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Ng DHL, Chia TRT, Young BE, Sadarangani S, Puah SH, Low JGH, Yan GZ, Mo Y, Ngiam NJ, Wang SSY, Loo YT, Ong FEJQ, Li AY, Ho S, Ng L, Tambyah PA, Yeo TW. Study protocol: infectious diseases consortium (I3D) for study on integrated and innovative approaches for management of respiratory infections: respiratory infections research and outcome study (RESPIRO). BMC Infect Dis 2024; 24:123. [PMID: 38262970 PMCID: PMC10807062 DOI: 10.1186/s12879-023-08795-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Community-acquired respiratory infections are a leading cause of illness and death globally. The aetiologies of community-acquired pneumonia remain poorly defined. The RESPIRO study is an ongoing prospective observational cohort study aimed at developing pragmatic logistical and analytic platforms to accurately identify the causes of moderate-to-severe community-acquired pneumonia in adults and understand the factors influencing disease caused by individual pathogens. The study is currently underway in Singapore and has plans for expansion into the broader region. METHODS RESPIRO is being conducted at three major tertiary hospitals in Singapore. Adults hospitalised with acute community-acquired pneumonia or lower respiratory tract infections, based on established clinical, laboratory and radiological criteria, will be recruited. Over the course of the illness, clinical data and biological samples will be collected longitudinally and stored in a biorepository for future analysis. DISCUSSION The RESPIRO study is designed to be hypothesis generating, complementary to and easily integrated with other research projects and clinical trials. The detailed clinical database and biorepository will yield insights into the epidemiology and outcomes of community-acquired lower respiratory tract infections in Singapore and the surrounding region and offers the opportunity to deeply characterise the microbiology and immunopathology of community-acquired pneumonia.
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Affiliation(s)
- Dorothy Hui Lin Ng
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
| | - Travis Ren Teen Chia
- National Centre of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - Barnaby Edward Young
- National Centre of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Sapna Sadarangani
- National Centre of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ser Hon Puah
- Department of Respiratory & Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Jenny Guek Hong Low
- Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
- Viral Research and Experimental Medicine Centre (ViREMiCS), SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, College Road, Singapore, Singapore
| | - Gabriel Zherong Yan
- Division of Infectious Diseases, National University Hospital, Singapore, Singapore
| | - Yin Mo
- Division of Infectious Diseases, National University Hospital, Singapore, Singapore
| | | | | | - Yan Tong Loo
- National Centre of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Andrew Yunkai Li
- Division of Respiratory & Critical Care Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Sharlene Ho
- Department of Respiratory & Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Lisa Ng
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Division of Infectious Diseases, National University Hospital, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tsin Wen Yeo
- National Centre of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Aho Glele LS, de Rougemont A. Non-Pharmacological Strategies and Interventions for Effective COVID-19 Control: A Narrative Review. J Clin Med 2023; 12:6465. [PMID: 37892603 PMCID: PMC10607620 DOI: 10.3390/jcm12206465] [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: 08/03/2023] [Revised: 08/24/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic had a devastating impact on the world, causing widespread illness and death. Focusing on prevention strategies to limit the spread of the disease remains essential. Despite the advent of vaccines, maintaining a vigilant approach to prevention remains paramount. We reviewed effective strategies to prevent COVID-19 transmission, including various prevention measures and interventions and both established practices and unresolved issues that have been addressed in meta-analyses, literature reviews, or in the health care context. Standard precautions are the cornerstone of infection control, with hand hygiene and mask use as key components. The use of surgical masks is recommended to prevent droplet transmission, while eye protection is recommended in combination with masks. In terms of room occupancy, ventilation is critical in reducing the risk of transmission in poorly ventilated environments. Chemical disinfection of indoor air with Triethylene glycol-based products can provide safe additional protection. Since viral RNA detection on surfaces does not necessarily indicate infectivity, the risk of transmission by surface contact remains low if surfaces are properly maintained and hand hygiene is practiced regularly. Thus, prevention of SARS-CoV-2 transmission requires a multifaceted approach, including reducing particle emissions from infected persons by wearing masks, eliminating aerosols by ventilation and air treatment, ensuring physical separation, and protecting exposed persons with masks and eye protection.
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Affiliation(s)
- Ludwig Serge Aho Glele
- Epidemiology and Infection Control Department, University Hospital of Dijon, 21000 Dijon, France
| | - Alexis de Rougemont
- National Reference Centre for Gastroenteritis Viruses, Laboratory of Virology, University Hospital of Dijon, 21000 Dijon, France;
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3
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Rombauts A, Bódalo Torruella M, Abelenda-Alonso G, Perera-Bel J, Ferrer-Salvador A, Acedo-Terrades A, Gabarrós-Subirà M, Oriol I, Gudiol C, Nonell L, Carratalà J. Dynamics of Gene Expression Profiling and Identification of High-Risk Patients for Severe COVID-19. Biomedicines 2023; 11:biomedicines11051348. [PMID: 37239019 DOI: 10.3390/biomedicines11051348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023] Open
Abstract
The clinical manifestations of SARS-CoV-2 infection vary widely, from asymptomatic infection to the development of acute respiratory distress syndrome (ARDS) and death. The host response elicited by SARS-CoV-2 plays a key role in determining the clinical outcome. We hypothesized that determining the dynamic whole blood transcriptomic profile of hospitalized adult COVID-19 patients and characterizing the subgroup that develops severe disease and ARDS would broaden our understanding of the heterogeneity in clinical outcomes. We recruited 60 hospitalized patients with RT-PCR-confirmed SARS-CoV-2 infection, among whom 19 developed ARDS. Peripheral blood was collected using PAXGene RNA tubes within 24 h of admission and on day 7. There were 2572 differently expressed genes in patients with ARDS at baseline and 1149 at day 7. We found a dysregulated inflammatory response in COVID-19 ARDS patients, with an increased expression of genes related to pro-inflammatory molecules and neutrophil and macrophage activation at admission, in addition to an immune regulation loss. This led, in turn, to a higher expression of genes related to reactive oxygen species, protein polyubiquitination, and metalloproteinases in the latter stages. Some of the most significant differences in gene expression found between patients with and without ARDS corresponded to long non-coding RNA involved in epigenetic control.
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Affiliation(s)
- Alexander Rombauts
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | | | - Gabriela Abelenda-Alonso
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | - Júlia Perera-Bel
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Anna Ferrer-Salvador
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | | | - Maria Gabarrós-Subirà
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Isabel Oriol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
| | - Carlota Gudiol
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lara Nonell
- MARGenomics, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Jordi Carratalà
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-IDIBELL, 08908 Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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4
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Tjaden AH, Edelstein SL, Ahmed N, Calamari L, Dantuluri KL, Gibbs M, Hinkelman A, Mongraw‐Chaffin M, Sanders JW, Saydah S, Plumb ID. Association between COVID-19 and consistent mask wearing during contact with others outside the household-A nested case-control analysis, November 2020-October 2021. Influenza Other Respir Viruses 2023; 17:e13080. [PMID: 36606308 PMCID: PMC9835433 DOI: 10.1111/irv.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Face masks have been recommended to reduce SARS-CoV-2 transmission. However, evidence of the individual benefit of face masks remains limited, including by vaccination status. METHODS As part of the COVID-19 Community Research Partnership cohort study, we performed a nested case-control analysis to assess the association between self-reported consistent mask use during contact with others outside the household and subsequent odds of symptomatic SARS-CoV-2 infection (COVID-19) during November 2020-October 2021. Using conditional logistic regression, we compared 359 case-participants to 3544 control-participants who were matched by date, adjusting for enrollment site, age group, sex, race/ethnicity, urban/rural county classification, and healthcare worker occupation. RESULTS COVID-19 was associated with not consistently wearing a mask (adjusted odds ratio [aOR] 1.49; 95% confidence interval [CI] [1.14, 1.95]). Compared with persons ≥14 days after mRNA vaccination who also reported always wearing a mask, COVID-19 was associated with being unvaccinated (aOR 5.94; 95% CI [3.04, 11.62]), not wearing a mask (aOR 1.62; 95% CI [1.07, 2.47]), or both unvaccinated and not wearing a mask (aOR 9.07; 95% CI [4.81, 17.09]). CONCLUSIONS Our findings indicate that consistent mask wearing can complement vaccination to reduce the risk of COVID-19.
