infections into a historical time series of Reffective by location and day based on assumptions of duration from infection to infectiousness and time an individual spent being infectious. For each of these quantities, we estimated a distribution based on an ensemble framework that captured uncertainty in data sources, model design, and parameter assumptions. FINDINGS Global daily SARS-CoV-2 infections fluctuated between 3 million and 17 million new infections per day between April, 2020, and October, 2021, peaking in mid-April, 2021, primarily as a result of surges in India. Between the start of the pandemic and Nov 14, 2021, there were an estimated 3·80 billion (95% uncertainty interval 3·44-4·08) total SARS-CoV-2 infections and reinfections combined, and an estimated 3·39 billion (3·08-3·63) individuals, or 43·9% (39·9-46·9) of the global population, had been infected one or more times. 1·34 billion (1·20-1·49) of these infections occurred in south Asia, the highest among the seven super-regions, although the sub-Saharan Africa super-region had the highest infection rate (79·3 per 100 population [69·0-86·4]). The high-income super-region had the fewest infections (239 million [226-252]), and southeast Asia, east Asia, and Oceania had the lowest infection rate (13·0 per 100 population [8·4-17·7]). The cumulative proportion of the population ever infected varied greatly between countries and territories, with rates higher than 70% in 40 countries and lower than 20% in 39 countries. There was no discernible relationship between Reffective and total immunity, and even at total immunity levels of 80%, we observed no indication of an abrupt drop in Reffective, indicating that there is not a clear herd immunity threshold observed in the data. INTERPRETATION COVID-19 has already had a staggering impact on the world up to the beginning of the omicron (B.1.1.529) wave, with over 40% of the global population infected at least once by Nov 14, 2021. The vast differences in cumulative proportion of the population infected across locations could help policy makers identify the transmission-prevention strategies that have been most effective, as well as the populations at greatest risk for future infection. This information might also be useful for targeted transmission-prevention interventions, including vaccine prioritisation. Our statistical approach to estimating SARS-CoV-2 infection allows estimates to be updated and disseminated rapidly on the basis of newly available data, which has and will be crucially important for timely COVID-19 research, science, and policy responses. FUNDING Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.
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12
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Stefanelli P, Rezza G. COVID-19 Vaccination Strategies and Their Adaptation to the Emergence of SARS-CoV-2 Variants. Vaccines (Basel) 2022; 10:905. [PMID: 35746513 PMCID: PMC9229267 DOI: 10.3390/vaccines10060905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/09/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023] Open
Abstract
About one year after the identification of the first cases of pneumonia due to a novel coronavirus in Wuhan, several vaccines against SARS-CoV-2/COVID-19 started to be approved for emergency use or authorized for early or limited use. The rapid development of effective vaccines based on different technological platforms represents an unprecedented success for vaccinology, providing a unique opportunity for a successful public health intervention. However, it is widely known that only a limited number of vaccine doses are usually available at the beginning of vaccination campaigns against an emerging virus; in this phase, protecting health care workers and reducing mortality rates is the priority. When a larger number of vaccines become available, the identification of the drivers of virus circulation coupled with the use of transmission blocking vaccines are key to achieve epidemic control through population immunity. However, as we learned during the vaccination campaigns against the pandemic coronavirus, several factors may hamper this process. Thus, flexible plans are required to obtain the best sustainable result with available tools, modulating vaccination strategies in accordance with improved scientific knowledge, and taking into account the duration of protective immune response, virus evolution, and changing epidemic dynamics.
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Affiliation(s)
- Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Giovanni Rezza
- Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy;
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13
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Borras-Bermejo B, Piñana M, Andrés C, Zules R, González-Sánchez A, Esperalba J, Parés-Badell O, García-Cehic D, Rando A, Campos C, Codina MG, Martín MC, Castillo C, García-Comuñas K, Vásquez-Mercado R, Martins-Martins R, Colomer-Castell S, Pumarola T, Campins M, Quer J, Antón A. Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain. Front Microbiol 2022; 13:876409. [PMID: 35722299 PMCID: PMC9201979 DOI: 10.3389/fmicb.2022.876409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/20/2022] [Indexed: 12/26/2022] Open
Abstract
Background Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the main concern is whether reinfections are possible, and which are the associated risk factors. This study aims to describe the clinical and molecular characteristics of 24 sequence-confirmed reinfection SARS-CoV-2 cases over 1 year in Barcelona (Catalonia, Spain). Methods Patients with > 45 days between two positive PCR tests regardless of symptoms and negative tests between episodes were initially considered as suspected reinfection cases from November 2020 to May 2021. Whole-genome sequencing (WGS) was performed to confirm genetic differences between consensus sequences and for phylogenetic studies based on PANGOLIN nomenclature. Reinfections were confirmed by the number of mutations, change in lineage, or epidemiological criteria. Results From 39 reported suspected reinfection cases, complete viral genomes could be sequenced from both episodes of 24 patients, all were confirmed as true reinfections. With a median age of 44 years (interquartile range [IQR] 32–65), 66% were women and 58% were healthcare workers (HCWs). The median days between episodes were 122 (IQR 72–199), occurring one-third within 3 months. Reinfection episodes were frequently asymptomatic and less severe than primary infections. The absence of seroconversion was associated with symptomatic reinfections. Only one case was reinfected with a variant of concern (VOC). Conclusion Severe acute respiratory syndrome coronavirus 2 reinfections can occur in a shorter time than previously reported and are mainly found in immunocompetent patients. Surveillance through WGS is useful to identify viral mutations associated with immune evasion.
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Affiliation(s)
- Blanca Borras-Bermejo
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Piñana
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ricardo Zules
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejandra González-Sánchez
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Juliana Esperalba
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Oleguer Parés-Badell
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Damir García-Cehic
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ariadna Rando
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Campos
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Maria Gema Codina
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Carmen Martín
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Carla Castillo
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Karen García-Comuñas
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Rodrigo Vásquez-Mercado
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Reginald Martins-Martins
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
| | - Sergi Colomer-Castell
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Tomàs Pumarola
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Magda Campins
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Quer
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d’Hebron Institut de Recerca, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Josep Quer,
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Andrés Antón,
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Kaplonek P, Cizmeci D, Fischinger S, Collier AR, Suscovich T, Linde C, Broge T, Mann C, Amanat F, Dayal D, Rhee J, de St. Aubin M, Nilles EJ, Musk ER, Menon AS, Saphire EO, Krammer F, Lauffenburger DA, Barouch DH, Alter G. mRNA-1273 and BNT162b2 COVID-19 vaccines elicit antibodies with differences in Fc-mediated effector functions. Sci Transl Med 2022; 14:eabm2311. [PMID: 35348368 PMCID: PMC8995030 DOI: 10.1126/scitranslmed.abm2311] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/17/2022] [Indexed: 01/02/2023]
Abstract
The successful development of several coronavirus disease 2019 (COVID-19) vaccines has substantially reduced morbidity and mortality in regions of the world where the vaccines have been deployed. However, in the wake of the emergence of viral variants that are able to evade vaccine-induced neutralizing antibodies, real-world vaccine efficacy has begun to show differences across the two approved mRNA platforms, BNT162b2 and mRNA-1273; these findings suggest that subtle variation in immune responses induced by the BNT162b2 and mRNA-1273 vaccines may confer differential protection. Given our emerging appreciation for the importance of additional antibody functions beyond neutralization, we profiled the postboost binding and functional capacity of humoral immune responses induced by the BNT162b2 and mRNA-1273 vaccines in a cohort of hospital staff. Both vaccines induced robust humoral immune responses to wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to variants of concern. However, differences emerged across epitope-specific responses, with higher concentrations of receptor binding domain (RBD)- and N-terminal domain-specific IgA observed in recipients of mRNA-1273. Antibodies eliciting neutrophil phagocytosis and natural killer cell activation were also increased in mRNA-1273 vaccine recipients as compared to BNT162b2 recipients. RBD-specific antibody depletion highlighted the different roles of non-RBD-specific antibody effector functions induced across the mRNA vaccines. These data provide insights into potential differences in protective immunity conferred by these vaccines.
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Affiliation(s)
- Paulina Kaplonek
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Deniz Cizmeci
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | | | - Ai-ris Collier
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | | | | | - Colin Mann
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Diana Dayal
- Space Exploration Technologies Corp, Hawthorne, CA 90250, USA
| | - Justin Rhee
- Space Exploration Technologies Corp, Hawthorne, CA 90250, USA
| | | | | | - Elon R. Musk
- Space Exploration Technologies Corp, Hawthorne, CA 90250, USA
| | - Anil S. Menon
- Space Exploration Technologies Corp, Hawthorne, CA 90250, USA
| | - Erica Ollmann Saphire
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Douglas A. Lauffenburger
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Dan H. Barouch
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
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15
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Matsunaga A, Tsuzuki S, Morioka S, Ohmagari N, Ishizaka Y. Long COVID: current status in Japan and knowledge about its molecular background. Glob Health Med 2022; 4:83-93. [PMID: 35586759 PMCID: PMC9066464 DOI: 10.35772/ghm.2022.01013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
Even after recovering from coronavirus disease 2019 (COVID-19), patients can experience prolonged complaints, referred to as "long COVID". Similar to reports in Caucasians, a follow-up study in Japan revealed that fatigue, dyspnea, cough, anosmia/dysgeusia, and dyssomnia are common symptoms. Although the precise mode of long COVID remains elusive, multiple etiologies such as direct organ damage by infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), autoimmunity, prolonged inflammatory reactions, and psychiatric impairment seem to be involved. Notably, SARS-CoV-2 is neurotropic, and viral RNA and proteins are continuously detectable in multiple organs, including the brain. Viral proteins exert a number of different toxic effects on cells, suggesting that persistent infection is a key element for understanding long COVID. Here, we first reviewed the current status of long COVID in Japan, and then summarized literature that help us understand the molecular background of the symptoms. Finally, we discuss the feasibility of vaccination as a treatment for patients with long COVID.
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Affiliation(s)
- Akihiro Matsunaga
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan
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16
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Ren X, Zhou J, Guo J, Hao C, Zheng M, Zhang R, Huang Q, Yao X, Li R, Jin Y. Reinfection in patients with COVID-19: a systematic review. Glob Health Res Policy 2022; 7:12. [PMID: 35488305 PMCID: PMC9051013 DOI: 10.1186/s41256-022-00245-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND With the continuation of the COVID-19 pandemic, some COVID-19 patients have become reinfected with the virus. Viral gene sequencing has found that some of these patients were reinfected by the different and others by same strains. This has raised concerns about the effectiveness of immunity after infection and the reliability of vaccines. To this end, we conducted a systematic review to assess the characteristics of patients with reinfection and possible causes. METHODS A systematic search was conducted across eight databases: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and SinoMed from December 1, 2019 to September 1, 2021. The quality of included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. RESULTS This study included 50 studies from 20 countries. There were 118 cases of reinfection. Twenty-five patients were reported to have at least one complication. The shortest duration between the first infection and reinfection was 19 days and the longest was 293 days. During the first infection and reinfection, cough (51.6% and 43.9%) and fever (50% and 30.3%) were the most common symptoms respectively. Nine patients recovered, seven patients died, and five patients were hospitalized, but 97 patients' prognosis were unknown. B.1 is the most common variant strain at the first infection. B.1.1.7, B.1.128 and B.1.351 were the most common variant strains at reinfection. Thirty-three patients were infected by different strains and 9 patients were reported as being infected with the same strain. CONCLUSIONS Our research shows that it is possible for rehabilitated patients to be reinfected by SARS-COV-2. To date, the causes and risk factors of COVID-19 reinfection are not fully understood. For patients with reinfection, the diagnosis and management should be consistent with the treatment of the first infection. The public, including rehabilitated patients, should be fully vaccinated, wear masks in public places, and pay attention to maintaining social distance to avoid reinfection with the virus.
