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Tański W, Tomasiewicz A, Jankowska-Polańska B. Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations-An Uncontrolled Prospective Observational Pilot Study. J Clin Med 2024; 13:839. [PMID: 38337533 PMCID: PMC10856322 DOI: 10.3390/jcm13030839] [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: 12/20/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
The COVID-19 pandemic represents a global health and social challenge. However, the impact of a SARS-CoV-2 infection itself on mental health and sleep quality remains poorly understood. The purpose of the present uncontrolled prospective observational pilot study was to evaluate the impact of past COVID-19 disease on the incidence of quantitative and qualitative sleep disturbances. A group of 61 subjects (37 female, 24 male) reported sleep disturbances that had lasted for at least one month and had started after recovery from COVID-19. The study used self-reported instruments: the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI), as well as an objective method-actigraphy-for quantitative analysis of sleep architecture. It was shown that sleep disturbances most commonly started after recovery (68.3%, n = 41) and lasted for more than one month (83.6%, n = 51). ESS scores of 7.8 ± 5.0 points indicate moderate daytime sleepiness, and ISI scores of 16.3 ± 5.8 points denote moderate insomnia. ESS scores were negatively correlated with total time in bed (r = -0.3780, p = 0.003), total sleep time (r = -0.2969, p = 0.020), and wakefulness after sleep onset (r = -0.2654, p = 0.039). In addition, ESS scores were correlated negatively with the respondents' age (B = -0.17, p = 0.000) and time from COVID-19 onset. A positive correlation was found between wakefulness after sleep onset and ESS scores (B = -0.05, p = 0.039). ISI scores were positively correlated with time in bed (r = 0.3275, p = 0.010). Female gender was found to be a significant predictor of insomnia's severity (B = 2.159, t = 3.04, p = 0.004). In conclusion, patients with a history of COVID-19 report long-lasting sleep disturbances that do not subside spontaneously. In the patient group studied, moderate levels of daytime sleepiness and insomnia were found. The most frequently reported problems included irregular sleep, frequent awakenings, and difficulty maintaining sleep, while normal sleep duration was preserved. These findings underscore the need for continued attention to the long-term consequences of COVID-19 on sleep health and emphasize the importance of targeted interventions to address these enduring sleep disturbances in affected individuals.
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Affiliation(s)
- Wojciech Tański
- Department of Internal Medicine, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland;
- Faculty of Medicine, Wrocław University of Science and Technology, 50-376 Wroclaw, Poland
| | - Anna Tomasiewicz
- Student Research Club of Surgical Specialties, Wroclaw Medical University, 50-532 Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Faculty of Medicine, Wrocław University of Science and Technology, 50-376 Wroclaw, Poland
- Center for Research and Innovation, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland
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2
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Aogo RA, Zambrana JV, Sanchez N, Ojeda S, Kuan G, Balmaseda A, Gordon A, Harris E, Katzelnick LC. Effects of boosting and waning in highly exposed populations on dengue epidemic dynamics. Sci Transl Med 2023; 15:eadi1734. [PMID: 37967199 PMCID: PMC11001200 DOI: 10.1126/scitranslmed.adi1734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/13/2023] [Indexed: 11/17/2023]
Abstract
Sequential infection with multiple dengue virus (DENV) serotypes is thought to induce enduring protection against dengue disease. However, long-term antibody waning has been observed after repeated DENV infection. Here, we provide evidence that highly immune Nicaraguan children and adults (n = 4478) experience boosting and waning of antibodies during and after major Zika and dengue epidemics. We develop a susceptible-infected-recovered-susceptible (SIRS-type) model that tracks immunity by titer rather than number of infections to show that boosts in highly immune individuals can contribute to herd immunity, delaying their susceptibility to transmissible infection. In contrast, our model of lifelong immunity in highly immune individuals, as previously assumed, results in complete disease eradication after introduction. Periodic epidemics under this scenario can only be sustained with a constant influx of infected individuals into the population or a high basic reproductive number. We also find that Zika virus infection can boost DENV immunity and produce delays and then surges in dengue epidemics, as observed with real epidemiological data. This work provides insight into factors shaping periodicity in dengue incidence and may inform vaccine efforts to maintain population immunity.