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Affiliation(s)
- Ashley H. Tjaden
- Milken Institute School of Public Health, Biostatistics CenterGeorge Washington UniversityRockvilleMarylandUSA
| | - Sharon L. Edelstein
- Milken Institute School of Public Health, Biostatistics CenterGeorge Washington UniversityRockvilleMarylandUSA
| | - Naheed Ahmed
- Department of Population HealthNYU Grossman School of MedicineNew York CityNew YorkUSA
| | - Lydia Calamari
- Carolinas Medical CenterAtrium HealthCharlotteNorth CarolinaUSA
| | - Keerti L. Dantuluri
- Department of Pediatrics (Infectious Diseases)Levine Children's Hospital, Atrium HealthCharlotteNorth CarolinaUSA
| | - Michael Gibbs
- Carolinas Medical CenterAtrium HealthCharlotteNorth CarolinaUSA
| | - Amy Hinkelman
- Campbell University School of Osteopathic MedicineLillingtonNorth CarolinaUSA
| | - Morgana Mongraw‐Chaffin
- Department of Epidemiology and PreventionWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - John W. Sanders
- Section on Cardiovascular Medicine, Department of MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Sharon Saydah
- U.S. Centers for Disease Control and Prevention COVID‐19 ResponseAtlantaGeorgiaUSA
| | - Ian D. Plumb
- U.S. Centers for Disease Control and Prevention COVID‐19 ResponseAtlantaGeorgiaUSA
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5
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Auerbach JD, Forsyth AD, Davey C, Hargreaves JR. Living with COVID-19 and preparing for future pandemics: revisiting lessons from the HIV pandemic. Lancet HIV 2023; 10:e62-e68. [PMID: 36370713 PMCID: PMC9764384 DOI: 10.1016/s2352-3018(22)00301-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/22/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022]
Abstract
In April, 2020, just months into the COVID-19 pandemic, an international group of public health researchers published three lessons learned from the HIV pandemic for the response to COVID-19, which were to: anticipate health inequalities, create an enabling environment to support behavioural change, and engage a multidisciplinary effort. We revisit these lessons in light of more than 2 years' experience with the COVID-19 pandemic. With specific examples, we detail how inequalities have played out within and between countries, highlight factors that support or impede the creation of enabling environments, and note ongoing issues with the scarcity of integrated science and health system approaches. We argue that to better apply lessons learned as the COVID-19 pandemic matures and other infectious disease outbreaks emerge, it will be imperative to create dialogue among polarised perspectives, identify shared priorities, and draw on multidisciplinary evidence.
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Affiliation(s)
- Judith D Auerbach
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Calum Davey
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - James R Hargreaves
- Department of Epidemiology and Evaluation, London School of Hygiene & Tropical Medicine, London, UK
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6
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Shahrin L, Mahfuz M, Rahman MW, Hossain MR, Khandaker AM, Alam MA, Osmany DMMF, Islam MM, Chisti MJ, Ahmed CM, Ahmed T. Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects. Life (Basel) 2022; 12:life12122047. [PMID: 36556412 PMCID: PMC9786013 DOI: 10.3390/life12122047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Considering that it has been more than 24 months since SARS-CoV-2 emerged, it is crucial to identify measures that prevent and control pathogen transmission in workplace settings. Our aim was to report results of a hospital-based program that delivered hydroxychloroquine (HCQ) tablets as COVID-19 prophylaxis to the frontline healthcare workers (HCW)s who cared for COVID-19 patients and to evaluate the efficacy of HCQ. Setting and participants: Quasi-experimental, controlled, single-center study. The included participants were doctors, nurses, health workers, cleaning staff, and non-healthcare supportive staff. The main outcome was contracting COVID-19 anytime during the period of taking the prophylaxis, confirmed by RT-PCR. A total of 336 participants, without any clinical evidence of COVID-19 and without any known contact with family members, were included in the trial; 230 were assigned to HCQ and 106 declined to take any drug. Results: Among the participants, 43 (18.7%) in the HCQ group and 11 (10.4%) participants in the control group developed COVID-19. For the evaluation of side effects, we evaluated 12-lead ECGs of both groups at the baseline and after 4 weeks to monitor QTc interval. A total of 91% (198 of 217) participants in the prophylaxis group and 92% (11 of 12) in the control group had a QTc < 45o msec, which is within normal limits. Conclusions: Although the number of symptomatic infections in health personnel was lower in the control group, the difference was not statistically significant. However, in the absence of any effective pre-exposure prophylaxis medicine for COVID-19, practicing proper infection prevention and control (IPC) and vaccination is the only way forward.
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Affiliation(s)
- Lubaba Shahrin
- Dhaka Hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
- Correspondence: ; Tel.: +880-2-8860523-32 (ext. 2303); Fax: +880-2-882-3116 or +880-2-988-5657
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
| | - Md. Waliur Rahman
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
| | - Md. Rezaul Hossain
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | | | - Md. Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
| | - Din M. M. F. Osmany
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
| | - Md. Munirul Islam
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
| | - Mohammod Jobayer Chisti
- Dhaka Hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
| | - Chaudhury Meshkat Ahmed
- Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), Dhaka 1212, Bangladesh
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Building Process-Oriented Data Science Solutions for Real-World Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148427. [PMID: 35886279 PMCID: PMC9318799 DOI: 10.3390/ijerph19148427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has highlighted some of the opportunities, problems and barriers facing the application of Artificial Intelligence to the medical domain. It is becoming increasingly important to determine how Artificial Intelligence will help healthcare providers understand and improve the daily practice of medicine. As a part of the Artificial Intelligence research field, the Process-Oriented Data Science community has been active in the analysis of this situation and in identifying current challenges and available solutions. We have identified a need to integrate the best efforts made by the community to ensure that promised improvements to care processes can be achieved in real healthcare. In this paper, we argue that it is necessary to provide appropriate tools to support medical experts and that frequent, interactive communication between medical experts and data miners is needed to co-create solutions. Process-Oriented Data Science, and specifically concrete techniques such as Process Mining, can offer an easy to manage set of tools for developing understandable and explainable Artificial Intelligence solutions. Process Mining offers tools, methods and a data driven approach that can involve medical experts in the process of co-discovering real-world evidence in an interactive way. It is time for Process-Oriented Data scientists to collaborate more closely with healthcare professionals to provide and build useful, understandable solutions that answer practical questions in daily practice. With a shared vision, we should be better prepared to meet the complex challenges that will shape the future of healthcare.
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8
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Thompson-Bonilla MDR, León JA, Cárdenas-Turrent MB, Peña-Thompson A, Hanessian-De la Garza D, Zavala-Vega S, Xicohtencatl-Cortes J, Ochoa SA, Cruz-Córdova A, Arellano-Galindo J. Features of antibody responses after SARS-COV-2 infection in healthcare workers in the first wave of COVID-19 pandemic in Mexico City. J Int Med Res 2022; 50:3000605221099458. [PMID: 35879824 PMCID: PMC9340344 DOI: 10.1177/03000605221099458] [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: 12/12/2022] Open
Abstract
Objective To investigate the antibody response to SARS-CoV-2 and identify associated
factors in frontline and second-line healthcare workers (HCWs) at a large
hospital in Mexico City during the first wave of COVID-19 pandemic. Methods This was a cross-sectional study of HCWs returning to work following
mandatory isolation after recovering from COVID-19. Immunoglobulin (Ig) M
and IgG antibodies elicited by SARS-CoV-2 were semiquantitatively measured
using densitometric analysis of band intensities in lateral flow assay (LFA)
devices. The mean pixel intensity (dots-per-inch [dpi]) of each band on the
LFA was considered a measure of antibody titre. Results Of the 111 HCWs involved in the study, antibody responses were detected in
73/111 (66%) participants. Severe COVID symptoms was associated with old
age. No differences in IgM intensity were observed between men and women,
but IgG intensity was significantly higher in men than in women. Second-line
HCWs produced a higher IgG intensity than firstline HCWs. The IgG intensity
was high in severe cases. Conclusions For HCWs who may acquire SARS-CoV-2 infection, it is necessary to establish a
routine program for detection of the virus to avoid risk of infection and
spread of COVID-19.
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Affiliation(s)
- Maria Del Rocío Thompson-Bonilla
- Laboratorio de Medicina Genómica, Hospital Regional "1° de Ocutbre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Jorge A León
- Scientific Management of KPC Biotech. California, USA
| | | | - Alba Peña-Thompson
- Laboratorio de Medicina Genómica, Hospital Regional "1° de Ocutbre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - Sergio Zavala-Vega
- Laboratorio de Neuropatología, Instituto Nacional de Neurología y Neurocirugía. Manuel Velasco Suarez, Mexico City, Mexico
| | - Juan Xicohtencatl-Cortes
- Laboratorio de Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Sara A Ochoa
- Laboratorio de Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Ariadnna Cruz-Córdova
- Laboratorio de Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - José Arellano-Galindo
- Unidad de Investigación en Enfermedades Infecciosas, Laboratorio de Virología Clínica y Experimental, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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9
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Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant transmits much more rapidly than prior SARS-CoV-2 viruses. The primary mode of transmission is via short range aerosols that are emitted from the respiratory tract of an index case. There is marked heterogeneity in the spread of this virus, with 10% to 20% of index cases contributing to 80% of secondary cases, while most index cases have no subsequent transmissions. Vaccination, ventilation, masking, eye protection, and rapid case identification with contact tracing and isolation can all decrease the transmission of this virus.
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Affiliation(s)
- Eric A Meyerowitz
- Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
| | - Aaron Richterman
- Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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10
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Tellier R. COVID-19: the case for aerosol transmission. Interface Focus 2022; 12:20210072. [PMID: 35261731 PMCID: PMC8831082 DOI: 10.1098/rsfs.2021.0072] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/06/2021] [Indexed: 01/21/2023] Open
Abstract
The COVID-19 pandemic is the most severe pandemic caused by a respiratory virus since the 1918 influenza pandemic. As is the case with other respiratory viruses, three modes of transmission have been invoked: contact (direct and through fomites), large droplets and aerosols. This narrative review makes the case that aerosol transmission is an important mode for COVID-19, through reviewing studies about bioaerosol physiology, detection of infectious SARS-CoV-2 in exhaled bioaerosols, prolonged SARS-CoV-2 infectivity persistence in aerosols created in the laboratory, detection of SARS-CoV-2 in air samples, investigation of outbreaks with manifest involvement of aerosols, and animal model experiments. SARS-CoV-2 joins influenza A virus as a virus with proven pandemic capacity that can be spread by the aerosol route. This has profound implications for the control of the current pandemic and for future pandemic preparedness.