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Affiliation(s)
- Xiangying Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Guo
- Department of Acupuncture Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunmei Hao
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Mengxue Zheng
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Rong Zhang
- Department of Neurotumor Disease Diagnosis and Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaomei Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Center for Clinical Practice Guideline Conduction and Evaluation, Children’s Hospital of Fudan University, Shanghai, China
| | - Ruiling Li
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
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Koupaei M, Mohamadi MH, Yashmi I, Shahabi AH, Shabani AH, Heidary M, Khoshnood S. Clinical manifestations, treatment options, and comorbidities in COVID-19 relapse patients: A systematic review. J Clin Lab Anal 2022; 36:e24402. [PMID: 35396748 PMCID: PMC9102618 DOI: 10.1002/jcla.24402] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 12/21/2022] Open
Abstract
Introduction Interest revolving around coronavirus disease 2019 (COVID‐19) reinfection is escalating rapidly. By definition, reinfection denotes severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), PCR redetection, and COVID‐19 recurrence within three months of the initial symptoms. The main aim of the current systematic review was to evaluate the features of COVID‐19 relapse patients. Materials and methods For this study, we used a string of terms developed by a skilled librarian and through a systematical search in PubMed, Web of Science, and Embase for eligible studies. Clinical surveys of any type were included from January 2019 to March 2021. Eligible studies consisted of two positive assessments separated by a negative result via RT‐PCR. Results Fifty‐four studies included 207 cases of COVID‐19 reinfection. Children were less likely to have COVID‐19 relapse. However, the most patients were in the age group of 20–40 years. Asthenia (66.6%), headache (66.6%), and cough (54.7%) were prevalent symptoms in the first SARS‐CoV‐2 infection. Asthenia (62.9%), myalgia (62.9%), and headache (61.1%) were most frequent in the second one. The most common treatment options used in first COVID‐19 infection were lopinavir/ritonavir (80%), oxygen support (69.2%), and oseltamivir (66.6). However, for the treatment of second infection, mostly antibiotics (100%), dexamethasone (100%), and remdesivir (80%) were used. In addition, obesity (32.5%), kidney failure (30.7%), and hypertension (30.1%) were the most common comorbidities. Unfortunately, approximately 4.5% of patients died. Conclusion We found the potency of COVID‐19 recurrence as an outstanding issue. This feature should be regarded in the COVID‐19 management. Furthermore, the first and second COVID‐19 are similar in clinical features. For clinically practical comparison of the symptoms severity between two epochs of infection, uniform data of both are required. We suggest that future studies undertake a homogenous approach to establish the clinical patterns of the reinfection phenomena.
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Affiliation(s)
- Maryam Koupaei
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Ilya Yashmi
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Amir Hossein Shahabi
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Amir Hosein Shabani
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohsen Heidary
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran.,Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Saeed Khoshnood
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
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18
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Fahrner JE, Lahmar I, Goubet AG, Haddad Y, Carrier A, Mazzenga M, Drubay D, Alves Costa Silva C, de Sousa E, Thelemaque C, Melenotte C, Dubuisson A, Geraud A, Ferrere G, Birebent R, Bigenwald C, Picard M, Cerbone L, Lérias JR, Laparra A, Bernard-Tessier A, Kloeckner B, Gazzano M, Danlos FX, Terrisse S, Pizzato E, Flament C, Ly P, Tartour E, Benhamouda N, Meziani L, Ahmed-Belkacem A, Miyara M, Gorochov G, Barlesi F, Trubert A, Ungar B, Estrada Y, Pradon C, Gallois E, Pommeret F, Colomba E, Lavaud P, Deloger M, Droin N, Deutsch E, Gachot B, Spano JP, Merad M, Scotté F, Marabelle A, Griscelli F, Blay JY, Soria JC, Merad M, André F, Villemonteix J, Chevalier MF, Caillat-Zucman S, Fenollar F, Guttman-Yassky E, Launay O, Kroemer G, La Scola B, Maeurer M, Derosa L, Zitvogel L. The Polarity and Specificity of Antiviral T Lymphocyte Responses Determine Susceptibility to SARS-CoV-2 Infection in Patients with Cancer and Healthy Individuals. Cancer Discov 2022; 12:958-983. [PMID: 35179201 PMCID: PMC9394394 DOI: 10.1158/2159-8290.cd-21-1441] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 01/07/2023]
Abstract
Vaccination against coronavirus disease 2019 (COVID-19) relies on the in-depth understanding of protective immune responses to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We characterized the polarity and specificity of memory T cells directed against SARS-CoV-2 viral lysates and peptides to determine correlates with spontaneous, virus-elicited, or vaccine-induced protection against COVID-19 in disease-free and cancer-bearing individuals. A disbalance between type 1 and 2 cytokine release was associated with high susceptibility to COVID-19. Individuals susceptible to infection exhibited a specific deficit in the T helper 1/T cytotoxic 1 (Th1/Tc1) peptide repertoire affecting the receptor binding domain of the spike protein (S1-RBD), a hotspot of viral mutations. Current vaccines triggered Th1/Tc1 responses in only a fraction of all subject categories, more effectively against the original sequence of S1-RBD than that from viral variants. We speculate that the next generation of vaccines should elicit Th1/Tc1 T-cell responses against the S1-RBD domain of emerging viral variants. SIGNIFICANCE This study prospectively analyzed virus-specific T-cell correlates of protection against COVID-19 in healthy and cancer-bearing individuals. A disbalance between Th1/Th2 recall responses conferred susceptibility to COVID-19 in both populations, coinciding with selective defects in Th1 recognition of the receptor binding domain of spike. See related commentary by McGary and Vardhana, p. 892. This article is highlighted in the In This Issue feature, p. 873.
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Affiliation(s)
- Jean-Eudes Fahrner
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France.,Transgene S.A., Illkirch-Graffenstaden, France
| | - Imran Lahmar
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Anne-Gaëlle Goubet
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Yacine Haddad
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Agathe Carrier
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Marine Mazzenga
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Damien Drubay
- Gustave Roussy, Villejuif, France.,Département de Biostatistique et d'Epidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Carolina Alves Costa Silva
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Lyon COVID Study Group
- Open Innovation & Partnerships (OIP), bioMérieux S.A., Marcy l'Etoile, France. R&D – Immunoassay, bioMérieux S.A., Marcy l'Etoile, France.,Joint Research Unit Hospices Civils de Lyon-bioMérieux, Civils Hospices of Lyon, Lyon Sud Hospital, Pierre-Bénite, France.,International Center of Research in Infectiology, Lyon University, INSERM U1111, CNRS UMR 5308, ENS, UCBL, Lyon, France.,Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
| | - Eric de Sousa
- ImmunoTherapy/ImmunoSurgery, Champalimaud Centre for the Unknown, Lisboa, Portugal
| | - Cassandra Thelemaque
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Cléa Melenotte
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France.,Aix-Marseille Université, Institut Hospitalo-Universitaire, Institut de Recherche pour le Développement, Assistance Publique – Hôpitaux de Marseille, Microbes Evolution Phylogeny and Infections, Marseille, France
| | - Agathe Dubuisson
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Arthur Geraud
- Gustave Roussy, Villejuif, France.,Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Gladys Ferrere
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Roxanne Birebent
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Camille Bigenwald
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Marion Picard
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Luigi Cerbone
- Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Joana R. Lérias
- ImmunoTherapy/ImmunoSurgery, Champalimaud Centre for the Unknown, Lisboa, Portugal
| | - Ariane Laparra
- Gustave Roussy, Villejuif, France.,Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Alice Bernard-Tessier
- Gustave Roussy, Villejuif, France.,Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Benoît Kloeckner
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Marianne Gazzano
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - François-Xavier Danlos
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Safae Terrisse
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Eugenie Pizzato
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Caroline Flament
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Pierre Ly
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Eric Tartour
- Center of clinical investigations BIOTHERIS, INSERM CIC1428, Gustave Roussy, Villejuif, France.,Department of Immunology, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Nadine Benhamouda
- Center of clinical investigations BIOTHERIS, INSERM CIC1428, Gustave Roussy, Villejuif, France.,Department of Immunology, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | | | | | - Makoto Miyara
- Univ Paris Est Créteil, INSERM U955, IMRB, Créteil, France
| | - Guy Gorochov
- Univ Paris Est Créteil, INSERM U955, IMRB, Créteil, France
| | - Fabrice Barlesi
- Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France.,Sorbonne Université/Institut National de la Santé et de la Recherche Médicale, U1135, Centre d'Immunologie et des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Alexandre Trubert
- Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France
| | - Benjamin Ungar
- Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - Yeriel Estrada
- Department of Dermatology, Center of Excellence in Eczema Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Caroline Pradon
- Gustave Roussy, Villejuif, France.,Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York.,Centre de Ressources Biologiques, ET-EXTRA, Gustave Roussy, Villejuif, France
| | - Emmanuelle Gallois
- Gustave Roussy, Villejuif, France.,Département de Biologie Médicale et Pathologie Médicales, Service de Biochimie, Gustave Roussy, Villejuif, France
| | - Fanny Pommeret
- Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Emeline Colomba
- Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Pernelle Lavaud
- Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Marc Deloger
- Département de Biologie Médicale et Pathologie Médicales, Service de Microbiologie, Gustave Roussy, Villejuif, France
| | - Nathalie Droin
- Gustave Roussy, Plateforme de Bioinformatique, Université Paris-Saclay, INSERM US23, CNRS UMS, Villejuif, France
| | - Eric Deutsch
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Gustave Roussy, Plateforme de génomique, Université Paris-Saclay, INSERM US23, CNRS UMS, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, U1030, Gustave Roussy, Villejuif, France
| | - Bertrand Gachot
- Gustave Roussy, Villejuif, France.,Département de Radiothérapie, Gustave Roussy, Villejuif, France
| | | | - Mansouria Merad
- Gustave Roussy, Villejuif, France.,Department of Medical Oncology, Pitié-Salpétrière Hospital, APHP, Sorbonne Université, Paris, France
| | - Florian Scotté
- Gustave Roussy, Villejuif, France.,Service de Médecine aigue d’Urgence en Cancérologie, Gustave Roussy, Villejuif, France
| | - Aurélien Marabelle
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France.,Département d'Innovation Thérapeutique et d'Essais Précoces (DITEP), Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France.,Département Interdisciplinaire d'Organisation des Parcours Patients, Gustave Roussy, Villejuif, France
| | - Frank Griscelli
- Gustave Roussy, Villejuif, France.,Département de Biologie Médicale et Pathologie Médicales, Service de Biochimie, Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale – UMR935/UA9, Université Paris-Saclay, Villejuif, France.,INGESTEM National IPSC Infrastructure, Université de Paris-Saclay, Villejuif, France.,Université de Paris, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Jean-Yves Blay