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Affiliation(s)
- Rosemary A. Aogo
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Jose Victor Zambrana
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, 12014, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, 14007, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, 16064, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720-3370, USA
| | - Leah C. Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
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Rotundo S, Borelli M, Scaglione V, Lionello R, Biamonte F, Olivadese V, Quirino A, Morrone HL, Matera G, Costanzo FS, Russo A, Trecarichi EM, Torti C. Interleukin-6 2/lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies. Clin Exp Med 2023; 23:3681-3687. [PMID: 37097384 PMCID: PMC10127195 DOI: 10.1007/s10238-023-01081-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-62/lymphocyte count ratio (IL-62/LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-62/LC being above the risk cut-off. In conclusion, IL-62/LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-62/LC biomarker are lower than the risk cut-off.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy.
| | - Massimo Borelli
- UMG School of PhD Programmes, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Scaglione
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Flavia Biamonte
- Department of Clinical and Experimental Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Alessandro Russo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Carlo Torti
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
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Sun K, Loria V, Aparicio A, Porras C, Vanegas JC, Zúñiga M, Morera M, Avila C, Abdelnour A, Gail MH, Pfeiffer R, Cohen JI, Burbelo PD, Abed MA, Viboud C, Hildesheim A, Herrero R, Prevots DR. Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica. COMMUNICATIONS MEDICINE 2023; 3:102. [PMID: 37481623 PMCID: PMC10363136 DOI: 10.1038/s43856-023-00325-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/21/2023] [Indexed: 07/24/2023] Open
Abstract
INTRODUCTION Variability in household secondary attack rates and transmission risks factors of SARS-CoV-2 remain poorly understood. METHODS We conducted a household transmission study of SARS-CoV-2 in Costa Rica, with SARS-CoV-2 index cases selected from a larger prospective cohort study and their household contacts were enrolled. A total of 719 household contacts of 304 household index cases were enrolled from November 21, 2020, through July 31, 2021. Blood specimens were collected from contacts within 30-60 days of index case diagnosis; and serum was tested for presence of spike and nucleocapsid SARS-CoV-2 IgG antibodies. Evidence of SARS-CoV-2 prior infections among household contacts was defined based on the presence of both spike and nucleocapsid antibodies. We fitted a chain binomial model to the serologic data, to account for exogenous community infection risk and potential multi-generational transmissions within the household. RESULTS Overall seroprevalence was 53% (95% confidence interval (CI) 48-58%) among household contacts. The estimated household secondary attack rate is 34% (95% CI 5-75%). Mask wearing by the index case is associated with the household transmission risk reduction by 67% (adjusted odds ratio = 0.33 with 95% CI: 0.09-0.75) and not sharing bedroom with the index case is associated with the risk reduction of household transmission by 78% (adjusted odds ratio = 0.22 with 95% CI 0.10-0.41). The estimated distribution of household secondary attack rates is highly heterogeneous across index cases, with 30% of index cases being the source for 80% of secondary cases. CONCLUSIONS Modeling analysis suggests that behavioral factors are important drivers of the observed SARS-CoV-2 transmission heterogeneity within the household.
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Affiliation(s)
- Kaiyuan Sun
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health (NIH), Bethesda, MD, USA.
| | - Viviana Loria
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Amada Aparicio
- Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Juan Carlos Vanegas
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Michael Zúñiga
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - Melvin Morera
- Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Carlos Avila
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | | | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Ruth Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Peter D Burbelo
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - Mehdi A Abed
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health (NIH), Bethesda, MD, USA
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas (ACIB) - Fundación INCIENSA (FUNIN), San José, Costa Rica
| | - D Rebecca Prevots
- Epidemiology and Population Studies Unit, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA.
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5
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Yang MC, Su YT, Chen PH, Tsai CC, Lin TI, Wu JR. Changing patterns of infectious diseases in children during the COVID-19 pandemic. Front Cell Infect Microbiol 2023; 13:1200617. [PMID: 37457965 PMCID: PMC10339349 DOI: 10.3389/fcimb.2023.1200617] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Each infectious disease has had its own epidemic pattern and seasonality for decades. However, public health mitigation measures during the coronavirus disease 2019 (COVID-19) pandemic have resulted in changing epidemic patterns of infectious diseases. Stringent measures resulted in low incidences of various infectious diseases during the outbreak of COVID-19, including influenza, respiratory syncytial virus, pneumococcus, enterovirus, and parainfluenza. Owing to the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and subsequent immunity development, decreasing virulence of SARS-CoV-2, and worldwide immunization against SARS-CoV-2 in children beyond 6 months of age, mitigation measures are lifted country by country. Consequently, the immunity debt to infectious respiratory viruses other than SARS-CoV-2 contributed to the "off-season," "see-saw," and "upsurge" patterns of various infectious diseases in children. Moreover, apart from the persistence of SARS-CoV-2, the coexistence of other circulating viruses or bacterial outbreaks may lead to twindemics or tripledemics during the following years. Therefore, it is necessary to maintain hand hygiene and immunization policies against various pathogens to alleviate the ongoing impact of infectious diseases on children.