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Affiliation(s)
- Raymond Tellier
- Department of Medicine, McGill University, Montreal, Quebec, Canada
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11
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Longitudinal SARS-CoV-2 Testing among the Unvaccinated Is Punctuated by Intermittent Positivity and Variable Rates of Increasing Cycle Threshold Values. Microbiol Spectr 2022; 10:e0271521. [PMID: 35315712 PMCID: PMC9045176 DOI: 10.1128/spectrum.02715-21] [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
The coronavirus disease 2019 (COVID-19) pandemic is complicated by cases of vaccine breakthrough and reinfection and widespread transmission of variants of concern (VOCs). Consequently, the need to interpret longitudinal positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests is crucial in guiding clinical decisions regarding infection control precautions and treatment. Although diagnostic real-time reverse transcription (RT)-PCR tests yield CT values that are inversely correlated with RNA quantity, these tests are only approved for qualitative interpretation. In this study, we performed a retrospective review of 72,217 SARS-CoV-2 positive tests and identified 264 patients with longitudinal positivity prior to vaccination and VOC circulation. Patients with longitudinal positivity fell into two categories: short-term (207, 78%) or prolonged (57, 22%) positivity, defined as ≤28 (range, 1 to 28; median, 16) days and >28 (range, 29 to 152; median, 41) days, respectively. In general, CT values increased over time in both groups; however, 11 short-term-positive patients had greater amounts of RNA detected at their terminal test than at the first positive test, and 6 patients had RNA detected at CT values of <35 at least 40 days after initial infection. Oscillating positive and negative results occurred in both groups, although oscillation was seen three times more frequently in prolonged-positive patients. Patients with prolonged positivity had diverse clinical characteristics but were often critically ill and were discharged to high-level care or deceased (22%). Overall, this study demonstrates that caution must be emphasized when interpreting CT values as a proxy for infectivity, a predictor of severity, or a guide for patient care decisions in the absence of additional clinical context, particularly among the unvaccinated population. IMPORTANCE We describe the duration of positivity and the COVID-19 treatment and outcome characteristics of an unvaccinated population of patients with prolonged SARS-CoV-2 positivity. This investigation serves to highlight challenges in using CT values to guide clinical decisions among unvaccinated individuals.
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12
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Khamees A, Bani-Issa J, Zoubi MSA, Qasem T, AbuAlArjah MI, Alawadin SA, Al-Shami K, Hussein FE, Hussein E, Bashayreh IH, Tambuwala MM, Al-Saghir M, Cornelison CT. SARS-CoV-2 and Coronavirus Disease Mitigation: Treatment Options, Vaccinations and Variants. Pathogens 2022; 11:275. [PMID: 35215217 PMCID: PMC8876838 DOI: 10.3390/pathogens11020275] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 01/27/2023] Open
Abstract
COVID-19 is caused by a novel coronavirus (2019-nCoV), which was declared as a pandemic after it emerged in China 2019. A vast international effort has been conducted to prevent and treat COVID-19 due to its high transmissibility and severe morbidity and mortality rates, particularly in individuals with chronic co-morbidities. In addition, polymorphic variants increased the need for proper vaccination to overcome the infectivity of new variants that are emerging across the globe. Many treatment options have been proposed and more than 25 vaccines are in various stages of development; however, the infection peaks are oscillating periodically, which raises a significant question about the effectiveness of the prevention measures and the persistence of this pandemic disease. In this review, we are exploring the most recent knowledge and advances in the treatment and vaccination options as well as the new emerging variants of 2019-nCoV and the possible mitigation of one of the most aggressive pandemics in the last centuries.
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Affiliation(s)
- Almu’atasim Khamees
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (A.K.); (J.B.-I.); (K.A.-S.); (F.E.H.)
| | - Jamal Bani-Issa
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (A.K.); (J.B.-I.); (K.A.-S.); (F.E.H.)
| | - Mazhar Salim Al Zoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (M.S.A.Z.); (T.Q.); (M.I.A.)
| | - Taqwa Qasem
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (M.S.A.Z.); (T.Q.); (M.I.A.)
| | - Manal Issam AbuAlArjah
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (M.S.A.Z.); (T.Q.); (M.I.A.)
| | | | - Khayry Al-Shami
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (A.K.); (J.B.-I.); (K.A.-S.); (F.E.H.)
| | - Farah E. Hussein
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan; (A.K.); (J.B.-I.); (K.A.-S.); (F.E.H.)
| | - Emad Hussein
- Department of Food Science and Human Nutrition, A’Sharqiyah University, P.O. Box 42, Ibra 400, Oman;
- Department of Biological Sciences, Faculty of Sciences, Yarmouk University, Irbid 211-63, Jordan
| | - Ibrahim H. Bashayreh
- Nursing Department, Fatima College of Health Sciences, Al-Ain Campus, P.O. Box 24162, Abu-Dhabi 31201, United Arab Emirates;
| | - Murtaza M. Tambuwala
- School of Pharmacy and Pharmaceutical Science, Ulster University, Coleraine BT52 1SA, UK;
| | - Mohannad Al-Saghir
- Department of Biological Sciences, Ohio University, Zanesville, OH 43701, USA;
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13
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Elkington PT, Dickinson AS, Mavrogordato MN, Spencer DC, Gillams RJ, De Grazia A, Rosini S, Garay-Baquero DJ, Diment LE, Mahobia N, Mant A, Baynham T, Morgan H. A Personal Respirator to Improve Protection for Healthcare Workers Treating COVID-19 (PeRSo). FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:664259. [PMID: 35047921 PMCID: PMC8757800 DOI: 10.3389/fmedt.2021.664259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/14/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction: SARS-CoV-2 infection is a global pandemic. Personal Protective Equipment (PPE) to protect healthcare workers has been a recurrent challenge in terms of global stocks, supply logistics and suitability. In some settings, around 20% of healthcare workers treating COVID-19 cases have become infected, which leads to staff absence at peaks of the pandemic, and in some cases mortality. Methods: To address shortcomings in PPE, we developed a simple powered air purifying respirator, made from inexpensive and widely available components. The prototype was designed to minimize manufacturing complexity so that derivative versions could be developed in low resource settings with minor modification. Results: The “Personal Respirator – Southampton” (PeRSo) delivers High-Efficiency Particulate Air (HEPA) filtered air from a battery powered fan-filter assembly into a lightweight hood with a clear visor that can be comfortably worn for several hours. Validation testing demonstrates that the prototype removes microbes, avoids excessive CO2 build-up in normal use, and passes fit test protocols widely used to evaluate standard N95/FFP2 and N99/FFP3 face masks. Feedback from doctors and nurses indicate the PeRSo prototype was preferred to standard FFP2 and FFP3 masks, being more comfortable and reducing the time and risk of recurrently changing PPE. Patients report better communication and reassurance as the entire face is visible. Conclusion: Rapid upscale of production of cheaply produced powered air purifying respirators, designed to achieve regulatory approval in the country of production, could protect healthcare workers from infection and improve healthcare delivery during the COVID-19 pandemic.
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Affiliation(s)
- Paul T Elkington
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alexander S Dickinson
- Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,Mechanical Engineering Department, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Mark N Mavrogordato
- Mechanical Engineering Department, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Daniel C Spencer
- School of Electronics & Computer Science, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Richard J Gillams
- Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,School of Electronics & Computer Science, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Antonio De Grazia
- Mechanical Engineering Department, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Sebastian Rosini
- Mechanical Engineering Department, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Diana J Garay-Baquero
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Laura E Diment
- Mechanical Engineering Department, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Nitin Mahobia
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alexandra Mant
- Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Tom Baynham
- INDO Lighting Ltd., Southampton, United Kingdom
| | - Hywel Morgan
- Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.,School of Electronics & Computer Science, Faculty of Engineering & Physical Sciences, University of Southampton, Southampton, United Kingdom
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Affiliation(s)
- Omid Arasteh
- Department of Clinical PharmacyFaculty of PharmacyMashhad University of Medical SciencesMashhadIran
| | - Hossein Khalili
- Department of Clinical PharmacyFaculty of PharmacyTehran University of Medical SciencesTehranIran
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15
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Defêche J, Azarzar S, Mesdagh A, Dellot P, Tytgat A, Bureau F, Gillet L, Belhadj Y, Bontems S, Hayette MP, Schils R, Rahmouni S, Ernst M, Moutschen M, Darcis G. In-Depth Longitudinal Comparison of Clinical Specimens to Detect SARS-CoV-2. Pathogens 2021; 10:pathogens10111362. [PMID: 34832518 PMCID: PMC8622859 DOI: 10.3390/pathogens10111362] [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: 08/31/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/03/2022] Open
Abstract
The testing and isolation of patients with coronavirus disease 2019 (COVID-19) are indispensable tools to control the ongoing COVID-19 pandemic. PCR tests are considered the “gold standard” of COVID-19 testing and mostly involve testing nasopharyngeal swab specimens. Our study aimed to compare the sensitivity of tests for various sample specimens. Seventy-five participants with confirmed COVID-19 were included in the study. Nasopharyngeal swabs, oropharyngeal swabs, Oracol-collected saliva, throat washes and rectal specimens were collected along with pooled swabs. Participants were asked to complete a questionnaire to correlate specific clinical symptoms and the symptom duration with the sensitivity of detecting COVID-19 in various sample specimens. Sampling was repeated after 7 to 10 days (T2), then after 14 to 20 days (T3) to perform a longitudinal analysis of sample specimen sensitivity. At the first time point, the highest percentages of SARS-CoV-2-positive samples were observed for nasopharyngeal samples (84.3%), while 74%, 68.2%, 58.8% and 3.5% of throat washing, Oracol-collected saliva, oropharyngeal and rectal samples tested positive, respectively. The sensitivity of all sampling methods except throat wash samples decreased rapidly at later time points compared to the first collection. The throat washing method exhibited better performance than the gold standard nasopharyngeal swab at the second and third time points after the first positive test date. Nasopharyngeal swabs were the most sensitive specimens for early detection after symptom onset. Throat washing is a sensitive alternative method. It was found that SARS-CoV-2 persists longer in the throat and saliva than in the nasopharynx.