- Centre Léon Bérard, Lyon, France.,Université Claude Bernard, Lyon, France.,Unicancer, Paris, France
| | - Jean-Charles Soria
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France
| | - Miriam Merad
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Oncological Science, Icahn School of Medicine at Mount Sinai, New York, New York.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Fabrice André
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, U981, Gustave Roussy, Villejuif, France
| | - Juliette Villemonteix
- Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, APHP, Université de Paris, Paris, France
| | - Mathieu F. Chevalier
- INSERM UMR 976, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Sophie Caillat-Zucman
- Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint-Louis, APHP, Université de Paris, Paris, France.,INSERM UMR 976, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Florence Fenollar
- IHU Méditérranée Infection, VITROME, IRD, AP-HM, SSA, Aix-Marseille University, Marseille, France
| | - Emma Guttman-Yassky
- Department of Dermatology, Center of Excellence in Eczema Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Odile Launay
- Université de Paris, Inserm CIC 1417, I-Reivac, APHP, Hopital Cochin, Paris, France
| | - Guido Kroemer
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, Inserm U1138, Institut Universitaire de France, Paris, France.,Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris-Saclay, Villejuif, France.,Pôle de Biologie, Hôpital Européen George Pompidou, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Bernard La Scola
- Institut Hospitalo-Universitaire, Méditerranée Infection, Marseille, France
| | - Markus Maeurer
- ImmunoTherapy/ImmunoSurgery, Champalimaud Centre for the Unknown, Lisboa, Portugal.,Medizinische Klinik, Johannes Gutenberg University Mainz, Germany
| | - Lisa Derosa
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France.,Département d'Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Laurence Zitvogel
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicêtre, France.,Gustave Roussy, Villejuif, France.,Institut National de la Santé et de la Recherche Médicale, UMR1015, Gustave Roussy, Villejuif, France.,Center of clinical investigations BIOTHERIS, INSERM CIC1428, Gustave Roussy, Villejuif, France.,Corresponding Author: Laurence Zitvogel, University Paris-Saclay, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, Villejuif Cedex 94805, France. Phone: 331-4211-5041; E-mail:
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19
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de Castro MV, Santos KS, Apostolico JS, Fernandes ER, Almeida RR, Levin G, Magawa JY, Nunes JPS, Bruni M, Yamamoto MM, Lima AC, Silva MVR, Matos LRB, Coria VR, Castelli EC, Scliar MO, Kuramoto A, Bruno FR, Jacintho LC, Nunes K, Wang JYT, Coelho VP, Neto MM, Maciel RMB, Naslavsky MS, Passos-Bueno MR, Boscardin SB, Rosa DS, Kalil J, Zatz M, Cunha-Neto E. Recurrence of COVID-19 associated with reduced T-cell responses in a monozygotic twin pair. Open Biol 2022; 12:210240. [PMID: 35104433 PMCID: PMC8807054 DOI: 10.1098/rsob.210240] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Recurrence of COVID-19 in recovered patients has been increasingly reported. However, the immune mechanisms behind the recurrence have not been thoroughly investigated. The presence of neutralizing antibodies (nAbs) in recurrence/reinfection cases suggests that other types of immune response are involved in protection against recurrence. Here, we investigated the innate type I/III interferon (IFN) response, binding and nAb assays and T-cell responses to severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) with IFN gamma (IFNγ) enzyme-linked spot assay (ELISPOT) in three pairs of young adult monozygotic (MZ) twins with previous confirmed COVID-19, one of them presenting a severe recurrence four months after the initial infection. Twin studies have been of paramount importance to comprehend the immunogenetics of infectious diseases. Each MZ twin pair was previously exposed to SARS-CoV-2, as seen by clinical reports. The six individuals presented similar overall recovered immune responses except for the recurrence case, who presented a drastically reduced number of recognized SARS-CoV-2 T-cell epitopes on ELISPOT as compared to her twin sister and the other twin pairs. Our results suggest that the lack of a broad T-cell response to initial infection may have led to recurrence, emphasizing that an effective SARS-CoV-2-specific T-cell immune response is key for complete viral control and avoidance of clinical recurrence of COVID-19.
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Affiliation(s)
- Mateus V. de Castro
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Keity S. Santos
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Juliana S. Apostolico
- Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Department of Microbiology, Immunology and Parasitology, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Edgar R. Fernandes
- Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Department of Microbiology, Immunology and Parasitology, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Rafael R. Almeida
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil
| | - Gabriel Levin
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil
| | - Jhosiene Y. Magawa
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - João Paulo S. Nunes
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Mirian Bruni
- Department of Parasitology, Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcio M. Yamamoto
- Department of Parasitology, Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ariane C. Lima
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Monize V. R. Silva
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Larissa R. B. Matos
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vivian R. Coria
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Erick C. Castelli
- School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil
| | - Marilia O. Scliar
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andreia Kuramoto
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Fernanda R. Bruno
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Lucas C. Jacintho
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | - Kelly Nunes
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jaqueline Y. T. Wang
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Veronica P. Coelho
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil
| | | | | | - Michel S. Naslavsky
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Rita Passos-Bueno
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvia B. Boscardin
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Division of Clinical Immunology and Allergy, Department of Medicine, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo SP, Brazil,Department of Parasitology, Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Daniela S. Rosa
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Department of Microbiology, Immunology and Parasitology, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Jorge Kalil
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil,Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil,Institute for Investigation in Immunology—Instituto Nacional de Ciência e Tecnologia—iii-INCT, São Paulo, SP, Brazil
| | - Mayana Zatz
- Human Genome and Stem Cell Research Center (HUG-CELL), Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Edecio Cunha-Neto
- Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, (HCFMUSP), São Paulo, SP, Brazil
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20
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Ruiz-Galiana J, De Lucas Ramos P, García-Botella A, García-Lledó A, Gómez-Pavón J, González Del Castillo J, Hernández-Sampelayo T, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Cantón R, Bouza E. Persistence and viability of SARS-CoV-2 in primary infection and reinfections. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:1-6. [PMID: 34661382 PMCID: PMC8790642 DOI: 10.37201/req/129.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Since the beginning of the SARS-CoV-2 epidemic, virus isolation in the infected patient was only possible for a short period of time and it was striking that this occurred constantly and did not provide guidance on the clinical course. This fact led to confusion about the efficacy of some of the drugs initially used, which seemed to have a high efficiency in viral clearance and proved ineffective in modifying the course of the disease. The immune response also did not prove to be definitive in terms of evolution, although most of the patients with very mild disease had a weak or no antibody response, and the opposite was true for the most severe patients. With whatever the antibody response, few cases have been re-infected after a first infection and generally, those that have, have not reproduced a spectrum of disease similar to the first infection. Among those re-infected, a large number have been asymptomatic or with very few symptoms, others have had a moderate picture and very few have had a poor evolution. Despite this dynamic of rapid viral clearance, laboratory tests were still able to generate positive results in the recovery of genomic sequences and this occurred in patients who were already symptom-free, in others who were still ill and in those who were very seriously ill. There was also no good correlate. For this reason and with the perspective of this year and the half of pandemic, we compiled what the literature leaves us in these aspects and anticipating that, as always in biology, there are cases that jump the limits of the general behavior of the dynamics of infection in general.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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21
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Rodríguez-Grande C, Alcalá L, Estévez A, Sola-Campoy PJ, Buenestado-Serrano S, Martínez-Laperche C, Manuel de la Cueva V, Alonso R, Andrés-Zayas C, Adán-Jiménez J, Losada C, Rico-Luna C, Comas I, González-Candelas F, Catalán P, Muñoz P, Pérez-Lago L, García de Viedma D. Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain. Emerg Infect Dis 2022; 28:85-94. [PMID: 34843661 PMCID: PMC8714233 DOI: 10.3201/eid2801.211952] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Estimates of the burden of severe acute respiratory syndrome coronavirus 2 reinfections are limited by the scarcity of population-level studies incorporating genomic support. We conducted a systematic study of reinfections in Madrid, Spain, supported by genomic viral analysis and host genetic analysis, to cleanse laboratory errors and to discriminate between reinfections and recurrences involving the same strain. Among the 41,195 cases diagnosed (March 2020-March 2021), 93 (0.23%) had 2 positive reverse transcription PCR tests (55-346 days apart). After eliminating cases with specimens not stored, of suboptimal sequence quality, or belonging to different persons, we obtained valid data from 22 cases. Of those, 4 (0.01%) cases were recurrences involving the same strain; case-patients were 39-93 years of age, and 3 were immunosuppressed. Eighteen (0.04%) cases were reinfections; patients were 19-84 years of age, and most had no relevant clinical history. The second episode was more severe in 8 cases.
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22
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Abrokwa SK, Müller SA, Méndez-Brito A, Hanefeld J, El Bcheraoui C. Recurrent SARS-CoV-2 infections and their potential risk to public health - a systematic review. PLoS One 2021; 16:e0261221. [PMID: 34882750 PMCID: PMC8659325 DOI: 10.1371/journal.pone.0261221] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To inform quarantine and contact-tracing policies concerning re-positive cases-cases testing positive among those recovered. MATERIALS AND METHODS We systematically reviewed and appraised relevant literature from PubMed and Embase for the extent of re-positive cases and their epidemiological characteristics. RESULTS In 90 case reports/series, a total of 276 re-positive cases were found. Among confirmed reinfections, 50% occurred within 90 days from recovery. Four reports related onward transmission. In thirty-five observational studies, rate of re-positives ranged from zero to 50% with no onward transmissions reported. In eight reviews, pooled recurrence rate ranged from 12% to 17.7%. Probability of re-positive increased with several factors. CONCLUSION Recurrence of a positive SARS-CoV-2 test is commonly reported within the first weeks following recovery from a first infection.