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Affiliation(s)
- Ming-Chun Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Hong Chen
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Chung Tsai
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ting-I Lin
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jiunn-Ren Wu
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
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6
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Frutos AM, Kuan G, Lopez R, Ojeda S, Shotwell A, Sanchez N, Saborio S, Plazaola M, Barilla C, Kenah E, Balmaseda A, Gordon A. Infection-Induced Immunity Is Associated With Protection Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Decreased Infectivity. Clin Infect Dis 2023; 76:2126-2133. [PMID: 36774538 PMCID: PMC10273383 DOI: 10.1093/cid/ciad074] [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: 10/10/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND The impact of infection-induced immunity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has not been well established. Here we estimate the effects of prior infection induced immunity in adults and children on SARS-CoV-2 transmission in households. METHODS We conducted a household cohort study from March 2020-November 2022 in Managua, Nicaragua; following a housheold SARS-CoV-2 infection, household members are closely monitored for infection. We estimate the association of time period, age, symptoms, and prior infection with secondary attack risk. RESULTS Overall, transmission occurred in 70.2% of households, 40.9% of household contacts were infected, and the secondary attack risk ranged from 8.1% to 13.9% depending on the time period. Symptomatic infected individuals were more infectious (rate ratio [RR] 21.2, 95% confidence interval [CI]: 7.4-60.7) and participants with a prior infection were half as likely to be infected compared to naïve individuals (RR 0.52, 95% CI:.38-.70). In models stratified by age, prior infection was associated with decreased infectivity in adults and adolescents (secondary attack risk [SAR] 12.3, 95% CI: 10.3, 14.8 vs 17.5, 95% CI: 14.8, 20.7). However, although young children were less likely to transmit, neither prior infection nor symptom presentation was associated with infectivity. During the Omicron era, infection-induced immunity remained protective against infection. CONCLUSIONS Infection-induced immunity is associated with decreased infectivity for adults and adolescents. Although young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics.
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Affiliation(s)
- Aaron M Frutos
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Guillermina Kuan
- Health Center Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Abigail Shotwell
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Saira Saborio
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | - Eben Kenah
- Biostatistics Division, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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7
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Maier HE, Plazaola M, Lopez R, Sanchez N, Saborio S, Ojeda S, Barilla C, Kuan G, Balmaseda A, Gordon A. SARS-CoV-2 infection-induced immunity and the duration of viral shedding: Results from a Nicaraguan household cohort study. Influenza Other Respir Viruses 2023; 17:e13074. [PMID: 36457275 PMCID: PMC9835439 DOI: 10.1111/irv.13074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Much of the world's population has been infected with SARS-CoV-2. Thus, immunity from prior infection will play a critical role in future SARS-CoV-2 transmission. We investigated the impact of infection-induced immunity on viral shedding duration and viral load. METHODS We conducted a household cohort study in Managua, Nicaragua, with an embedded transmission study that closely monitors participants regardless of symptoms. Real-time reverse-transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assays (ELISAs) were used to measure infections and seropositivity, respectively. Blood samples were collected twice annually and surrounding household intensive monitoring periods. We used accelerated failure time models to compare shedding times. Participants vaccinated ≥14 days prior to infection were excluded from primary analyses. RESULTS There were 600 RT-PCR-confirmed SARS-CoV-2 infections in unvaccinated participants between May 1, 2020, and March 10, 2022, with prior ELISA data. Prior infection was associated with 48% shorter shedding times (event time ratio [ETR] 0.52, 95% CI: 0.39-0.69, mean shedding: 13.7 vs. 26.4 days). A fourfold higher anti-SARS-CoV-2 spike titer was associated with 17% shorter shedding (ETR 0.83, 95% CI: 0.78-0.90). Similarly, maximum viral loads (lowest cycle threshold [CT]) were lower for previously infected individuals (mean CT 29.8 vs. 28.0, p = 4.02 × 10-3 ), for adults and children ≥10 years, but not for children 0-9 years; there was little difference in CT levels for previously infected versus naïve adults aged above 60 years. CONCLUSIONS Prior infection-induced immunity was associated with shorter viral shedding and lower viral loads, which may be important in the transition from pandemic to endemicity.