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Affiliation(s)
- Justine Defêche
- Department of Clinical Microbiology, University of Liège, 4000 Liège, Belgium; (J.D.); (S.B.); (M.-P.H.)
| | - Samira Azarzar
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Alyssia Mesdagh
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Patricia Dellot
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Amandine Tytgat
- Laboratory of Cellular and Molecular Immunology, GIGA Institute, University of Liège, 4000 Liège, Belgium; (A.T.); (F.B.)
| | - Fabrice Bureau
- Laboratory of Cellular and Molecular Immunology, GIGA Institute, University of Liège, 4000 Liège, Belgium; (A.T.); (F.B.)
| | - Laurent Gillet
- Immunology-Vaccinology Laboratory, Department of Infectious and Parasitic Diseases, FARAH, University of Liège, 4000 Liège, Belgium;
| | - Yasmine Belhadj
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Sebastien Bontems
- Department of Clinical Microbiology, University of Liège, 4000 Liège, Belgium; (J.D.); (S.B.); (M.-P.H.)
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University of Liège, 4000 Liège, Belgium; (J.D.); (S.B.); (M.-P.H.)
| | - Raphaël Schils
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Souad Rahmouni
- Unit of Animal Genomics, GIGA Institute, University of Liège, 4000 Liège, Belgium;
| | - Marie Ernst
- Biostatistics and Medico-Economic Information Department, University Hospital of Liege, 4000 Liege, Belgium;
| | - Michel Moutschen
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
| | - Gilles Darcis
- Department of Infectious Diseases, Liège University Hospital, 4000 Liège, Belgium; (S.A.); (A.M.); (P.D.); (Y.B.); (R.S.); (M.M.)
- Correspondence: ; Tel.: +32-4-366-72-35
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16
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Meuris C, Kremer C, Geerinck A, Locquet M, Bruyère O, Defêche J, Meex C, Hayette MP, Duchene L, Dellot P, Azarzar S, Maréchal N, Sauvage AS, Frippiat F, Giot JB, Léonard P, Fombellida K, Moutschen M, Durkin K, Artesi M, Bours V, Faes C, Hens N, Darcis G. Transmission of SARS-CoV-2 After COVID-19 Screening and Mitigation Measures for Primary School Children Attending School in Liège, Belgium. JAMA Netw Open 2021; 4:e2128757. [PMID: 34636913 PMCID: PMC8511974 DOI: 10.1001/jamanetworkopen.2021.28757] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
IMPORTANCE Recent data suggest a relatively low incidence of COVID-19 among children. The possible role that children attending primary school may play in the transmission of SARS-CoV-2 remains poorly understood. OBJECTIVE To gain a better understanding of the possible role of children in the transmission of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from September 21 to December 31, 2020, in a primary school in Liège, Belgium, among a volunteer sample of 181 children, parents, and school employees. EXPOSURES Participants were tested for SARS-CoV-2 infection once a week for 15 weeks through throat washing, performed with 5 mL of saline and collected in a sterile tube after approximately 30 seconds of gargling. Quantitative reverse transcription-polymerase chain reaction was performed to detect SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES In case of test positivity, participants were asked to complete a questionnaire aimed at determining the timing of symptom onset and symptom duration. SARS-CoV-2 genetic sequencing was also performed. Confirmed cases were linked based on available information on known contacts and viral sequences. RESULTS A total of 181 individuals participated in this study, including 63 children (34 girls [54.0%]; mean [SD] age, 8.6 [1.9] years [range, 5-13 years]) and 118 adults (75 women [63.6%]; mean [SD] age, 42.5 [5.7] years [range, 30-59 years]). Forty-five individuals (24.9%) tested positive: 13 children (20.6%; 95% CI, 10.6%-30.6%) and 32 adults (27.1%; 95% CI, 19.1%-35.7%) (P = .34). Children were more often asymptomatic compared with adults (6 [46.2%; 95% CI, 19.1%-73.3%] vs 4 of 31 [12.9%; 95% CI, 1.3%-24.5%]; P = .04). The median duration of symptoms was shorter in children than in adults (0.00 days [IQR, 0.00-1.00 days] vs 15.00 days [IQR, 7.00-22.00 days]). A reconstruction of the outbreak revealed that most transmission events occurred between teachers and between children within the school. Of the observed household transmission events, most seemed to have originated from a child or teacher who acquired the infection at school. CONCLUSIONS AND RELEVANCE Despite the implementation of several mitigation measures, the incidence of COVID-19 among children attending primary school in this study was comparable to that observed among teachers and parents. Transmission tree reconstruction suggests that most transmission events originated from within the school. Additional measures should be considered to reduce the transmission of SARS-CoV-2 at school, including intensified testing.
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Affiliation(s)
- Christelle Meuris
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Cécile Kremer
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Anton Geerinck
- World Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Medea Locquet
- World Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- World Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Justine Defêche
- Department of Clinical Microbiology, University of Liège, Liège, Belgium
| | - Cécile Meex
- Department of Clinical Microbiology, University of Liège, Liège, Belgium
| | | | - Loic Duchene
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Patricia Dellot
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Samira Azarzar
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Nicole Maréchal
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Anne-Sophie Sauvage
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Frederic Frippiat
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Jean-Baptiste Giot
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Philippe Léonard
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Karine Fombellida
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Keith Durkin
- Department of Human Genetics, Centre Hospitalier Universitaire Liège, Medical Genomics, Groupe Interdisciplinaire et Génoprotéomique Appliquée Research Center, University of Liège, Liège, Belgium
| | - Maria Artesi
- Department of Human Genetics, Centre Hospitalier Universitaire Liège, Medical Genomics, Groupe Interdisciplinaire et Génoprotéomique Appliquée Research Center, University of Liège, Liège, Belgium
| | - Vincent Bours
- Department of Human Genetics, Centre Hospitalier Universitaire Liège, Medical Genomics, Groupe Interdisciplinaire et Génoprotéomique Appliquée Research Center, University of Liège, Liège, Belgium
| | - Christel Faes
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Niel Hens
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases, Liège University Hospital, Liège, Belgium
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17
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Giannella M, Pierrotti LC, Helanterä I, Manuel O. SARS-CoV-2 vaccination in solid-organ transplant recipients: What the clinician needs to know. Transpl Int 2021; 34:1776-1788. [PMID: 34450686 PMCID: PMC8646251 DOI: 10.1111/tri.14029] [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: 05/19/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 12/21/2022]
Abstract
In response to the COVID-19 pandemic, SARS-CoV-2 vaccines have been developed at an unparalleled speed, with 14 SARS-CoV-2 vaccines currently authorized. Solid-organ transplant (SOT) recipients are at risk for developing a higher rate of COVID-19-related complications and therefore they are at priority for immunization against SARS-CoV-2. Preliminary data suggest that although SARS-CoV-2 vaccines are safe in SOT recipients (with similar rate of adverse events than in the general population), the antibody responses are decreased in this population. Risk factors for poor vaccine immunogenicity include older age, shorter time from transplantation, use of mycophenolate and belatacept, and worse allograft function. SOT recipients should continue to be advised to maintain hand hygiene, use of facemasks, and social distancing after SARS-CoV-2 vaccine. Vaccination of household contacts should be also prioritized. Although highly encouraged for research purposes, systematic assessment in clinical practice of humoral and cellular immune responses after SARS-CoV-2 vaccination is controversial, since correlation between immunological findings and clinical protection from severe COVID-19, and cutoffs for protection are currently unknown in SOT recipients. Alternative immunization schemes, including a booster dose, higher doses, and modulation of immunosuppression during vaccination, need to be assessed in the context of well-designed clinical trials.