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Affiliation(s)
- Seth Kofi Abrokwa
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Alba Méndez-Brito
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
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23
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Yinda CK, Port JR, Bushmaker T, Fischer RJ, Schulz JE, Holbrook MG, Shaia C, de Wit E, van Doremalen N, Munster VJ. Prior aerosol infection with lineage A SARS-CoV-2 variant protects hamsters from disease, but not reinfection with B.1.351 SARS-CoV-2 variant. Emerg Microbes Infect 2021; 10:1284-1292. [PMID: 34120579 PMCID: PMC8238069 DOI: 10.1080/22221751.2021.1943539] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 12/12/2022]
Abstract
The circulation of SARS-CoV-2 has resulted in the emergence of variants of concern (VOCs). It is currently unclear whether the previous infection with SARS-CoV-2 provides protection against reinfection with VOCs. Here, we show that low dose aerosol exposure to hCoV-19/human/USA/WA-CDC-WA1/2020 (WA1, lineage A), resulted in a productive mild infection. In contrast, a low dose of SARS-CoV-2 via fomites did not result in productive infection in the majority of exposed hamsters and these animals remained non-seroconverted. After recovery, hamsters were re-exposed to hCoV-19/South African/KRISP-K005325/2020 (VOC B.1.351) via an intranasal challenge. Seroconverted rechallenged animals did not lose weight and shed virus for three days. They had a little infectious virus and no pathology in the lungs. In contrast, shedding, weight loss and extensive pulmonary pathology caused by B.1.351 replication were observed in the non-seroconverted animals. The rechallenged seroconverted animals did not transmit the virus to naïve sentinels via direct contact transmission, in contrast to the non-seroconverted animals. Reinfection with B.1.351 triggered an anamnestic response that boosted not only neutralizing titres against lineage A, but also titres against B.1.351. Our results confirm that aerosol exposure is a more efficient infection route than fomite exposure. Furthermore, initial infection with SARS-CoV-2 lineage A does not prevent heterologous reinfection with B.1.351 but prevents disease and onward transmission. These data suggest that previous SARS-CoV-2 exposure induces partial protective immunity. The reinfection generated a broadly neutralizing humoral response capable of effectively neutralizing B.1.351 while maintaining its ability to neutralize the virus to which the initial response was directed against.
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Affiliation(s)
- Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Julia R. Port
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Trenton Bushmaker
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Robert J. Fischer
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jonathan E. Schulz
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Myndi G. Holbrook
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Carl Shaia
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Emmie de Wit
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Neeltje van Doremalen
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Vincent J. Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
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24
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Pérez Lago L, Pérez Latorre L, Herranz M, Tejerina F, Sola-Campoy PJ, Sicilia J, Suárez-González J, Andrés-Zayas C, Chiner-Oms A, Jiménez-Serrano S, García-González N, Comas I, González-Candelas F, Martínez-Laperche C, Catalán P, Muñoz P, García de Viedma D. Complete Analysis of the Epidemiological Scenario around a SARS-CoV-2 Reinfection: Previous Infection Events and Subsequent Transmission. mSphere 2021; 6:e0059621. [PMID: 34494886 PMCID: PMC8550076 DOI: 10.1128/msphere.00596-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/12/2021] [Indexed: 11/20/2022] Open
Abstract
The first descriptions of reinfection by SARS-CoV-2 have been recently reported. However, these studies focus exclusively on the reinfected case, without considering the epidemiological context of the event. Our objectives were to perform a complete analysis of the sequential infections and community transmission events around a SARS-CoV-2 reinfection, including the infection events preceding it, the exposure, and subsequent transmissions. Our analysis was supported by host genetics, viral whole-genome sequencing, phylogenomic viral population analysis, and refined epidemiological data obtained from interviews with the involved subjects. The reinfection involved a 53-year-old woman with asthma (Case A), with a first COVID-19 episode in April 2020 and a much more severe second episode 4-1/2 months later, with SARS-CoV-2 seroconversion in August, that required hospital admission. An extended genomic analysis allowed us to demonstrate that the strain involved in Case A's reinfection was circulating in the epidemiological context of Case A and was also transmitted subsequently from Case A to her family context. The reinfection was also supported by a phylogenetic analysis, including 348 strains from Madrid, which revealed that the strain involved in the reinfection was circulating by the time Case A suffered the second episode, August-September 2020, but absent at the time range corresponding to Case A's first episode. IMPORTANCE We present the first complete analysis of the epidemiological scenario around a reinfection by SARS-CoV-2, more severe than the first episode, including three cases preceding the reinfection, the reinfected case per se, and the subsequent transmission to another seven cases.
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Affiliation(s)
- Laura Pérez Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Leire Pérez Latorre
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marta Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Francisco Tejerina
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Pedro J. Sola-Campoy
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Jon Sicilia
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Cristina Andrés-Zayas
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | | | | | - Neris García-González
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia-CSIC, Valencia, Spain
- CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando González-Candelas
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain
- CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Servicio de Oncohematología, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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25
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Pérez Lago L, Pérez Latorre L, Herranz M, Tejerina F, Sola-Campoy PJ, Sicilia J, Suárez-González J, Andrés-Zayas C, Chiner-Oms A, Jiménez-Serrano S, García-González N, Comas I, González-Candelas F, Martínez-Laperche C, Catalán P, Muñoz P, García de Viedma D. Complete Analysis of the Epidemiological Scenario around a SARS-CoV-2 Reinfection: Previous Infection Events and Subsequent Transmission. mSphere 2021; 6:e0059621. [PMID: 34494886 DOI: 10.21203/rs.3.rs-106167/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
The first descriptions of reinfection by SARS-CoV-2 have been recently reported. However, these studies focus exclusively on the reinfected case, without considering the epidemiological context of the event. Our objectives were to perform a complete analysis of the sequential infections and community transmission events around a SARS-CoV-2 reinfection, including the infection events preceding it, the exposure, and subsequent transmissions. Our analysis was supported by host genetics, viral whole-genome sequencing, phylogenomic viral population analysis, and refined epidemiological data obtained from interviews with the involved subjects. The reinfection involved a 53-year-old woman with asthma (Case A), with a first COVID-19 episode in April 2020 and a much more severe second episode 4-1/2 months later, with SARS-CoV-2 seroconversion in August, that required hospital admission. An extended genomic analysis allowed us to demonstrate that the strain involved in Case A's reinfection was circulating in the epidemiological context of Case A and was also transmitted subsequently from Case A to her family context. The reinfection was also supported by a phylogenetic analysis, including 348 strains from Madrid, which revealed that the strain involved in the reinfection was circulating by the time Case A suffered the second episode, August-September 2020, but absent at the time range corresponding to Case A's first episode. IMPORTANCE We present the first complete analysis of the epidemiological scenario around a reinfection by SARS-CoV-2, more severe than the first episode, including three cases preceding the reinfection, the reinfected case per se, and the subsequent transmission to another seven cases.
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Affiliation(s)
- Laura Pérez Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Leire Pérez Latorre
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marta Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Francisco Tejerina
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Pedro J Sola-Campoy
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Jon Sicilia
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Cristina Andrés-Zayas
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | | | | | - Neris García-González
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia-CSIC, Valencia, Spain
- CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando González-Candelas
- Joint Research Unit Infection and Public Health FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain
- CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Servicio de Oncohematología, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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26
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Pérez-Lago L, Kestler M, Sola-Campoy PJ, Rodriguez-Grande C, Flores-García RF, Buenestado-Serrano S, Herranz M, Alcalá L, Martínez-Laperche C, Suárez-González J, Catalán P, Muñoz P, García de Viedma D. SARS-CoV-2 superinfection and reinfection with three different strains. Transbound Emerg Dis 2021; 69:3084-3089. [PMID: 34687493 PMCID: PMC8662055 DOI: 10.1111/tbed.14352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 11/27/2022]
Abstract
We report a corona virus disease (COVID‐19) case with unprecedented viral complexity. In the first severe episode, two different severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) strains (superinfection) were identified within a week. Three months after discharge, the patient was readmitted and was infected in a nosocomial outbreak with a different strain, suffering a second milder COVID‐19 episode.
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Affiliation(s)
- Laura Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Martha Kestler
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Pedro J Sola-Campoy
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Cristina Rodriguez-Grande
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Rubén Francisco Flores-García
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Dirección de Enfermería. Gerencia., Gregorio Marañón General University Hospital, Madrid, Spain
| | - Sergio Buenestado-Serrano
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marta Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Bunyola, Spain
| | - Luis Alcalá
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Bunyola, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Servicio de Hematología, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Bunyola, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Bunyola, Spain.,Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Bunyola, Spain
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- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain
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27
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Lo Muzio L, Ambosino M, Lo Muzio E, Quadri MFA. SARS-CoV-2 Reinfection Is a New Challenge for the Effectiveness of Global Vaccination Campaign: A Systematic Review of Cases Reported in Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11001. [PMID: 34682746 PMCID: PMC8535385 DOI: 10.3390/ijerph182011001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/03/2021] [Accepted: 10/09/2021] [Indexed: 12/28/2022]
Abstract
Reinfection with SARS-CoV-2 seems to be a rare phenomenon. The objective of this study is to carry out a systematic search of literature on the SARS-CoV-2 reinfection in order to understand the success of the global vaccine campaigns. A systematic search was performed. Inclusion criteria included a positive RT-PCR test of more than 90 days after the initial test and the confirmed recovery or a positive RT-PCR test of more than 45 days after the initial test that is accompanied by compatible symptoms or epidemiological exposure, naturally after the confirmed recovery. Only 117 articles were included in the final review with 260 confirmed cases. The severity of the reinfection episode was more severe in 92/260 (35.3%) with death only in 14 cases. The observation that many reinfection cases were less severe than initial cases is interesting because it may suggest partial protection from disease. Another interesting line of data is the detection of different clades or lineages by genome sequencing between initial infection and reinfection in 52/260 cases (20%). The findings are useful and contribute towards the role of vaccination in response to the COVID-19 infections. Due to the reinfection cases with SARS-CoV-2, it is evident that the level of immunity is not 100% for all individuals. These data highlight how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all people after healing from COVID-19 or becoming asymptomatic positive.