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Affiliation(s)
- Hannah E Maier
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua.,Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Saira Saborio
- Sustainable Sciences Institute, Managua, Nicaragua.,Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua.,Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua.,Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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8
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Wu YK, Lan CC, Hsieh PC, Yang MC, Su WL, Wu CW, Huang HY. Early pulmonary rehabilitation of COVID-19 patients in an isolation ward and intensive care unit. Tzu Chi Med J 2023. [DOI: 10.4103/tcmj.tcmj_136_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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9
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Kubale JT, Frutos AM, Balmaseda A, Cerpas C, Saborio S, Ojeda S, Barilla C, Sanchez N, Vasquez G, Moreira H, Shotwell A, Meyers A, Lopez R, Plazaola M, Kuan G, Gordon A. High Co-circulation of Influenza and Severe Acute Respiratory Syndrome Coronavirus 2. Open Forum Infect Dis 2022; 9:ofac642. [PMID: 36519125 PMCID: PMC9745763 DOI: 10.1093/ofid/ofac642] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
In the first 2 years of the coronavirus disease 2019 pandemic, influenza transmission decreased substantially worldwide, meaning that health systems were not faced with simultaneous respiratory epidemics. In 2022, however, substantial influenza transmission returned to Nicaragua where it co-circulated with severe acute respiratory syndrome coronavirus 2, causing substantial disease burden.
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Affiliation(s)
- John T Kubale
- ICPSR, University of Michigan, Ann Arbor, Michigan, USA
| | - Aaron M Frutos
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Angel Balmaseda
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Cristhiam Cerpas
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Saira Saborio
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Carlos Barilla
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Gerald Vasquez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Hanny Moreira
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Abigail Shotwell
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Alyssa Meyers
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Roger Lopez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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10
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Chen Q, Zhu K, Liu X, Zhuang C, Huang X, Huang Y, Yao X, Quan J, Lin H, Huang S, Su Y, Wu T, Zhang J, Xia N. The Protection of Naturally Acquired Antibodies Against Subsequent SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. Emerg Microbes Infect 2022; 11:793-803. [PMID: 35195494 PMCID: PMC8920404 DOI: 10.1080/22221751.2022.2046446] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The specific antibodies induced by SARS-CoV-2 infection may provide protection against a subsequent infection. However, the efficacy and duration of protection provided by naturally acquired immunity against subsequent SARS-CoV-2 infection remain controversial. We systematically searched for the literature describing COVID-19 reinfection published before 07 February 2022. The outcomes were the pooled incidence rate ratio (IRR) for estimating the risk of subsequent infection. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. Statistical analyses were conducted using the R programming language 4.0.2. We identified 19 eligible studies including more than 3.5 million individuals without the history of COVID-19 vaccination. The efficacy of naturally acquired antibodies against reinfection was estimated at 84% (pooled IRR = 0.16, 95% CI: 0.14-0.18), with higher efficacy against symptomatic COVID-19 cases (pooled IRR = 0.09, 95% CI = 0.07-0.12) than asymptomatic infection (pooled IRR = 0.28, 95% CI = 0.14-0.54). In the subgroup analyses, the pooled IRRs of COVID-19 infection in health care workers (HCWs) and the general population were 0.22 (95% CI = 0.16-0.31) and 0.14 (95% CI = 0.12-0.17), respectively, with a significant difference (P = 0.02), and those in older (over 60 years) and younger (under 60 years) populations were 0.26 (95% CI = 0.15–0.48) and 0.16 (95% CI = 0.14-0.19), respectively. The risk of subsequent infection in the seropositive population appeared to increase slowly over time. In conclusion, naturally acquired antibodies against SARS-CoV-2 can significantly reduce the risk of subsequent infection, with a protection efficacy of 84%. Registration number: CRD42021286222
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Affiliation(s)
- Qi Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Kongxin Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Xiaohui Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Chunlan Zhuang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Xingcheng Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Yue Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Xingmei Yao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Jiali Quan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Hongyan Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People's Republic of China.,The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen City, Fujian Province, People's Republic of China
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Infection-induced immunity is associated with protection against SARS-CoV-2 infection, but not decreased infectivity during household transmission. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.10.10.22280915. [PMID: 36263069 PMCID: PMC9580390 DOI: 10.1101/2022.10.10.22280915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Understanding the impact of infection-induced immunity on SARS-CoV-2 transmission will provide insight into the transition of SARS-CoV-2 to endemicity. Here we estimate the effects of prior infection induced immunity and children on SARS-CoV-2 transmission in households. Methods We conducted a household cohort study between March 2020-June 2022 in Managua, Nicaragua where when one household member tests positive for SARS-CoV-2, household members are closely monitored for SARS-CoV-2 infection. Using a pairwise survival model, we estimate the association of infection period, age, symptoms, and infection-induced immunity with secondary attack risk. Results Overall transmission occurred in 72.4% of households, 42% of household contacts were infected and the secondary attack risk was 13.0% (95% CI: 11.7, 14.6). Prior immunity did not impact the probability of transmitting SARS-CoV-2. However, participants with pre-existing infection-induced immunity were half as likely to be infected compared to naïve individuals (RR 0.53, 95% CI: 0.39, 0.72), but this reduction was not observed in children. Likewise, symptomatic infected individuals were more likely to transmit (RR 24.4, 95% CI: 7.8, 76.1); however, symptom presentation was not associated with infectivity of young children. Young children were less likely to transmit SARS-CoV-2 than adults. During the omicron era, infection-induced immunity remained protective against infection. Conclusions Infection-induced immunity is associated with protection against infection for adults and adolescents. While young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics. Article summary Infection-induced immunity protects against SARS-CoV-2 infection for adolescents and adults; however, there was no protection in children. Prior immunity in an infected individual did not impact the probability they will spread SARS-CoV-2 in a household setting.