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Affiliation(s)
- Maddalena Giannella
- Infectious Diseases UnitDepartment of Medical and Surgical SciencesIRCCS Azienda Ospedaliero‐Universitaria di Bologna, Policlinico di Sant’OrsolaAlma Mater Studiorum University of BolognaBolognaItaly
| | - Lígia C. Pierrotti
- Department of Infectious DiseasesUniversity of São Paulo School of Medicine Hospital das ClínicasSão PauloBrazil
| | - Ilkka Helanterä
- Transplantation and Liver SurgeryHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Oriol Manuel
- Infectious Diseases Service and Transplantation CenterLausanne University HospitalLausanneSwitzerland
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18
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Mallach G, Kasloff SB, Kovesi T, Kumar A, Kulka R, Krishnan J, Robert B, McGuinty M, den Otter-Moore S, Yazji B, Cutts T. Aerosol SARS-CoV-2 in hospitals and long-term care homes during the COVID-19 pandemic. PLoS One 2021; 16:e0258151. [PMID: 34591919 PMCID: PMC8483369 DOI: 10.1371/journal.pone.0258151] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/19/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Few studies have quantified aerosol concentrations of SARS-CoV-2 in hospitals and long-term care homes, and fewer still have examined samples for viability. This information is needed to clarify transmission risks beyond close contact. METHODS We deployed particulate air samplers in rooms with COVID-19 positive patients in hospital ward and ICU rooms, rooms in long-term care homes experiencing outbreaks, and a correctional facility experiencing an outbreak. Samplers were placed between 2 and 3 meters from the patient. Aerosol (small liquid particles suspended in air) samples were collected onto gelatin filters by Ultrasonic Personal Air Samplers (UPAS) fitted with <2.5μm (micrometer) and <10 μm size-selective inlets operated for 16 hours (total 1.92m3), and with a Coriolis Biosampler over 10 minutes (total 1.5m3). Samples were assayed for viable SARS-CoV-2 virus and for the viral genome by multiplex PCR using the E and N protein target sequences. We validated the sampling methods by inoculating gelatin filters with viable vesicular stomatitis virus (VSV), and with three concentrations of viable SARS-CoV-2, operating personal samplers for 16hrs, and quantifying viable virus recovery by TCID50 assay. RESULTS In total, 138 samples were collected from 99 rooms. RNA samples were positive in 9.1% (6/66) of samples obtained with the UPAS 2.5μm samplers, 13.5% (7/52) with the UPAS 10μm samplers, and 10.0% (2/20) samples obtained with the Coriolis samplers. Culturable virus was not recovered in any samples. Viral RNA was detected in 15.1% of the rooms sampled. There was no significant difference in viral RNA recovery between the different room locations or samplers. Method development experiments indicated minimal loss of SARS-CoV-2 viability via the personal air sampler operation.
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Affiliation(s)
- Gary Mallach
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - Samantha B. Kasloff
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Tom Kovesi
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Anand Kumar
- Sections of Critical Care Medicine and Infectious Diseases, Departments of Medicine, Medical Microbiology and Pharmacology, University of Manitoba, Winnipeg, Canada
| | - Ryan Kulka
- Water and Air Quality Bureau, Health Canada, Ottawa, Canada
| | - Jay Krishnan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Benoit Robert
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Michaeline McGuinty
- Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | | | - Bashour Yazji
- Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Todd Cutts
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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19
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Morrow JB, Packman AI, Martinez KF, Van Den Wymelenberg K, Goeres D, Farmer DK, Mitchell J, Ng L, Hazi Y, Schoch-Spana M, Quinn S, Bahnfleth W, Olsiewski P. Critical Capability Needs for Reduction of Transmission of SARS-CoV-2 Indoors. Front Bioeng Biotechnol 2021; 9:641599. [PMID: 34660544 PMCID: PMC8513777 DOI: 10.3389/fbioe.2021.641599] [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: 12/14/2020] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
Coordination of efforts to assess the challenges and pain points felt by industries from around the globe working to reduce COVID-19 transmission in the indoor environment as well as innovative solutions applied to meet these challenges is mandatory. Indoor infectious viral disease transmission (such as coronavirus, norovirus, influenza) is a complex problem that needs better integration of our current knowledge and intervention strategies. Critical to providing a reduction in transmission is to map the four core technical areas of environmental microbiology, transmission science, building science, and social science. To that end a three-stage science and innovation Summit was held to gather information on current standards, policies and procedures applied to reduce transmission in built spaces, as well as the technical challenges, science needs, and research priorities. The Summit elucidated steps than can be taken to reduce transmission of SARS-CoV-2 indoors and calls for significant investments in research to enhance our knowledge of viral pathogen persistence and transport in the built environment, risk assessment and mitigation strategy such as processes and procedures to reduce the risk of exposure and infection through building systems operations, biosurveillance capacity, communication form leadership, and stakeholder engagement for optimal response. These findings reflect the effective application of existing knowledge and standards, emerging science, and lessons-learned from current efforts to confront SARS-CoV-2.
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Affiliation(s)
- Jayne B. Morrow
- Center for Biofilm Engineering, Montana State University, Bozeman, MT, United States
- Integrated Bioscience and Built Environment Consortium (IBEC), Sanford, FL, United States
| | - Aaron I. Packman
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL, United States
| | - Kenneth F. Martinez
- Integrated Bioscience and Built Environment Consortium (IBEC), Sanford, FL, United States
- HWC Inc., Washington, DC, United States
| | - Kevin Van Den Wymelenberg
- Biology and the Built Environment Center, College of Design, Institute for Health in the Built Environment, University of Oregon, Eugene, OR, United States
| | - Darla Goeres
- Center for Biofilm Engineering, Montana State University, Bozeman, MT, United States
| | - Delphine K. Farmer
- Department of Chemistry, Colorado State University, Fort Collins, CO, United States
| | - Jade Mitchell
- Department of Biosystems Engineering, Michigan State University, East Lansing, MI, United States
| | - Lisa Ng
- Engineering Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, United States
| | - Yair Hazi
- HWC Inc., Washington, DC, United States
| | - Monica Schoch-Spana
- Johns Hopkins Center for Health Security, John Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sandra Quinn
- Department of Family Science and Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, United States
| | - William Bahnfleth
- Department of Architectural Engineering, The Pennsylvania State University, University Park, PA, United States
| | - Paula Olsiewski
- Johns Hopkins Center for Health Security, John Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
- Alfred P. Sloan Foundation, New York, NY, United States
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Comparison of SARS-CoV-2 PCR-Based Detection Using Saliva or Nasopharyngeal Swab Specimens in Asymptomatic Populations. Microbiol Spectr 2021; 9:e0006221. [PMID: 34431689 PMCID: PMC8552704 DOI: 10.1128/spectrum.00062-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has challenged clinical diagnostic operations due to supply shortages and high staffing needs to collect nasopharyngeal (NP) swab samples. Saliva is an easily accessible alternative specimen type to overcome some of these challenges. In this study, we first used paired saliva and NP swab specimens (n = 128) to compare test performance characteristics with three RNA extraction platforms, i.e., Maxwell RSC (Promega), MagNA Pure 96 (Roche), and KingFisher Flex (Thermo Fisher Scientific), together with two PCR chemistries, i.e., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (2019-nCoV) Centers for Disease Control and Prevention (CDC) quantitative PCR (qPCR) probe assay (Integrated DNA Technologies) and TagPath COVID-19 combination kit (Thermo Fisher Scientific). This study demonstrated that both saliva and NP swab specimens performed well, with 97% agreement when tested by the CDC qPCR chemistry using Maxwell and MagNA Pure RNA extraction platforms. We then compared 12 weeks of saliva and NP swab testing results using two independent asymptomatic populations, including a community surveillance program using saliva samples only (n = 466) and preoperative screening using NP swab samples only (n = 8,461). The positive detection rates among participants with either saliva or NP swab samples were 1.07% and 1.12%, respectively, which confirms the low pretest probabilities for COVID-19 infections in asymptomatic populations. Notably, there was no increased proportion of low-titer cases (inconclusive results) reported in the asymptomatic groups, compared with the all-comers groups (0.21% and 0.66%, respectively, in the community population and 0.25% and 0.49%, respectively, in the preoperative population); this suggests that low-viral-titer carriers can be found similarly in both groups with saliva or NP swab specimens. In summary, saliva can be considered a good alternative for noninvasive but well-instructed self-collection. IMPORTANCE Our study shows that saliva is a noninvasive respiratory secretion sample type that contains equal or more host materials (RNase P), compared with those contained in the corresponding NP swab specimens, in 103 paired samples. SARS-CoV-2 detection with two RNA extraction platforms, Maxwell and MagNA Pure, with CDC qPCR chemistry showed similar test sensitivities for paired specimens. We then analyzed SARS-CoV-2 detections rates in two independent groups of asymptomatic participants, i.e., a group at a community screening station with supervised saliva collection only (n = 466) and a preoperative screening group (n = 8,461) with NP swabbing only. Similar detection rates of 1.07% for the community group and 1.12% for the preoperative group supported the similar test performances in these groups predicted to have low pretest probabilities of infection. With mindful preparation, saliva can be considered for schools and clinical participants when adequate collection education can be provided and compliance can be established.
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21
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Padmanabhan R, Abed HS, Meskin N, Khattab T, Shraim M, Al-Hitmi MA. A review of mathematical model-based scenario analysis and interventions for COVID-19. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 209:106301. [PMID: 34392001 PMCID: PMC8314871 DOI: 10.1016/j.cmpb.2021.106301] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/17/2021] [Indexed: 05/11/2023]
Abstract
Mathematical model-based analysis has proven its potential as a critical tool in the battle against COVID-19 by enabling better understanding of the disease transmission dynamics, deeper analysis of the cost-effectiveness of various scenarios, and more accurate forecast of the trends with and without interventions. However, due to the outpouring of information and disparity between reported mathematical models, there exists a need for a more concise and unified discussion pertaining to the mathematical modeling of COVID-19 to overcome related skepticism. Towards this goal, this paper presents a review of mathematical model-based scenario analysis and interventions for COVID-19 with the main objectives of (1) including a brief overview of the existing reviews on mathematical models, (2) providing an integrated framework to unify models, (3) investigating various mitigation strategies and model parameters that reflect the effect of interventions, (4) discussing different mathematical models used to conduct scenario-based analysis, and (5) surveying active control methods used to combat COVID-19.