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Affiliation(s)
- Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 70122 Foggia, Italy;
- Consorzio Interuniversitario Nazionale per la Bio-Oncologia (C.I.N.B.O.), 66100 Chieti, Italy
| | - Mariateresa Ambosino
- Department of Clinical and Experimental Medicine, University of Foggia, 70122 Foggia, Italy;
| | - Eleonora Lo Muzio
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy;
| | - Mir Faeq Ali Quadri
- Department of Preventive Dental Sciences, Jazan University, Jazan 82511, Saudi Arabia;
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28
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Pérez-Lago L, Machado M, Herranz M, Sola-Campoy PJ, Suárez-González J, Martínez-Laperche C, Comas I, Alcalá L, Catalán P, Muñoz P, García de Viedma D. Host Genetic Analysis Should Be Mandatory for Proper Classification of COVID-19 Reinfections. Open Forum Infect Dis 2021; 8:ofab402. [PMID: 34552994 PMCID: PMC8436387 DOI: 10.1093/ofid/ofab402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/02/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Laura Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marina Machado
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marta Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Pedro J Sola-Campoy
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Julia Suárez-González
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Genomics Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Carolina Martínez-Laperche
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Substitute Servicio de Oncohematología by Servicio de Hematología, Madrid, Spain
| | - Iñaki Comas
- Instituto de Biomedicina de Valencia-CSIC, Valencia, Spain.,CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Luis Alcalá
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Gregorio Marañón General University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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29
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Kulkarni O, Narreddy S, Zaveri L, Kalal IG, Tallapaka KB, Sowpati DT. Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection Without Mutations in the Spike Protein. Clin Infect Dis 2021; 73:e1239-e1241. [PMID: 34492695 PMCID: PMC7929054 DOI: 10.1093/cid/ciab136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Onkar Kulkarni
- Council of Scientific and Industrial Research (CSIR) Centre for Cellular and Molecular Biology, Hyderabad, India
| | | | - Lamuk Zaveri
- Council of Scientific and Industrial Research (CSIR) Centre for Cellular and Molecular Biology, Hyderabad, India
| | | | - Karthik Bharadwaj Tallapaka
- Council of Scientific and Industrial Research (CSIR) Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Divya Tej Sowpati
- Council of Scientific and Industrial Research (CSIR) Centre for Cellular and Molecular Biology, Hyderabad, India
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30
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Kaplonek P, Cizmeci D, Fischinger S, Collier AR, Suscovich T, Linde C, Broge T, Mann C, Amanat F, Dayal D, Rhee J, de St. Aubin M, Nilles EJ, Musk ER, Menon AS, Saphire EO, Krammer F, Lauffenburger DA, Barouch DH, Alter G. Subtle immunological differences in mRNA-1273 and BNT162b2 COVID-19 vaccine induced Fc-functional profiles. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.08.31.458247. [PMID: 34494026 PMCID: PMC8423223 DOI: 10.1101/2021.08.31.458247] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The successful development of several COVID-19 vaccines has substantially reduced morbidity and mortality in regions of the world where the vaccines have been deployed. However, in the wake of the emergence of viral variants, able to evade vaccine induced neutralizing antibodies, real world vaccine efficacy has begun to show differences across the mRNA platforms, suggesting that subtle variation in immune responses induced by the BNT162b2 and mRNA1273 vaccines may provide differential protection. Given our emerging appreciation for the importance of additional antibody functions, beyond neutralization, here we profiled the postboost binding and functional capacity of the humoral response induced by the BNT162b2 and mRNA-1273 in a cohort of hospital staff. Both vaccines induced robust humoral immune responses to WT SARS-CoV-2 and VOCs. However, differences emerged across epitopespecific responses, with higher RBD- and NTD-specific IgA, as well as functional antibodies (ADNP and ADNK) in mRNA-1273 vaccine recipients. Additionally, RBD-specific antibody depletion highlighted the different roles of non-RBD-specific antibody effector function induced across the mRNA vaccines, providing novel insights into potential differences in protective immunity generated across these vaccines in the setting of newly emerging VOCs.
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Affiliation(s)
| | - Deniz Cizmeci
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | | | - Ai-ris Collier
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | | | | | - Colin Mann
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diana Dayal
- Space Exploration Technologies Corp, Hawthorne, CA, USA
| | - Justin Rhee
- Space Exploration Technologies Corp, Hawthorne, CA, USA
| | | | | | - Elon R. Musk
- Space Exploration Technologies Corp, Hawthorne, CA, USA
| | - Anil S. Menon
- Space Exploration Technologies Corp, Hawthorne, CA, USA
| | - Erica Ollmann Saphire
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla Institute for Immunology, La Jolla, CA, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Dan H. Barouch
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
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31
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Søraas A, Kalleberg KT, Dahl JA, Søraas CL, Myklebust TÅ, Axelsen E, Lind A, Bævre-Jensen R, Jørgensen SB, Istre MS, Kjetland EF, Ursin G. Persisting symptoms three to eight months after non-hospitalized COVID-19, a prospective cohort study. PLoS One 2021; 16:e0256142. [PMID: 34437579 PMCID: PMC8389372 DOI: 10.1371/journal.pone.0256142] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/30/2021] [Indexed: 11/18/2022] Open
Abstract
Long-COVID-19 is a proposed syndrome negatively affecting the health of COVID-19 patients. We present data on self-rated health three to eight months after laboratory confirmed COVID-19 disease compared to a control group of SARS-CoV-2 negative patients. We followed a cohort of 8786 non-hospitalized patients who were invited after SARS-CoV-2 testing between February 1 and April 15, 2020 (794 positive, 7229 negative). Participants answered online surveys at baseline and follow-up including questions on demographics, symptoms, risk factors for SARS-CoV-2, and self-rated health compared to one year ago. Determinants for a worsening of self-rated health as compared to one year ago among the SARS-CoV-2 positive group were analyzed using multivariate logistic regression and also compared to the population norm. The follow-up questionnaire was completed by 85% of the SARS-CoV-2 positive and 75% of the SARS-CoV-2 negative participants on average 132 days after the SARS-CoV-2 test. At follow-up, 36% of the SARS-CoV-2 positive participants rated their health “somewhat” or “much” worse than one year ago. In contrast, 18% of the SARS-CoV-2 negative participants reported a similar deterioration of health while the population norm is 12%. Sore throat and cough were more frequently reported by the control group at follow-up. Neither gender nor follow-up time was associated with the multivariate odds of worsening of self-reported health compared to one year ago. Age had an inverted-U formed association with a worsening of health while being fit and being a health professional were associated with lower multivariate odds. A significant proportion of non-hospitalized COVID-19 patients, regardless of age, have not returned to their usual health three to eight months after infection.
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Affiliation(s)
- Arne Søraas
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- * E-mail:
| | | | - John Arne Dahl
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Camilla Lund Søraas
- Department of Environmental and Occupational Medicine, Oslo University Hospital, Oslo, Norway
| | - Tor Åge Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Cancer Registry of Norway, Oslo, Norway
| | | | - Andreas Lind
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Roar Bævre-Jensen
- Department of Medical Microbiology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Silje Bakken Jørgensen
- Department of Clinical Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - Mette S. Istre
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Eyrun F. Kjetland
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Dept of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Dept. of Preventive Medicine, University of Southern California, Los Angeles, California, United States of America
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32
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The impact of spike N501Y mutation on neutralizing activity and RBD binding of SARS-CoV-2 convalescent serum. EBioMedicine 2021; 71:103544. [PMID: 34419925 PMCID: PMC8374549 DOI: 10.1016/j.ebiom.2021.103544] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 01/21/2023] Open
Abstract
Background Several SARS-CoV-2 lineages with spike receptor binding domain (RBD) N501Y mutation have spread globally. We evaluated the impact of N501Y on neutralizing activity of COVID-19 convalescent sera and on anti-RBD IgG assays. Methods The susceptibility to neutralization by COVID-19 patients’ convalescent sera from Hong Kong were compared between two SARS-CoV-2 isolates (B117-1/B117-2) from the α variant with N501Y and 4 non-N501Y isolates. The effect of N501Y on antibody binding was assessed. The performance of commercially-available IgG assays was determined for patients infected with N501Y variants. Findings The microneutralization antibody (MN) titers of convalescent sera from 9 recovered COVID-19 patients against B117-1 (geometric mean titer[GMT],80; 95% CI, 47–136) were similar to those against the non-N501Y viruses. However, MN titer of these serum against B117-2 (GMT, 20; 95% CI, 11–36) was statistically significantly reduced when compared with non-N501Y viruses (P < 0.01; one-way ANOVA). The difference between B117-1 and B117-2 was confirmed by testing 60 additional convalescent sera. B117-1 and B117-2 differ by only 3 amino acids (nsp2-S512Y, nsp13-K460R, spike-A1056V). Enzyme immunoassay using 272 convalescent sera showed reduced binding of anti-RBD IgG to N501Y or N501Y-E484K-K417N when compared with that of wild-type RBD (mean difference: 0.1116 and 0.5613, respectively; one-way ANOVA). Of 7 anti-N-IgG positive sera from patients infected with N501Y variants (collected 9-14 days post symptom onset), 6 (85.7%) tested negative for a commercially-available anti-S1-IgG assay. Interpretation We highlighted the importance of using a panel of viruses within the same lineage to determine the impact of virus variants on neutralization. Furthermore, clinicians should be aware of the potential reduced sensitivity of anti-RBD IgG assays.
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33
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Safety and humoral responses to BNT162b2 mRNA vaccination of SARS-CoV-2 previously infected and naive populations. Sci Rep 2021; 11:16543. [PMID: 34400714 PMCID: PMC8367980 DOI: 10.1038/s41598-021-96129-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/03/2021] [Indexed: 01/28/2023] Open
Abstract
Since COVID-19 risk of reinfection is of great concern, the safety and efficacy of the mRNA-based vaccines in previously infected populations should be assessed. We studied 78 individuals previously infected with SARS-CoV-19, who received a single dose of BNT162b2 mRNA COVID-19 vaccine, and 1:2 ratio matched infection-naïve cohort who received two injections. The evaluation procedure included symptom monitoring, and serological tests. Among the post-infected population, the median IgG-S response after the first vaccine dose was 3.35 AU, compared to 2.38 AU after the second vaccine injection in the infection naive group. A strong correlation was demonstrated between IgG-S level before vaccination, and the corresponding responses after a single vaccine dose (r = 0.8, p < 0.001) in the post infected population. Short-term severe symptoms that required medical attention were found in 6.8% among the post-infected individuals, while none were found in the infection naïve population. Our data suggest that a single vaccine dose is sufficient to induce an intense immune response in post-infected population regardless of seropositivity. Although some short-term safety issues were observed compared to the infection naïve population, a single dose regimen can be considered safe in post-infected populations.
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34
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Singh J, Pandit P, McArthur AG, Banerjee A, Mossman K. Evolutionary trajectory of SARS-CoV-2 and emerging variants. Virol J 2021; 18:166. [PMID: 34389034 PMCID: PMC8361246 DOI: 10.1186/s12985-021-01633-w] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
The emergence of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and more recently, the independent evolution of multiple SARS-CoV-2 variants has generated renewed interest in virus evolution and cross-species transmission. While all known human coronaviruses (HCoVs) are speculated to have originated in animals, very little is known about their evolutionary history and factors that enable some CoVs to co-exist with humans as low pathogenic and endemic infections (HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1), while others, such as SARS-CoV, MERS-CoV and SARS-CoV-2 have evolved to cause severe disease. In this review, we highlight the origins of all known HCoVs and map positively selected for mutations within HCoV proteins to discuss the evolutionary trajectory of SARS-CoV-2. Furthermore, we discuss emerging mutations within SARS-CoV-2 and variants of concern (VOC), along with highlighting the demonstrated or speculated impact of these mutations on virus transmission, pathogenicity, and neutralization by natural or vaccine-mediated immunity.
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Affiliation(s)
- Jalen Singh
- School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada
| | - Pranav Pandit
- EpiCenter for Disease Dynamics, One Health Institute, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Andrew G McArthur
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada
| | - Arinjay Banerjee
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, SK, Canada.
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
- Department of Biology, University of Waterloo, Waterloo, ON, Canada.
| | - Karen Mossman
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
- McMaster Immunology Research Centre, McMaster University, Hamilton, ON, Canada.