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Özcan S, Dönmez E, Yavuz ST, Ziyrek M, İnce O, Küçük H, Taşdemir ZA, Yılmaz İ, Varol S, Şahin İ, Okuyan E. Prognostic significance of serum galectin-3 in hospitalized patients with COVID-19. Cytokine 2022; 158:155970. [PMID: 35917725 PMCID: PMC9329148 DOI: 10.1016/j.cyto.2022.155970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/07/2022] [Accepted: 07/16/2022] [Indexed: 11/25/2022]
Abstract
Background Methods Results Conclusion
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13
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Chien TJ, Liu CY, Chang YI, Fang CJ, Pai JH, Wu YX, Chen SW. Therapeutic effects of herbal-medicine combined therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials. Front Pharmacol 2022; 13:950012. [PMID: 36120361 PMCID: PMC9475194 DOI: 10.3389/fphar.2022.950012] [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: 05/22/2022] [Accepted: 08/08/2022] [Indexed: 01/09/2023] Open
Abstract
Background/Aim: Since 2019, the COVID-19 pandemic has been a devastating disease affecting global health to a great extent. Some countries have added on herbal medicines as a complementary treatment for combating COVID-19 due to the urgency of stopping the spread of this viral disease. However, whether these herbal medicines are effective is uncertain. This systematic review and meta-analysis aimed to evaluate the effects of herbal medicine combined therapy in the treatment of COVID-19. Methods: A literature search was performed following the PRISMA Statement and without language restrictions. Seven databases were searched from inception through December 2021. All selected studies were randomized clinical trials (RCTs). Comparing the effects of herbal medicine combined therapy with conventional western medicine, including improvement of clinical symptoms, chest CT images, viral conversion rate, C-reactive protein (CRP) and interleukin 6. Cochrane criteria were applied to examine the methodological quality of the enrolled trials; and meta-analysis software (RevMan 5.4.1) was used for data analysis. Results: In total, the data of 5,417 participants from 40 trials were included in this systematic review; and 28 trials were qualified for meta-analysis. The trials had medium-to-high quality based on GRADE system. Meta-analysis showed that combining herbal medicine vs conventional treatment in 1) coughing (1.43 95% CI:1.21, 1.71, p = 0.0001), 2) fever (1.09 95% CI:1.00, 1.19, p = 0.06), 3) fatigue (1.21 95% CI:1.10, 1.33, p = 0.0001); 4) CT images (1.26 95% CI:1.19, 1.34, P ≤ 0.00001), 5) viral conversion rates (1.22 95% CI:1.06, 1.40, p = 0.005) and 6) viral conversion times (-3.72 95% CI: -6.05, -1.40, p = 0.002), 7) IL6 change (1.97 95% CI: -0.72, 4.66, p = 0.15) and 8) CRP change (-7.92 95% CI: -11.30, -4.53, P ≤ 0.00001). Conclusion: Herbal medicine combined therapy significantly reduces COVID-19 clinical symptoms, improving CT images and viral conversion rates. Reported adverse events are mild. However, for certain biases in the included studies, and the need for further study on effective components of herbal medicine. Further large trials with better randomized design are warranted to definite a more definite role of herbal medicine.