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Affiliation(s)
| | - Hadeel S Abed
- Department of Electrical Engineering, Qatar University, Qatar.
| | - Nader Meskin
- Department of Electrical Engineering, Qatar University, Qatar.
| | - Tamer Khattab
- Department of Electrical Engineering, Qatar University, Qatar.
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Qatar.
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22
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Hetemäki I, Kääriäinen S, Alho P, Mikkola J, Savolainen-Kopra C, Ikonen N, Nohynek H, Lyytikäinen O. An outbreak caused by the SARS-CoV-2 Delta variant (B.1.617.2) in a secondary care hospital in Finland, May 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34328076 PMCID: PMC8323455 DOI: 10.2807/1560-7917.es.2021.26.30.2100636] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An outbreak caused by the SARS-CoV-2 Delta variant (B.1.617.2) spread from one inpatient in a secondary care hospital to three primary care facilities, resulting in 58 infections including 18 deaths in patients and 45 infections in healthcare workers (HCW). Only one of the deceased cases was fully vaccinated. Transmission occurred despite the use of personal protective equipment by the HCW, as advised in national guidelines, and a high two-dose COVID-19 vaccination coverage among permanent staff members in the COVID-19 cohort ward.
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Affiliation(s)
- Iivo Hetemäki
- Translational Immunology Program, Helsinki University and Helsinki University Central Hospital, Helsinki, Finland.,Infectious Diseases Unit, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Sohvi Kääriäinen
- Finnish Institute for Health and Welfare, Helsinki, Finland.,ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | - Pirjo Alho
- Infectious Diseases Unit, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Janne Mikkola
- Infectious Diseases Unit, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | | | - Niina Ikonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Nohynek
- Finnish Institute for Health and Welfare, Helsinki, Finland
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23
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Budaev S. Safety and Reverence: How Roman Catholic Liturgy Can Respond to the COVID-19 Pandemic. JOURNAL OF RELIGION AND HEALTH 2021; 60:2331-2352. [PMID: 34031781 PMCID: PMC8143074 DOI: 10.1007/s10943-021-01282-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 05/24/2023]
Abstract
The current COVID-19 pandemic is a major challenge for many religious denominations. The Roman Catholic Church strongly depends on physical communal worship and sacraments. Disagreements grow concerning the best balance between safety and piety. To address this issue, I review the major transmission risks for the SARS-CoV-2 virus and list certain measures to enhance the safety of the Roman Catholic Liturgy without compromising its intrinsic beauty and reverent spiritual attitude. This can be achieved through assimilation of several traditional elements into the modern liturgy. I emphasize that religious leadership and decision-making should be transparent and based on inclusiveness, pluralism, best scientific evidence and voluntary cooperation.
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Affiliation(s)
- Sergey Budaev
- Department of Biological Sciences, University of Bergen, Postboks 7803, 5020, Bergen, Norway.
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24
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Darcis G, Bouquegneau A, Maes N, Thys M, Henket M, Labye F, Rousseau AF, Canivet P, Desir C, Calmes D, Schils R, De Worm S, Léonard P, Meunier P, Moutschen M, Louis R, Guiot J. Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study. Int J Infect Dis 2021; 109:209-216. [PMID: 34273510 PMCID: PMC8278829 DOI: 10.1016/j.ijid.2021.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Various symptoms and considerable organ dysfunction persist following infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Uncertainty remains about the potential mid- and long-term health sequelae. This prospective study of patients hospitalized with coronavirus disease 2019 (COVID-19) in Liège University Hospital, Belgium aimed to determine the persistent consequences of COVID-19. Methods Patients admitted to the University Hospital of Liège with moderate-to-severe confirmed COVID-19, discharged between 2 March and 1 October 2020, were recruited prospectively. Follow-up at 3 and 6 months after hospital discharge included demographic and clinical data, biological data, pulmonary function tests (PFTs) and high-resolution computed tomography (CT) scans of the chest. Results In total, 199 individuals were included in the analysis. Most patients received oxygen supplementation (80.4%). Six months after discharge, 47% and 32% of patients still had exertional dyspnoea and fatigue. PFTs at 3-month follow-up revealed a reduced diffusion capacity of carbon monoxide (mean 71.6 ± 18.6%), and this increased significantly at 6-month follow-up (P<0.0001). Chest CT scans showed a high prevalence (68.9% of the cohort) of persistent abnormalities, mainly ground glass opacities. Duration of hospitalization, intensive care unit admission and mechanical ventilation were not associated with the persistence of symptoms 3 months after discharge. Conclusion The prevalence of persistent symptoms following hospitalization with COVID-19 is high and stable for up to 6 months after discharge. However, biological, functional and iconographic abnormalities improved significantly over time.
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Affiliation(s)
- Gilles Darcis
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium.
| | - Antoine Bouquegneau
- Department of Nephrology-Dialysis-Transplantation, University Hospital of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Marie Thys
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Monique Henket
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Florence Labye
- Department of Internal Medicine, University Hospital of Liège, Liège, Belgium
| | | | - Perrine Canivet
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Colin Desir
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Doriane Calmes
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Raphael Schils
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Sophie De Worm
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Philippe Léonard
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Renaud Louis
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Julien Guiot
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
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25
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Vanroye F, den Bossche DV, Brosius I, Tack B, Esbroeck MV, Jacobs J. COVID-19 Antibody Detecting Rapid Diagnostic Tests Show High Cross-Reactivity When Challenged with Pre-Pandemic Malaria, Schistosomiasis and Dengue Samples. Diagnostics (Basel) 2021; 11:diagnostics11071163. [PMID: 34202195 PMCID: PMC8305106 DOI: 10.3390/diagnostics11071163] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 Antibody Detecting Rapid Diagnostic Tests (COVID-19 Ab RDTs) are the preferred tool for SARS-CoV-2 seroprevalence studies, particularly in low- and middle-income countries. The present study challenged COVID-19 Ab RDTs with pre-pandemic samples of patients exposed to tropical pathogens. A retrospective study was performed on archived serum (n = 94) and EDTA whole blood (n = 126) samples obtained during 2010–2018 from 196 travelers with malaria (n = 170), schistosomiasis (n = 25) and dengue (n = 25). COVID-19 Ab RDTs were selected based on regulatory approval status, independent evaluation results and detecting antigens. Among 13 COVID-19 Ab RDT products, overall cross-reactivity was 18.5%; cross-reactivity for malaria, schistosomiasis and dengue was 20.3%, 18.1% and 7.5%, respectively. Cross-reactivity for current and recent malaria, malaria antibodies, Plasmodium species and parasite densities was similar. Cross-reactivity among the different RDT products ranged from 2.7% to 48.9% (median value 14.5%). IgM represented 67.9% of cross-reactive test lines. Cross-reactivity was not associated with detecting antigens, patient categories or disease (sub)groups, except for schistosomiasis (two products with ≥60% cross-reactivity). The high cross-reactivity for malaria, schistosomiasis and—to a lesser extent—dengue calls for risk mitigation when using COVID-19 Ab RDTs in co-endemic regions.
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Affiliation(s)
- Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Correspondence:
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Bieke Tack
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
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26
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Nizami DJ, Raman V, Paulose L, Hazari KS, Mallick AK. Role of laboratory biomarkers in assessing the severity of COVID-19 disease. A cross-sectional study. J Family Med Prim Care 2021; 10:2209-2215. [PMID: 34322414 PMCID: PMC8284239 DOI: 10.4103/jfmpc.jfmpc_145_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 03/22/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Corona virus disease 2019 (Covid-19) has high infectivity and mortality rate. Covid-19 patients can suddenly deteriorate and develop life threatening complications. Hence, there is a need to identify laboratory biomarkers in order to categorize high risk patients. The main purpose of the study is to investigate the role and correlation of laboratory parameters such as total leucocyte count (TLC), absolute lymphocyte count, platelet count, C-Reactive Proteins (CRP), serum ferritin, serum lactate dehydrogenase (LDH), serum procalcitonin and D-dimer in severe and non-severe Covid-19 patients. METHODOLOGY This retrospective cross-sectional study was conducted at Latifa Women and Child Hospital in the UAE after obtaining ethical committee clearance. Based on the symptoms and the criteria by National Institute of Health, USA, 109 patients were divided into three groups: Non-severe with 75, severe with 18 and critical with 16 patients. Laboratory data of these patients were assessed through the electronic medical records (SALAMA). Statistical analysis was done using Statistical Packages for Social Sciences (SPSS) version 25.0 (SPSS/PC; SPSS-25.0, Chicago, USA). Laboratory test profiles were expressed as mean (SD). Independent 't' test and ANOVA were used to study the significance of means. P value less than 0.05 was considered significant. RESULT Males were more severely affected than females. Severe and critically ill Covid-19 patients had a significantly higher TLC, serum LDH, ferritin and CRP and lower absolute lymphocyte count. PCT and D-dimer were significantly elevated in critical group. CONCLUSION Along with clinical presentation and radiological findings, biochemical parameter may also be considered as important predictors for assessing severity in covid-19 patients.