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35
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Albrecht L, Bishop E, Jay B, Lafoux B, Minoves M, Passaes C. COVID-19 Research: Lessons from Non-Human Primate Models. Vaccines (Basel) 2021; 9:886. [PMID: 34452011 PMCID: PMC8402317 DOI: 10.3390/vaccines9080886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). It emerged from China in December 2019 and rapidly spread across the globe, causing a pandemic with unprecedented impacts on public health and economy. Therefore, there is an urgent need for the development of curative treatments and vaccines. In humans, COVID-19 pathogenesis shows a wide range of symptoms, from asymptomatic to severe pneumonia. Identifying animal models of SARS-CoV-2 infection that reflect the clinical symptoms of COVID-19 is of critical importance. Nonhuman primates (NHPss) correspond to relevant models to assess vaccine and antiviral effectiveness. This review discusses the use of NHPs as models for COVID-19 research, with focus on the pathogenesis of SARS-CoV-2 infection, drug discovery and pre-clinical evaluation of vaccine candidates.
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Affiliation(s)
- Laure Albrecht
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Elodie Bishop
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Basile Jay
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Blaise Lafoux
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Marie Minoves
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
| | - Caroline Passaes
- Département de Sciences du vivant, Université de Paris, 75006 Paris, France
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36
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Massachi J, Donohue KC, Kelly JD. Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing. Am J Trop Med Hyg 2021; 105:884-889. [PMID: 34370705 PMCID: PMC8592142 DOI: 10.4269/ajtmh.21-0365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022] Open
Abstract
Evaluating cases of reinfection may offer some insight into areas for further investigation regarding durability of immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sixty cases of reinfection with viral sequencing were identified in PubMed, Embase, Web of Science, and medRxiv before May 1, 2021.Episodes of infection were separated by a median of 116 days. Severity of illness was greater among individuals reinfected within 90 days of initial infection, no asymptomatic initial cases developed severe reinfection, nearly half of cases had suspected escape variants, and nearly all individuals tested following reinfection were found to have detectable levels of anti-SARS-CoV-2 antibodies. This analysis is limited by the heterogeneous methods used among reports. Reinfection continues to be relatively rare. As the case rate presumably increases over time, this review will inform measurements to determine the natural history and causal determinants of reinfection in more rigorous observational cohort studies and other standardized surveillance approaches.
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Affiliation(s)
- Jonathan Massachi
- School of Medicine, University of California, San Francisco, California
| | | | - John Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Institute of Global Health Sciences, University of California, San Francisco, California
- F. I. Proctor Foundation, University of California, San Francisco, California
- San Francisco VA Medical Center, San Francisco, California
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37
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Patiño LH, Ballesteros N, Muñoz M, Castañeda S, Hernández C, Gomez S, Florez C, Rico A, Pardo L, Hernandez-Pereira CE, Delgado-Noguera L, Grillet ME, Hernandez MM, Khan Z, van de Guchte A, Dutta J, Gonzalez-Reiche AS, Simon V, van Bakel H, Sordillo EM, Ramírez JD, Paniz-Mondolfi AE. SARS-CoV-2 in Transit: Characterization of SARS-CoV-2 Genomes From Venezuelan Migrants in Colombia. Int J Infect Dis 2021; 110:410-416. [PMID: 34333122 PMCID: PMC10130730 DOI: 10.1016/j.ijid.2021.07.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/30/2021] [Accepted: 07/27/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate the genomic epidemiology of SARS-CoV-2 from Venezuelan migrants living in Colombia. METHODS This study sequenced SARS-CoV-2 from 30 clinical specimens collected from Venezuelan migrants. Genomes were compared with the Wuhan reference genome to identify polymorphisms, reconstruct phylogenetic relationships and perform comparative genomic analyses. Geographic, sociodemographic and clinical data were also studied across genotypes. RESULTS This study demonstrated the presence of six distinct SARS-CoV-2 lineages circulating among Venezuelan migrants, as well as a close relationship between SARS-CoV-2 genomic sequences obtained from individuals living in the Venezuelan-Colombian border regions of La Guajira (Colombia) and Zulia (Venezuela). Three clusters (C-1, C-2 and C-3) were well supported by phylogenomic inference, supporting the hypothesis of three potential transmission routes across the Colombian-Venezuelan border. These genomes included point mutations previously associated with increased infectivity. A mutation (L18F) in the N-terminal domain of the spike protein that has been associated with compromised binding of neutralizing antibodies was found in 2 of 30 (6.6%) genomes. A statistically significant association was identified with symptomatology for cluster C2. CONCLUSION The close phylogenetic relationships between SARS-CoV-2 genomes from Venezuelan migrants and from people living at the Venezuela-Colombian border support the importance of human movements for the spread of COVID-19 and for emerging virus variants.
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Affiliation(s)
- Luz H Patiño
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | | | | | | | - Carlos E Hernandez-Pereira
- Instituto de Investigaciones Biomédicas IDB/Emerging Pathogens Network-Incubadora Venezolana de la Ciencia, Cabudare, Venezuela
| | - Lourdes Delgado-Noguera
- Instituto de Investigaciones Biomédicas IDB/Emerging Pathogens Network-Incubadora Venezolana de la Ciencia, Cabudare, Venezuela
| | - Maria E Grillet
- Instituto de Zoología y Ecología Tropical, Universidad Central de Venezuela, Caracas, Venezuela
| | - Matthew M Hernandez
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zenab Khan
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana van de Guchte
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jayeeta Dutta
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ana S Gonzalez-Reiche
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viviana Simon
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Harm van Bakel
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emilia Mia Sordillo
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; St. Luke's-Roosevelt Institute for Health Sciences, Mount Sinai Health System, New York, NY, USA
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
| | - Alberto E Paniz-Mondolfi
- Instituto de Investigaciones Biomédicas IDB/Emerging Pathogens Network-Incubadora Venezolana de la Ciencia, Cabudare, Venezuela; Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Sanyang B, Kanteh A, Usuf E, Nadjm B, Jarju S, Bah A, Bojang A, Grey-Johnson M, Jones JC, Gai A, Sarr C, Sillah F, Wariri O, Oko F, Cerami C, Forrest K, Sey AP, Jallow H, Nwakanma D, Sesay AK, D'Alessandro U, Roca A. COVID-19 reinfections in The Gambia by phylogenetically distinct SARS-CoV-2 variants-first two confirmed events in west Africa. Lancet Glob Health 2021; 9:e905-e907. [PMID: 34090610 PMCID: PMC8175042 DOI: 10.1016/s2214-109x(21)00213-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Bakary Sanyang
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Abdoulie Kanteh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Effua Usuf
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Behzad Nadjm
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Sheikh Jarju
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Alasana Bah
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Abdoulie Bojang
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Mary Grey-Johnson
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Joquina Chiquita Jones
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Abdou Gai
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Catherine Sarr
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Fatoumata Sillah
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Oghenebrume Wariri
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Francis Oko
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Carla Cerami
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Karen Forrest
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | | | - Haruna Jallow
- National Public Health Laboratories, Kotu, The Gambia
| | - Davis Nwakanma
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Abdul Karim Sesay
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Anna Roca
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia.
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Abstract
The coronavirus disease 2019 (COVID‐19) pandemic has triggered a global health emergency and brought disaster to humans. Tremendous efforts have been made to control the pandemic, among which neutralizing antibodies (NAbs) are of specific interest to researchers. Neutralizing antibodies are generated within weeks after infection or immunization and can protect cells from virus intrusion and confer protective immunity to cells. Thus, production of NAbs is considered as a main goal for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines and NAbs may be used for patient treatment in the form of monoclonal antibodies. Neutralization assays are capable of quantitatively detecting NAbs against SARS‐CoV‐2, allowing to explore the relationship between the level of NAbs and the severity of the disease, and may predict the possibility of re‐infection in COVID‐19 patients. They can also be used to test the effects of monoclonal antibodies, convalescent plasma and vaccines. At present, wild‐type virus neutralization assay remains the gold standard for measuring Nabs, while pseudovirus neutralization assays, Surrogate virus neutralization test (sVNT) and high‐throughput versions of neutralization assays are popular alternatives with their own advantages and disadvantages. In this review article, we summarize the characteristics and recent progress of SARS‐CoV‐2 neutralization assays. Special attention is given to the current limitations of various neutralization assays so as to promote new possible strategies with NAbs by which rapid SARS‐CoV‐2 serological diagnosis and antiviral screening in the future will be achieved.
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Affiliation(s)
- Yuying Lu
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
| | - Jin Wang
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
| | - Qianlin Li
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
| | - Huan Hu
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
| | - Jiahai Lu
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
| | - Zeliang Chen
- Department of Epidemiology School of Public Health Sun Yat‐Sen University Guangzhou China
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41
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Desimmie BA, Raru YY, Awadh HM, He P, Teka S, Willenburg KS. Insights into SARS-CoV-2 Persistence and Its Relevance. Viruses 2021; 13:1025. [PMID: 34072390 PMCID: PMC8228265 DOI: 10.3390/v13061025] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), continues to wreak havoc, threatening the public health services and imposing economic collapse worldwide. Tailoring public health responses to the SARS-CoV-2 pandemic depends on understanding the mechanism of viral replication, disease pathogenesis, accurately identifying acute infections, and mapping the spreading risk of hotspots across the globe. However, effective identification and isolation of persons with asymptomatic and mild SARS-CoV-2 infections remain the major obstacles to efforts in controlling the SARS-CoV-2 spread and hence the pandemic. Understanding the mechanism of persistent viral shedding, reinfection, and the post-acute sequalae of SARS-CoV-2 infection (PASC) is crucial in our efforts to combat the pandemic and provide better care and rehabilitation to survivors. Here, we present a living literature review (January 2020 through 15 March 2021) on SARS-CoV-2 viral persistence, reinfection, and PASC. We also highlight potential areas of research to uncover putative links between viral persistence, intra-host evolution, host immune status, and protective immunity to guide and direct future basic science and clinical research priorities.
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Affiliation(s)
- Belete A. Desimmie
- Department of Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA; (Y.Y.R.); (H.M.A.); (P.H.); (S.T.)
| | | | | | | | | | - Kara S. Willenburg
- Department of Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA; (Y.Y.R.); (H.M.A.); (P.H.); (S.T.)
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Akhmetzhanov AR, Mizumoto K, Jung SM, Linton NM, Omori R, Nishiura H. Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February-March 2020. J Clin Med 2021; 10:2392. [PMID: 34071502 PMCID: PMC8198150 DOI: 10.3390/jcm10112392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 01/12/2023] Open
Abstract
Following the first report of the coronavirus disease 2019 (COVID-19) in Sapporo city, Hokkaido Prefecture, Japan, on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized due to having mild or no symptoms during the initial months of the outbreak. We therefore aimed to predict the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo city using data on cases diagnosed outside these areas. Two statistical frameworks involving a balance equation and an extrapolated linear regression model with a negative binomial link were used for deriving both estimates, respectively. The estimated cumulative incidence in Hokkaido as of 27 February was 2,297 cases (95% confidence interval (CI): 382-7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo city as of 28 February was estimated at 2233 cases (95% CI: 0-4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating a higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases helped to inform the public health response at the beginning of the pandemic and provided insight into the possible scope of undetected transmission for future assessments.