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Affiliation(s)
- Tsai-Ju Chien
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou, Taipei City Hospital, Taipei, Taiwan,Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,*Correspondence: Tsai-Ju Chien,
| | - Chia-Yu Liu
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yuan-I Chang
- Department and Institute of Physiology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Ju Fang
- Medical Library, National Cheng Kung University, Tainan, Taiwan,Department of Secretariat, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Juo-Hsiang Pai
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Xuan Wu
- Department and Institute of Physiology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuoh-Wen Chen
- Department and Institute of Physiology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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SARS-CoV-2 Spike-Binding Antibody Longevity and Protection from Reinfection with Antigenically Similar SARS-CoV-2 Variants. mBio 2022; 13:e0178422. [PMID: 35997286 PMCID: PMC9600418 DOI: 10.1128/mbio.01784-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The PARIS (Protection Associated with Rapid Immunity to SARS-CoV-2) cohort follows health care workers with and without documented coronavirus disease 2019 (COVID-19) since April 2020. We report our findings regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike-binding antibody stability and protection from infection in the pre-variant era. We analyzed data from 400 health care workers (150 seropositive and 250 seronegative at enrollment) for a median of 84 days. The SARS-CoV-2 spike-binding antibody titers were highly variable with antibody levels decreasing over the first 3 months, followed by a relative stabilization. We found that both more advanced age (>40 years) and female sex were associated with higher antibody levels (1.6-fold and 1.4-fold increases, respectively). Only six percent of the initially seropositive participants “seroreverted.” We documented a total of 11 new SARS-CoV-2 infections (10 naive participants and 1 previously infected participant without detectable antibodies; P < 0.01), indicating that spike antibodies limit the risk of reinfection. These observations, however, only apply to SARS-CoV-2 variants antigenically similar to the ancestral SARS-CoV-2 ones. In conclusion, SARS-CoV-2 antibody titers mounted upon infection are stable over several months and provide protection from infection with antigenically similar viruses.
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Maier HE, Balmaseda A, Saborio S, Ojeda S, Barilla C, Sanchez N, Lopez R, Plazaola M, Cerpas C, van Bakel H, Kubale J, Harris E, Kuan G, Gordon A. Protection Associated with Previous SARS-CoV-2 Infection in Nicaragua. N Engl J Med 2022; 387:568-570. [PMID: 35857652 PMCID: PMC9342422 DOI: 10.1056/nejmc2203985] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | | | - Harm van Bakel
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Eva Harris
- University of California, Berkeley, Berkeley, CA
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16
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Frutos AM, Kubale J, Kuan G, Ojeda S, Vydiswaran N, Sanchez N, Plazaola M, Patel M, Lopez R, Balmaseda A, Gordon A. SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children. PLOS GLOBAL PUBLIC HEALTH 2022; 2. [PMID: 35785016 PMCID: PMC9245908 DOI: 10.1371/journal.pgph.0000414] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic human coronavirus (HCoV) infections from 2011–2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Blood samples were collected from study participants annually in February-April. Respiratory samples were collected from participants that met testing criteria. Blood samples collected in were tested for SARS-CoV-2 antibodies and a subset of 2011–2016 blood samples from four-year-old children were tested for endemic HCoV antibodies. Respiratory samples were tested for each of the endemic HCoVs from 2011–2016 and for SARS-CoV-2 from 2020–2021 via rt-PCR. By April 2021, 854 (49%) cohort participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic HCoV infections from 2011–2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic HCoV infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.
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Affiliation(s)
- Aaron M. Frutos
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Guillermina Kuan
- Health Center Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Nivea Vydiswaran
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Nery Sanchez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Miguel Plazaola
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - May Patel
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Roger Lopez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
- * E-mail:
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Cavuşoğlu Türker B, Türker F, Ahbab S, Hoca E, Urvasızoğlu AO, Cetin SI, Ataoğlu HE. Evaluation of the Charlson Comorbidity Index and Laboratory Parameters as Independent Early Mortality Predictors in Covid 19 Patients. Int J Gen Med 2022; 15:6301-6307. [PMID: 35924178 PMCID: PMC9343174 DOI: 10.2147/ijgm.s374246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/20/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose Patients and methods Results Conclusion
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Affiliation(s)
- Betül Cavuşoğlu Türker
- University of Health Sciences, Taksim Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Fatih Türker
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
- Correspondence: Fatih Türker, University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, Aksaray, Dr. Adnan Adıvar Cd. No: 9, Fatih, İstanbul, 34130, Turkey, Tel +905364721656, Fax +90 212 453 20 00, Email
| | - Süleyman Ahbab
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Emre Hoca
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Ayşe Oznur Urvasızoğlu
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Seher Irem Cetin
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Hayriye Esra Ataoğlu
- University of Health Sciences, Haseki Health Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
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Cohen LE, Spiro DJ, Viboud C. Projecting the SARS-CoV-2 transition from pandemicity to endemicity: Epidemiological and immunological considerations. PLoS Pathog 2022; 18:e1010591. [PMID: 35771775 PMCID: PMC9246171 DOI: 10.1371/journal.ppat.1010591] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In this review, we discuss the epidemiological dynamics of different viral infections to project how the transition from a pandemic to endemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) might take shape. Drawing from theories of disease invasion and transmission dynamics, waning immunity in the face of viral evolution and antigenic drift, and empirical data from influenza, dengue, and seasonal coronaviruses, we discuss the putative periodicity, severity, and age dynamics of SARS-CoV-2 as it becomes endemic. We review recent studies on SARS-CoV-2 epidemiology, immunology, and evolution that are particularly useful in projecting the transition to endemicity and highlight gaps that warrant further research.