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Affiliation(s)
- Deba J. Nizami
- Department of Obstetrics and Gynecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE
| | - Vidya Raman
- Department of Obstetrics and Gynecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE
| | - L. Paulose
- Department of Obstetrics and Gynecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE
| | - Komal S. Hazari
- Department of Obstetrics and Gynecology, Latifa Hospital, Dubai Health Authority, Dubai, UAE
| | - Ayaz K. Mallick
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
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27
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Sriraman K, Shaikh A, Parikh S, Udupa S, Chatterjee N, Shastri J, Mistry N. Non-invasive adapted N-95 mask sampling captures variation in viral particles expelled by COVID-19 patients: Implications in understanding SARS-CoV2 transmission. PLoS One 2021; 16:e0249525. [PMID: 33844696 PMCID: PMC8041197 DOI: 10.1371/journal.pone.0249525] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/21/2021] [Indexed: 01/12/2023] Open
Abstract
Infectious respiratory particles expelled by SARS-CoV-2 positive patients are attributed to be the key driver of COVID-19 transmission. Understanding how and by whom the virus is transmitted can help implement better disease control strategies. Here we have described the use of a noninvasive mask sampling method to detect and quantify SARS-CoV-2 RNA in respiratory particles expelled by COVID-19 patients and discussed its relationship to transmission risk. Respiratory particles of 31 symptomatic SARS-CoV-2 positive patients and 31 asymptomatic healthy volunteers were captured on N-95 masks layered with a gelatin membrane in a 30-minute process that involved talking/reading, coughing, and tidal breathing. SARS-CoV-2 viral RNA was detected and quantified using rRT-PCR in the mask and in concomitantly collected nasopharyngeal swab (NPS) samples. The data were analyzed with respect to patient demographics and clinical presentation. Thirteen of 31(41.9%) patients showed SARS-COV-2 positivity in both the mask and NPS samples, while 16 patients were mask negative but NPS positive. Two patients were both mask and NPS negative. All healthy volunteers except one were mask and NPS negative. The mask positive patients had significantly lower NPS Ct value (26) compared to mask negative patients (30.5) and were more likely to be rapid antigen test positive. The mask positive patients could be further grouped into low emitters (expelling <100 viral copies) and high emitters (expelling >1000 viral copies). The study presents evidence for variation in emission of SARS-CoV-2 virus particles by COVID-19 patients reflecting differences in infectivity and transmission risk among individuals. The results conform to reported secondary infection rates and transmission and also suggest that mask sampling could be explored as an effective tool to assess individual transmission risks, at different time points and during different activities.
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Affiliation(s)
| | - Ambreen Shaikh
- The Foundation for Medical Research, Mumbai, Maharashtra, India
| | - Swapneil Parikh
- Molecular Laboratory, Viral Research, and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Sane Guruji Marg, Mumbai, Maharashtra, India
| | - Shreevatsa Udupa
- Molecular Laboratory, Viral Research, and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Sane Guruji Marg, Mumbai, Maharashtra, India
| | - Nirjhar Chatterjee
- Molecular Laboratory, Viral Research, and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Sane Guruji Marg, Mumbai, Maharashtra, India
| | - Jayanthi Shastri
- Molecular Laboratory, Viral Research, and Diagnostic Laboratory, Kasturba Hospital for Infectious Diseases, Sane Guruji Marg, Mumbai, Maharashtra, India
- Department of Microbiology, BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Nerges Mistry
- The Foundation for Medical Research, Mumbai, Maharashtra, India
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28
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Tsuchida T, Nitahara Y, Suzuki S, Komase Y, Candray K, Kido Y, Nakagama Y, Yamasaki Y, Imamura M, Kawahata K, Kunishima H, Fujitani S, Mineshita M, Matsuda T. Back to normal; serological testing for COVID-19 diagnosis unveils missed infections. J Med Virol 2021; 93:4549-4552. [PMID: 33739483 PMCID: PMC8250857 DOI: 10.1002/jmv.26949] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/03/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022]
Abstract
Background The gold standard for coronavirus disease (COVID‐19) diagnosis has been the detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA by nucleic acid amplification testing (NAAT). On the other hand, serological testing for COVID‐19 may offer advantages in detecting possibly overlooked infections by NAAT. Methods To evaluate seroconversion of NAAT‐negative pneumonia patients, immunoglobulin M (IgM) and IgG targeting the spike protein of SARS‐CoV‐2 were semiquantified by an immunofluorescence assay. Seroconversion was confirmed by another serological method, targeting the nucleocapsid protein. Results Eight suspected but unconfirmed COVID‐19 pneumonia patients (median age, 39 years; range, 21–55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2–27 days). None of them had tested positive for SARS‐CoV‐2 by NAAT. In contrast, all eight patients revealed seropositivity with the two serological methods, indicating actual seroconversion against SARS‐CoV‐2. The median period between onset and blood sampling was 26.5 days (7–51 days). Conclusion Eight patients with COVID‐19 pneumonia, initially tested negative for SARS‐CoV‐2 by NAAT, were finally confirmed of the diagnosis by serological testing. To cover the whole spectrum of this heterogenous infectious disease, serology testing should be implemented to the multitiered diagnostic algorithm for COVID‐19.
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Affiliation(s)
- Tomoya Tsuchida
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Nitahara
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shotaro Suzuki
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Yokohama, Japan
| | - Katherine Candray
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yasutoshi Kido
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yu Nakagama
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yukitaka Yamasaki
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Mitsuru Imamura
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kimito Kawahata
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shigeki Fujitani
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masamichi Mineshita
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takahide Matsuda
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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29
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Schultz É, Ward JK, Atlani-Duault L, Holmes SM, Mancini J. French Public Familiarity and Attitudes toward Clinical Research during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052611. [PMID: 33807787 PMCID: PMC7967331 DOI: 10.3390/ijerph18052611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic put clinical research in the media spotlight globally. This article proposes a first measure of familiarity with and attitude toward clinical research in France. Drawing from the “Health Literacy Survey 2019” (HLS19) conducted online between 27 May and 5 June 2020 on a sample of the French adult population (N = 1003), we show that a significant proportion of the French population claimed some familiarity with clinical trials (64.8%) and had positive attitudes (72%) toward them. One of the important findings of this study is that positive attitudes toward clinical research exist side by side with a strong distancing from the pharmaceutical industry. While respondents acknowledged that the pharmaceutical industry plays an important role in clinical research (68.3%), only one-quarter indicated that they trust the industry (25.7%). Positive attitudes toward clinical trials were associated with familiarity with clinical trials (Odds Ratio, OR 2.97 [1.90–4.63]), financial difficulties (OR 0.63 [0.46–0.85]), as well as mistrust of doctors (0.48 [0.27–0.85]) and of scientists (OR 0.62 [0.38–0.99]). Although the French media provided a great deal of information on how clinical research works during the first months of the pandemic, there remains profound mistrust of the pharmaceutical industry in France. This suspicion can undermine crisis management, especially in the areas of vaccine development and preparation for future pandemics.
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Affiliation(s)
- Émilien Schultz
- CEPED (UMR 196), Université de Paris, IRD, 75006 Paris, France;
- SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, CANBIOS Team (Équipe Labellisée LIGUE 2019), Aix-Marseille University, INSERM, IRD, 13009 Marseille, France; (S.M.H.); (J.M.)
- Correspondence:
| | - Jeremy K. Ward
- CERMES3, INSERM, CNRS, EHESS, Université de Paris, 94801 Villejuif, France;
- VITROME, Aix-Marseille University, IRD, AP-HM, SSA, 13005 Marseille, France
| | - Laëtitia Atlani-Duault
- CEPED (UMR 196), Université de Paris, IRD, 75006 Paris, France;
- Institut COVID-19 Add Memoriam, University of Paris, 75006 Paris, France
- WHO Collaborative Center for Research on Health and Humanitarian Policies and Practices, IRD, Université de Paris, 75006 Paris, France
| | - Seth M. Holmes
- SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, CANBIOS Team (Équipe Labellisée LIGUE 2019), Aix-Marseille University, INSERM, IRD, 13009 Marseille, France; (S.M.H.); (J.M.)
- Society and Environment, Medical Anthropology, and Public Health, University of Berkeley, Berkeley, CA 94720, USA
- Mediterranean Institute for Advanced Study IMéRA, Institut Paoli Calmettes, Aix-Marseille University, 13004 Marseille, France
| | - Julien Mancini
- SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, CANBIOS Team (Équipe Labellisée LIGUE 2019), Aix-Marseille University, INSERM, IRD, 13009 Marseille, France; (S.M.H.); (J.M.)
- BioSTIC, APHM, Timone, 13005 Marseille, France
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30
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Azimi P, Keshavarz Z, Cedeno Laurent JG, Stephens B, Allen JG. Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission. Proc Natl Acad Sci U S A 2021; 118:e2015482118. [PMID: 33536312 PMCID: PMC7923347 DOI: 10.1073/pnas.2015482118] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Several lines of existing evidence support the possibility of airborne transmission of coronavirus disease 2019 (COVID-19). However, quantitative information on the relative importance of transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains limited. To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we developed a modeling framework and leveraged detailed information available from the Diamond Princess cruise ship outbreak that occurred in early 2020. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors. A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases across the entire simulation period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of larger respiratory droplets and smaller respiratory aerosols were 41% and 59%, respectively. Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among the passengers, even considering a conservative assumption of high ventilation rates and no air recirculation conditions for the cruise ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions.