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Affiliation(s)
- Andrei R. Akhmetzhanov
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- Global Health Program, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Kenji Mizumoto
- Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Yoshida-Nakaadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan;
- Hakubi Center for Advanced Research, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto 606-8306, Japan
| | - Sung-Mok Jung
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
| | - Natalie M. Linton
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
| | - Ryosuke Omori
- Research Center for Zoonosis Control, Hokkaido University, Kita 19 Jo Nishi 10 Chome, Kita-ku, Sapporo-shi, Hokkaido 001-0019, Japan;
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan; (A.R.A.); (S.-M.J.); (N.M.L.)
- School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
- Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan
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Geers D, Shamier MC, Bogers S, den Hartog G, Gommers L, Nieuwkoop NN, Schmitz KS, Rijsbergen LC, van Osch JAT, Dijkhuizen E, Smits G, Comvalius A, van Mourik D, Caniels TG, van Gils MJ, Sanders RW, Oude Munnink BB, Molenkamp R, de Jager HJ, Haagmans BL, de Swart RL, Koopmans MPG, van Binnendijk RS, de Vries RD, GeurtsvanKessel CH. SARS-CoV-2 variants of concern partially escape humoral but not T-cell responses in COVID-19 convalescent donors and vaccinees. Sci Immunol 2021; 6:eabj1750. [PMID: 34035118 PMCID: PMC9268159 DOI: 10.1126/sciimmunol.abj1750] [Citation(s) in RCA: 374] [Impact Index Per Article: 124.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022]
Abstract
The emergence of SARS-CoV-2 variants harboring mutations in the spike (S) protein has raised concern about potential immune escape. Here, we studied humoral and cellular immune responses to wild type SARS-CoV-2 and the B.1.1.7 and B.1.351 variants of concern in a cohort of 121 BNT162b2 mRNA-vaccinated health care workers (HCW). Twenty-three HCW recovered from mild COVID-19 disease and exhibited a recall response with high levels of SARS-CoV-2-specific functional antibodies and virus-specific T cells after a single vaccination. Specific immune responses were also detected in seronegative HCW after one vaccination, but a second dose was required to reach high levels of functional antibodies and cellular immune responses in all individuals. Vaccination-induced antibodies cross-neutralized the variants B.1.1.7 and B.1.351, but the neutralizing capacity and Fc-mediated functionality against B.1.351 was consistently 2- to 4-fold lower than to the homologous virus. In addition, peripheral blood mononuclear cells were stimulated with peptide pools spanning the mutated S regions of B.1.1.7 and B.1.351 to detect cross-reactivity of SARS-CoV-2-specific T cells with variants. Importantly, we observed no differences in CD4+ T-cell activation in response to variant antigens, indicating that the B.1.1.7 and B.1.351 S proteins do not escape T-cell-mediated immunity elicited by the wild type S protein. In conclusion, this study shows that some variants can partially escape humoral immunity induced by SARS-CoV-2 infection or BNT162b2 vaccination, but S-specific CD4+ T-cell activation is not affected by the mutations in the B.1.1.7 and B.1.351 variants.
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Affiliation(s)
- Daryl Geers
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | - Marc C Shamier
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | - Susanne Bogers
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | - Gerco den Hartog
- Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment; Bilthoven, the Netherlands
| | - Lennert Gommers
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | | | | | | | | | - Emma Dijkhuizen
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | - Gaby Smits
- Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment; Bilthoven, the Netherlands
| | | | | | - Tom G Caniels
- Department of Medical Microbiology, Amsterdam UMC; Amsterdam, the Netherlands
| | - Marit J van Gils
- Department of Medical Microbiology, Amsterdam UMC; Amsterdam, the Netherlands
| | - Rogier W Sanders
- Department of Medical Microbiology, Amsterdam UMC; Amsterdam, the Netherlands
- Department of Microbiology and Immunology, Weill Medical College of Cornell University; New York, NY 10021, USA
| | | | | | - Herbert J de Jager
- Department of Occupational Health Services, Erasmus MC; Rotterdam, the Netherlands
| | - Bart L Haagmans
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | - Rik L de Swart
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands
| | | | - Robert S van Binnendijk
- Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment; Bilthoven, the Netherlands
| | - Rory D de Vries
- Department of Viroscience, Erasmus MC; Rotterdam, the Netherlands.
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Loconsole D, Sallustio A, Accogli M, Centrone F, Casulli D, Madaro A, Tedeschi E, Parisi A, Chironna M. Symptomatic SARS-CoV-2 Reinfection in a Healthy Healthcare Worker in Italy Confirmed by Whole-Genome Sequencing. Viruses 2021; 13:899. [PMID: 34066205 PMCID: PMC8150928 DOI: 10.3390/v13050899] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 12/13/2022] Open
Abstract
This study describes a case of SARS-CoV-2 reinfection confirmed by whole-genome sequencing in a healthy physician who had been working in a COVID-19 hospital in Italy since the beginning of the pandemic. Nasopharyngeal swabs were obtained from the patient at each presentation as part of routine surveillance. Nucleic acid amplification testing was performed on the two samples to confirm SARS-CoV-2 infection, and serological tests were used to detect SARS-CoV-2 IgG antibodies. Comparative genome analysis with whole-genome sequencing was performed on nasopharyngeal swabs collected during the two episodes of COVID-19. The first COVID-19 episode was in March 2020, and the second was in January 2021. Both SARS-CoV-2 infections presented with mild symptoms, and seroconversion for SARS-CoV-2 IgG was documented. Genomic analysis showed that the viral genome from the first infection belonged to the lineage B.1.1.74, while that from the second infection to the lineage B.1.177. Epidemiological, clinical, serological, and genomic analyses confirmed that the second episode of SARS-CoV-2 infection in the healthcare worker met the qualifications for "best evidence" for reinfection. Further studies are urgently needed to assess the frequency of such a worrisome occurrence, particularly in the light of the recent diffusion of SARS-CoV-2 variants of concern.
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Affiliation(s)
- Daniela Loconsole
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (D.L.); (M.A.); (F.C.)
| | - Anna Sallustio
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy; (A.S.); (D.C.)
| | - Marisa Accogli
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (D.L.); (M.A.); (F.C.)
| | - Francesca Centrone
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (D.L.); (M.A.); (F.C.)
| | - Daniele Casulli
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy; (A.S.); (D.C.)
| | - Antonino Madaro
- Department of Prevention, Local Health Unit of Bari, 70124 Bari, Italy;
| | - Ersilia Tedeschi
- Covid-Unit, Hospital F. Miulli, Acquaviva delle Fonti, 70124 Bari, Italy;
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy;
| | - Maria Chironna
- Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy; (D.L.); (M.A.); (F.C.)
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Killed whole-genome reduced-bacteria surface-expressed coronavirus fusion peptide vaccines protect against disease in a porcine model. Proc Natl Acad Sci U S A 2021; 118:2025622118. [PMID: 33858942 PMCID: PMC8106328 DOI: 10.1073/pnas.2025622118] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
As the coronavirus disease 2019 (COVID-19) pandemic rages on, it is important to explore new evolution-resistant vaccine antigens and new vaccine platforms that can produce readily scalable, inexpensive vaccines with easier storage and transport. We report here a synthetic biology-based vaccine platform that employs an expression vector with an inducible gram-negative autotransporter to express vaccine antigens on the surface of genome-reduced bacteria to enhance interaction of vaccine antigen with the immune system. As a proof-of-principle, we utilized genome-reduced Escherichia coli to express SARS-CoV-2 and porcine epidemic diarrhea virus (PEDV) fusion peptide (FP) on the cell surface, and evaluated their use as killed whole-cell vaccines. The FP sequence is highly conserved across coronaviruses; the six FP core amino acid residues, along with the four adjacent residues upstream and the three residues downstream from the core, are identical between SARS-CoV-2 and PEDV. We tested the efficacy of PEDV FP and SARS-CoV-2 FP vaccines in a PEDV challenge pig model. We demonstrated that both vaccines induced potent anamnestic responses upon virus challenge, potentiated interferon-γ responses, reduced viral RNA loads in jejunum tissue, and provided significant protection against clinical disease. However, neither vaccines elicited sterilizing immunity. Since SARS-CoV-2 FP and PEDV FP vaccines provided similar clinical protection, the coronavirus FP could be a target for a broadly protective vaccine using any platform. Importantly, the genome-reduced bacterial surface-expressed vaccine platform, when using a vaccine-appropriate bacterial vector, has potential utility as an inexpensive, readily manufactured, and rapid vaccine platform for other pathogens.
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Roberts AT, Piani F, Longo B, Andreini R, Meini S. Reinfection of SARS-CoV-2 - analysis of 23 cases from the literature. Infect Dis (Lond) 2021; 53:479-485. [PMID: 33849385 PMCID: PMC8054490 DOI: 10.1080/23744235.2021.1905174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION The duration of immunity after infection from SARS-CoV-2 conferring protection from subsequent COVID-19 episodes is not yet fully understood. We reviewed the literature for cases of documented reinfection. MATERIALS AND METHODS A comprehensive computerized search in PubMed, through 15 December 2020, using the following terms in combination: COVID-19, SARS-CoV-2, reinfection, reactivation, recurrence. To exclude cases due to prolonged viral shedding or protracted infection, only cases occurring at least 12 weeks apart or confirmed as being sustained by genetically different viruses by viral genome analysis were included. RESULTS We identified 23 cases globally, for which viral genome analysis was performed in 10 cases and serology in 19 cases. The mean interval between the two episodes was 15 weeks. Mean age of cases was 44.5 years, and 10 (43.5%) were women. In 17/23 cases, no comorbidity was observed. In 10 cases, the first episode was more severe than the ensuing episode, whereas in seven cases the ensuing episode was more severe. In four cases, there was no difference in severity and in two cases both episodes were asymptomatic. CONCLUSIONS From this sample of 23 cases, a clear pattern of the second episode being less or more severe did not emerge. A better understanding of immunity to SARS-CoV-2, necessary to assess the probability of a second infection and the durability of protection conferred by vaccination, is warranted.