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Affiliation(s)
- Lily E. Cohen
- Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - David J. Spiro
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Cecile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
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Kubale J, Balmaseda A, Frutos AM, Sanchez N, Plazaola M, Ojeda S, Saborio S, Lopez R, Barilla C, Vasquez G, Moreira H, Gajewski A, Campredon L, Maier HE, Chowdhury M, Cerpas C, Harris E, Kuan G, Gordon A. Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua. JAMA Netw Open 2022; 5:e2218794. [PMID: 35759261 PMCID: PMC9237791 DOI: 10.1001/jamanetworkopen.2022.18794] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/21/2022] [Indexed: 01/20/2023] Open
Abstract
Importance The impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated. Objective To characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children. Design, Setting, and Participants In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits. Exposures Prior COVID-19 infection as confirmed by positive anti-SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection at least 60 days before current COVID-19 infection. Main Outcomes and Measures Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case. Results This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%] male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections. Conclusions and Relevance In this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.
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Affiliation(s)
- John Kubale
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Angel Balmaseda
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aaron M. Frutos
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Carlos Barilla
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Gerald Vasquez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Hanny Moreira
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Lora Campredon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Hannah E. Maier
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Mahboob Chowdhury
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Cristhiam Cerpas
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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Bustos Carrillo FA, Mercado BL, Monterrey JC, Collado D, Saborio S, Miranda T, Barilla C, Ojeda S, Sanchez N, Plazaola M, Laguna HS, Elizondo D, Arguello S, Gajewski AM, Maier HE, Latta K, Carlson B, Coloma J, Katzelnick L, Sturrock H, Balmaseda A, Kuan G, Gordon A, Harris E. Epidemics of chikungunya, Zika, and COVID-19 reveal bias in case-based mapping. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.07.23.21261038. [PMID: 34341804 PMCID: PMC8328077 DOI: 10.1101/2021.07.23.21261038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accurate tracing of epidemic spread over space enables effective control measures. We examined three metrics of infection and disease in a pediatric cohort (N≈3,000) over two chikungunya and one Zika epidemic, and in a household cohort (N=1,793) over one COVID-19 epidemic in Managua, Nicaragua. We compared spatial incidence rates (cases/total population), infection risks (infections/total population), and disease risks (cases/infected population). We used generalized additive and mixed-effects models, Kulldorf's spatial scan statistic, and intracluster correlation coefficients. Across different analyses and all epidemics, incidence rates considerably underestimated infection and disease risks, producing large and spatially non-uniform biases distinct from biases due to incomplete case ascertainment. Infection and disease risks exhibited distinct spatial patterns, and incidence clusters inconsistently identified areas of either risk. While incidence rates are commonly used to infer infection and disease risk in a population, we find that this can induce substantial biases and adversely impact policies to control epidemics.