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Affiliation(s)
- Parham Azimi
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115;
| | - Zahra Keshavarz
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | | | - Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL 60616
| | - Joseph G Allen
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115;
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31
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Azimi P, Keshavarz Z, Cedeno Laurent JG, Stephens B, Allen JG. Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission. Proc Natl Acad Sci U S A 2021. [PMID: 33536312 DOI: 10.1101/2020.07.13.20153049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Several lines of existing evidence support the possibility of airborne transmission of coronavirus disease 2019 (COVID-19). However, quantitative information on the relative importance of transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains limited. To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we developed a modeling framework and leveraged detailed information available from the Diamond Princess cruise ship outbreak that occurred in early 2020. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors. A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases across the entire simulation period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of larger respiratory droplets and smaller respiratory aerosols were 41% and 59%, respectively. Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among the passengers, even considering a conservative assumption of high ventilation rates and no air recirculation conditions for the cruise ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions.
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Affiliation(s)
- Parham Azimi
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115;
| | - Zahra Keshavarz
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | | | - Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL 60616
| | - Joseph G Allen
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115;
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Cohen JF, Korevaar DA, Matczak S, Chalumeau M, Allali S, Toubiana J. COVID-19-Related Fatalities and Intensive-Care-Unit Admissions by Age Groups in Europe: A Meta-Analysis. Front Med (Lausanne) 2021; 7:560685. [PMID: 33521004 PMCID: PMC7840596 DOI: 10.3389/fmed.2020.560685] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives: Precise international estimates of the age breakdown of COVID-19–related deaths and intensive-care-unit (ICU) admissions are lacking. We evaluated the distribution of COVID-19–related fatalities and ICU admissions by age groups in Europe. Materials and methods: On April 6, 2020, we systematically reviewed official COVID-19–related data from 32 European countries. We included countries that provided data regarding more than 10 COVID-19–related deaths stratified by age according to pre-specified age groups (i.e., <40, 40–69, ≥70 years). We used random-effects meta-analysis to summarize the data. Results: Thirteen European countries were included in the review, for a total of 31,864 COVID-19–related deaths (range: 27–14,381 per country). In the main meta-analysis (including data from Germany, Hungary, Italy, The Netherlands, Portugal, Spain, Switzerland; 21,522 COVID-19–related fatalities), the summary proportions of individuals <40, 40–69, and ≥70 years old among all COVID-19–related deaths were 0.1% (0.0–0.2; I2 28.6%), 13.0% (10.8–15.4; I2 91.5%), and 86.6% (84.2–88.9; I2 91.5%), respectively. ICU data were available for four countries (France, Greece, Spain, Sweden). The summary proportions of individuals around <40–50, around 40–69, and around ≥60–70 years old among all COVID-19–related ICU admissions were 5.4% (3.4–7.8; I2 89.0%), 52.6% (41.8–63.3; I2 98.1%), and 41.8% (32.0–51.9; I2 99%), respectively. Conclusions: People under 40 years old represent a small fraction of most severe COVID-19 cases in Europe. These results may help health authorities respond to public concerns and guide future physical distancing and mitigation strategies. Specific measures to protect older people should be considered.
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Affiliation(s)
- Jérémie F Cohen
- Université de Paris, Centre of Research in Epidemiology and Statistics-CRESS, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Soraya Matczak
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Martin Chalumeau
- Université de Paris, Centre of Research in Epidemiology and Statistics-CRESS, INSERM, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Slimane Allali
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
| | - Julie Toubiana
- Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker Hospital for Sick Children, Université de Paris, Paris, France
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Meyerowitz EA, Richterman A. A defense of the classical model of transmission of respiratory pathogens. Clin Infect Dis 2021; 73:1318. [PMID: 33433558 DOI: 10.1093/cid/ciab016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eric A Meyerowitz
- Division of Infectious Diseases, Montefiore Medical Center, Bronx, New York
| | - Aaron Richterman
- Division of Infectious Diseases, Hospital of the University of Pennsylvania, Philadelphia, New York
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Mattoli S. Filling the Gap Until Full Vaccine Deployment in the War on Coronavirus Disease-19. Infect Dis Ther 2021; 10:27-34. [PMID: 33420955 PMCID: PMC7796690 DOI: 10.1007/s40121-020-00394-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 12/05/2022] Open
Abstract
The authorization for emergency use of a vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been issued in diverse countries in December 2020, and additional vaccine candidates soon may be cleared for a similar emergency use. If it is reasonable to believe that in some Western countries most people may be vaccinated by the end of 2021, insufficient supplies, access inequities across countries, and deficiencies in enforcing the participatory engagement of communities will present important challenges for the achievement of sufficient vaccination coverage worldwide in less than 2–3 years. A possible strategy for bridging the gap until full vaccine deployment is based on the integration of improved non-pharmaceutical measures and recently authorized pharmaceutical interventions to reduce as much as possible hospitalizations and deaths in the coming months, when recurring infection peaks are expected.
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Affiliation(s)
- Sabrina Mattoli
- Center of Expertise in Research and Innovation of the International Network for the Advancement of Viable Applicable Innovations in Life Sciences (InAvail), Basel, Switzerland. .,Avail Biomedical Research Institute, Munich, Germany.
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Shirley DA, Moonah S. COVID-19 and Corticosteroids: Unfamiliar but Potentially Fatal Infections That Can Arise following Short-Course Steroid Treatment. Am J Trop Med Hyg 2021; 104:790-793. [PMID: 33410395 PMCID: PMC7941796 DOI: 10.4269/ajtmh.20-1471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic complications in patients exposed to corticosteroids, even with short treatment courses. To prevent lethal outcomes, clinicians should be aware of the threat these two parasitic infections pose to at-risk patients receiving corticosteroids, especially in the era of COVID-19.
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Affiliation(s)
- Debbie-Ann Shirley
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
| | - Shannon Moonah
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
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Guedes AR, Tavares BDM, de Assis DB, Freire MP, Madalosso G, Levin AS, Perdigão LV, de Oliveira MS. Statewide evaluation of infection control measures for preventing coronavirus disease 2019 in hemodialysis facilities. Clinics (Sao Paulo) 2021; 76:e3299. [PMID: 34644739 PMCID: PMC8478131 DOI: 10.6061/clinics/2021/e3299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/14/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases. METHODS We conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in São Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic. RESULTS A total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had ≥1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86). CONCLUSION Attention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.
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Affiliation(s)
- Ana Rubia Guedes
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Corresponding author. E-mail:
| | - Bruno de Melo Tavares
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Denise Brandão de Assis
- Divisao de Infeccoes Hospitares, Centro de Vigilancia Epidemiologica “Prof. Alexandre Vranjac”, Centro de Controle de Doencas, Secretaria de Estado da Saude, Sao Paulo, SP, BR
| | - Maristela Pinheiro Freire
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Geraldine Madalosso
- Divisao de Infeccoes Hospitares, Centro de Vigilancia Epidemiologica “Prof. Alexandre Vranjac”, Centro de Controle de Doencas, Secretaria de Estado da Saude, Sao Paulo, SP, BR
| | - Anna S. Levin
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Departamento de Doencas Infecciosas, Laboratorio de Investigacao Medica - LIM 49 e Instituto de Medicina Tropical, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Lauro Vieira Perdigão
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Maura Salaroli de Oliveira
- Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Hausdorff WP, Flores J. Low-dose and oral exposure to SARS-CoV-2 may help us understand and prevent severe COVID-19. Int J Infect Dis 2020; 103:37-41. [PMID: 33227512 PMCID: PMC7678432 DOI: 10.1016/j.ijid.2020.11.171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 12/29/2022] Open
Abstract
Background The effectiveness and sustainability of current public health interventions designed to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission remain of great concern in many settings, especially in the absence of a transmission-preventing vaccine. Hypothesis It was hypothesized that a more targeted set of interventions focusing on preventing severe coronavirus disease 2019 (COVID-19), rather than SARS-CoV-2 transmission, would be less disruptive to society. To identify these, it would be helpful to better understand how the infecting dose of SARS-CoV-2 and its route of infection influence the clinical outcome, immunological protection, and likelihood of onward transmission. Proposal It is suggested that carefully controlled human infection model (CHIM) studies involving intranasal and oral administration of progressively increasing doses of SARS-CoV-2, starting with low levels, to healthy young adult volunteers may be the most expeditious and definitive way to answer these questions. Such studies would differ in objective from CHIM proposals designed to expedite vaccine development, although the latter might be adapted to address some of the questions raised here. Implications Results from the studies proposed here could help elucidate the relationship of infection to COVID-19 and thereby provide a scientific basis for more targeted and sustainable application of public health control measures, and inform the design of improved immunotherapeutics and more targeted vaccine development.
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Affiliation(s)
- William P Hausdorff
- PATH, 455 Massachusetts Ave NW, Washington DC 20001, USA; Université de Bruxelles, Brussels, Belgium.
| | - Jorge Flores
- PATH, 455 Massachusetts Ave NW, Washington DC 20001, USA.
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