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Affiliation(s)
- Anna Teresa Roberts
- Internal Medicine Unit, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Florence, Italy
| | - Fiorella Piani
- Internal Medicine Unit, Santa Maria Annunziata Hospital, Azienda USL Toscana Centro, Florence, Italy
| | - Benedetta Longo
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Pisa, Italy
| | - Roberto Andreini
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Pisa, Italy
| | - Simone Meini
- Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, Pisa, Italy
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Letizia AG, Ge Y, Vangeti S, Goforth C, Weir DL, Kuzmina NA, Balinsky CA, Chen HW, Ewing D, Soares-Schanoski A, George MC, Graham WD, Jones F, Bharaj P, Lizewski RA, Lizewski SE, Marayag J, Marjanovic N, Miller CM, Mofsowitz S, Nair VD, Nunez E, Parent DM, Porter CK, Santa Ana E, Schilling M, Stadlbauer D, Sugiharto VA, Termini M, Sun P, Tracy RP, Krammer F, Bukreyev A, Ramos I, Sealfon SC. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. THE LANCET RESPIRATORY MEDICINE 2021; 9:712-720. [PMID: 33865504 PMCID: PMC8049591 DOI: 10.1016/s2213-2600(21)00158-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/23/2023]
Abstract
Background Whether young adults who are infected with SARS-CoV-2 are at risk of subsequent infection is uncertain. We investigated the risk of subsequent SARS-CoV-2 infection among young adults seropositive for a previous infection. Methods This analysis was performed as part of the prospective COVID-19 Health Action Response for Marines study (CHARM). CHARM included predominantly male US Marine recruits, aged 18–20 years, following a 2-week unsupervised quarantine at home. After the home quarantine period, upon arrival at a Marine-supervised 2-week quarantine facility (college campus or hotel), participants were enrolled and were assessed for baseline SARS-CoV-2 IgG seropositivity, defined as a dilution of 1:150 or more on receptor-binding domain and full-length spike protein ELISA. Participants also completed a questionnaire consisting of demographic information, risk factors, reporting of 14 specific COVID-19-related symptoms or any other unspecified symptom, and brief medical history. SARS-CoV-2 infection was assessed by PCR at weeks 0, 1, and 2 of quarantine and participants completed a follow-up questionnaire, which included questions about the same COVID-19-related symptoms since the last study visit. Participants were excluded at this stage if they had a positive PCR test during quarantine. Participants who had three negative swab PCR results during quarantine and a baseline serum serology test at the beginning of the supervised quarantine that identified them as seronegative or seropositive for SARS-CoV-2 then went on to basic training at Marine Corps Recruit Depot—Parris Island. Three PCR tests were done at weeks 2, 4, and 6 in both seropositive and seronegative groups, along with the follow-up symptom questionnaire and baseline neutralising antibody titres on all subsequently infected seropositive and selected seropositive uninfected participants (prospective study period). Findings Between May 11, 2020, and Nov 2, 2020, we enrolled 3249 participants, of whom 3168 (98%) continued into the 2-week quarantine period. 3076 (95%) participants, 2825 (92%) of whom were men, were then followed up during the prospective study period after quarantine for 6 weeks. Among 189 seropositive participants, 19 (10%) had at least one positive PCR test for SARS-CoV-2 during the 6-week follow-up (1·1 cases per person-year). In contrast, 1079 (48%) of 2247 seronegative participants tested positive (6·2 cases per person-year). The incidence rate ratio was 0·18 (95% CI 0·11–0·28; p<0·001). Among seropositive recruits, infection was more likely with lower baseline full-length spike protein IgG titres than in those with higher baseline full-length spike protein IgG titres (hazard ratio 0·45 [95% CI 0·32–0·65]; p<0·001). Infected seropositive participants had viral loads that were about 10-times lower than those of infected seronegative participants (ORF1ab gene cycle threshold difference 3·95 [95% CI 1·23–6·67]; p=0·004). Among seropositive participants, baseline neutralising titres were detected in 45 (83%) of 54 uninfected and in six (32%) of 19 infected participants during the 6 weeks of observation (ID50 difference p<0·0001). Interpretation Seropositive young adults had about one-fifth the risk of subsequent infection compared with seronegative individuals. Although antibodies induced by initial infection are largely protective, they do not guarantee effective SARS-CoV-2 neutralisation activity or immunity against subsequent infection. These findings might be relevant for optimisation of mass vaccination strategies. Funding Defense Health Agency and Defense Advanced Research Projects Agency.
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Affiliation(s)
| | - Yongchao Ge
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sindhu Vangeti
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carl Goforth
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Dawn L Weir
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Natalia A Kuzmina
- Department of Pathology University of Texas Medical Branch and Galveston National Laboratory, Galveston, TX, USA
| | | | - Hua Wei Chen
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Dan Ewing
- Naval Medical Research Center, Silver Spring, MD, USA
| | | | | | | | - Franca Jones
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Preeti Bharaj
- Department of Pathology University of Texas Medical Branch and Galveston National Laboratory, Galveston, TX, USA
| | | | | | - Jan Marayag
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Nada Marjanovic
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Clare M Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sagie Mofsowitz
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Venugopalan D Nair
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Nunez
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Danielle M Parent
- Department of Pathology & Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Chad K Porter
- Naval Medical Research Center, Silver Spring, MD, USA
| | | | | | - Daniel Stadlbauer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Michael Termini
- and Naval Medical Readiness and Training Command Beaufort, Beaufort, SC, USA
| | - Peifang Sun
- Naval Medical Research Center, Silver Spring, MD, USA
| | - Russell P Tracy
- Department of Pathology & Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Bukreyev
- Department of Pathology University of Texas Medical Branch and Galveston National Laboratory, Galveston, TX, USA
| | - Irene Ramos
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stuart C Sealfon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Carbone M, Lednicky J, Xiao SY, Venditti M, Bucci E. Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For. J Thorac Oncol 2021; 16:546-571. [PMID: 33422679 PMCID: PMC7832772 DOI: 10.1016/j.jtho.2020.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads mainly by means of aerosols (microdroplets) in enclosed environments, especially those in which temperature and humidity are regulated by means of air-conditioning. About 30% of individuals infected with SARS-CoV-2 develop coronavirus disease 2019 (COVID-19) disease. Among them, approximately 25% require hospitalization. In medicine, cases are identified as those who become ill. During this pandemic, cases have been identified as those with a positive SARS-CoV-2 polymerase chain reaction test, including approximately 70% who were asymptomatic-this has caused unnecessary anxiety. Individuals more than 65 years old, those affected by obesity, diabetes, asthma, or are immune-depressed owing to cancer and other conditions, are at a higher risk of hospitalization and of dying of COVID-19. Healthy individuals younger than 40 years very rarely die of COVID-19. Estimates of the COVID-19 mortality rate vary because the definition of COVID-19-related deaths varies. Belgium has the highest death rate at 154.9 per 100,000 persons, because it includes anyone who died with symptoms compatible with COVID-19, even those never tested for SARS-CoV-2. The United States includes all patients who died with a positive test, whether they died because of, or with, SARS-CoV-2. Countries that include only patients in which COVID-19 was the main cause of death, rather than a cofactor, have lower death rates. Numerous therapies are being developed, and rapid improvements are anticipated. Because of disinformation, only approximately 50% of the U.S. population plans to receive a COVID-19 vaccine. By sharing accurate information, physicians, health professionals, and scientists play a key role in addressing myths and anxiety, help public health officials enact measures to decrease infections, and provide the best care for those who become sick. In this article, we discuss these issues.
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Affiliation(s)
- Michele Carbone
- Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, Hawaii; Department of Pathology, John A. Burns School of Medicine, Hawaii, Honolulu, Hawaii.
| | - John Lednicky
- Department of Environmental and Global Health, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, Florida
| | - Shu-Yuan Xiao
- Department of Pathology, University of Chicago Medicine, Chicago, llinois
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Universita` La Sapienza, Roma, Italy
| | - Enrico Bucci
- Sbarro Institute for Cancer Research and Molecular Medicine, College for Science and technology, Temple University, Philadelphia, Pennsylvania; Department of Biology, College for Science and Technology, Temple University, Philadelphia, Pennsylvania
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Ren X, Ren X, Lou J, Wang Y, Huang Q, Shi Y, Deng Y, Li X, Lu L, Yan S, Wang Y, Luo L, Zeng X, Yao X, Jin Y. A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR. EClinicalMedicine 2021; 34:100839. [PMID: 33898952 PMCID: PMC8052132 DOI: 10.1016/j.eclinm.2021.100839] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world. METHODS We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline. FINDINGS We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6-13·7) with high heterogeneity (I2 = 85%). INTERPRETATION To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.
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Affiliation(s)
- Xiangying Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Xiangge Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jiaao Lou
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yongbo Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, China
| | - Yuqing Deng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Thyroid Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyan Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Nephrology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liye Lu
- Yongnian District maternity and childcare hospital, Xinming Road No.28. Yongnian District, HanDan, Hebei, China
| | - Siyu Yan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yunyun Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lisha Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiantao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Corresponding authors.
| | - Xiaomei Yao
- Center for clinical practice guideline conduction and evaluation, Children's Hospital of Fudan University, Shanghai, China
- Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Corresponding author at: Center for clinical practice guideline conduction and evaluation, Children's Hospital of Fudan University, Shanghai, China.
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Corresponding authors.
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Hansen CH, Michlmayr D, Gubbels SM, Mølbak K, Ethelberg S. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. Lancet 2021; 397:1204-1212. [PMID: 33743221 PMCID: PMC7969130 DOI: 10.1016/s0140-6736(21)00575-4] [Citation(s) in RCA: 398] [Impact Index Per Article: 132.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The degree to which infection with SARS-CoV-2 confers protection towards subsequent reinfection is not well described. In 2020, as part of Denmark's extensive, free-of-charge PCR-testing strategy, approximately 4 million individuals (69% of the population) underwent 10·6 million tests. Using these national PCR-test data from 2020, we estimated protection towards repeat infection with SARS-CoV-2. METHODS In this population-level observational study, we collected individual-level data on patients who had been tested in Denmark in 2020 from the Danish Microbiology Database and analysed infection rates during the second surge of the COVID-19 epidemic, from Sept 1 to Dec 31, 2020, by comparison of infection rates between individuals with positive and negative PCR tests during the first surge (March to May, 2020). For the main analysis, we excluded people who tested positive for the first time between the two surges and those who died before the second surge. We did an alternative cohort analysis, in which we compared infection rates throughout the year between those with and without a previous confirmed infection at least 3 months earlier, irrespective of date. We also investigated whether differences were found by age group, sex, and time since infection in the alternative cohort analysis. We calculated rate ratios (RRs) adjusted for potential confounders and estimated protection against repeat infection as 1 - RR. FINDINGS During the first surge (ie, before June, 2020), 533 381 people were tested, of whom 11 727 (2·20%) were PCR positive, and 525 339 were eligible for follow-up in the second surge, of whom 11 068 (2·11%) had tested positive during the first surge. Among eligible PCR-positive individuals from the first surge of the epidemic, 72 (0·65% [95% CI 0·51-0·82]) tested positive again during the second surge compared with 16 819 (3·27% [3·22-3·32]) of 514 271 who tested negative during the first surge (adjusted RR 0·195 [95% CI 0·155-0·246]). Protection against repeat infection was 80·5% (95% CI 75·4-84·5). The alternative cohort analysis gave similar estimates (adjusted RR 0·212 [0·179-0·251], estimated protection 78·8% [74·9-82·1]). In the alternative cohort analysis, among those aged 65 years and older, observed protection against repeat infection was 47·1% (95% CI 24·7-62·8). We found no difference in estimated protection against repeat infection by sex (male 78·4% [72·1-83·2] vs female 79·1% [73·9-83·3]) or evidence of waning protection over time (3-6 months of follow-up 79·3% [74·4-83·3] vs ≥7 months of follow-up 77·7% [70·9-82·9]). INTERPRETATION Our findings could inform decisions on which groups should be vaccinated and advocate for vaccination of previously infected individuals because natural protection, especially among older people, cannot be relied on. FUNDING None.
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Affiliation(s)
- Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark; MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniela Michlmayr
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark; European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Kåre Mølbak
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark; Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark; Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.
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