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Affiliation(s)
| | | | | | | | | | | | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | | | | | | | | | - Krista Latta
- University of Michigan, Ann Arbor, Michigan, USA
| | | | - Josefina Coloma
- University of California, Berkeley, Berkeley, California, USA
| | - Leah Katzelnick
- University of California, Berkeley, Berkeley, California, USA
| | - Hugh Sturrock
- University of California, San Francisco, San Francisco, California, USA
- Locational, Poole, UK
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Ministry of Health, Managua, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Ministry of Health, Managua, Nicaragua
| | | | - Eva Harris
- University of California, Berkeley, Berkeley, California, USA
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21
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Kubale J, Balmaseda A, Frutos AM, Sanchez N, Plazaola M, Ojeda S, Saborio S, Lopez R, Barilla C, Vasquez G, Moreira H, Gajewski A, Campredon L, Maier H, Chowdhury M, Cerpas C, Harris E, Kuan G, Gordon A. Burden of SARS-CoV-2 and protection from symptomatic second infection in children. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.03.22268684. [PMID: 35018380 PMCID: PMC8750653 DOI: 10.1101/2022.01.03.22268684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
IMPORTANCE The impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their protection against re-infection is crucial as they will be among the last groups vaccinated. OBJECTIVE To characterize the burden of COVID-19 and assess how protection from symptomatic re-infection among children may vary by age. DESIGN A prospective, community-based pediatric cohort study conducted from March 1, 2020 through October 15, 2021. SETTING The Nicaraguan Pediatric Influenza Cohort is a community-based cohort in District 2 of Managua, Nicaragua. PARTICIPANTS A total of 1964 children aged 0-14 years participated in the cohort. Non-immunocompromised children were enrolled by random selection from a previous pediatric influenza cohort. Additional newborn infants aged ≤4 weeks were randomly selected and enrolled monthly, via home visits. EXPOSURES Prior COVID-19 infection as confirmed by positive anti SARS-CoV-2 antibodies (receptor binding domain [RBD] and spike protein) or real time RT-PCR confirmed COVID-19 infection ≥60 days prior to current COVID-19. MAIN OUTCOMES AND MEASURES Symptomatic COVID-19 cases confirmed by real time RT-PCR and hospitalization within 28 days of symptom onset of confirmed COVID-19 case. RESULTS Overall, 49.8% of children tested were seropositive over the course of the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (6.4%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children aged <2 years-16.1 per 100 person-years (95% Confidence Interval [CI]: 12.5, 20.5)-approximately three times that of children in any other age group assessed. Additionally, 41 (19.8%) symptomatic SARS-CoV-2 episodes were re-infections, with younger children slightly more protected against symptomatic reinfection. Among children aged 6-59 months, protection was 61% (Rate Ratio [RR]:0.39, 95% CI:0.2,0.8), while protection among children aged 5-9 and 10-14 years was 64% (RR:0.36,0.2,0.7), and 49% (RR:0.51,0.3-0.9), respectively. CONCLUSIONS AND RELEVANCE In this prospective community-based pediatric cohort rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing around age 5. Reinfections represent a large proportion of PCR-positive cases, with children <10 years displaying greater protection from symptomatic reinfection. A vaccine for children <5 years is urgently needed. KEY POINTS Question: What is the burden of COVID-19 among young children and how does protection from re-infection vary with age?Findings: In this study of 1964 children aged 0-14 years children <5 years had the highest rates of symptomatic and severe COVID-19 while also displaying greater protection against re-infection compared to children ≥10 years.Meaning: Given their greater risk of infection and severe disease compared to older children, effective vaccines against COVID-19 are urgently needed for children under 5.
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Affiliation(s)
- John Kubale
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Angel Balmaseda
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aaron M Frutos
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | | | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Carlos Barilla
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Gerald Vasquez
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Hanny Moreira
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | | | - Lora Campredon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Hannah Maier
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Mahboob Chowdhury
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Cristhiam Cerpas
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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22
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Grujić J, Bujandrić N, Budakov-Obradović Z, Dolinaj V, Bogdan D, Savić N, Cabezas-Cruz A, Mijatović D, Simin V, Anđelić N, Banović P. Demographic and Clinical Factors Associated with Reactivity of Anti-SARS-CoV-2 Antibodies in Serbian Convalescent Plasma Donors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010042. [PMID: 35010301 PMCID: PMC8751168 DOI: 10.3390/ijerph19010042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 05/02/2023]
Abstract
Passive immunotherapy with convalescent COVID-19 plasma (CCP) is used as a therapeutic procedure in many countries, including Serbia. In this study, we analyzed the association between demographic factors, COVID-19 severity and the reactivity of anti-SARS-CoV-2 antibodies (Abs) in Serbian CCP donors. Individuals (n = 468) recovered from confirmed SARS-CoV-2 infection, and who were willing to donate their plasma for passive immunization of COVID-19 patients were enrolled in the study. Plasma samples were tested for the presence of IgG reactive to SARS-CoV-2 spike glycoprotein (S1) and nucleocapsid antigens. Individuals were characterized according to age, gender, comorbidities, COVID-19 severity, ABO blood type and RhD factor. Total of 420 candidates (420/468; 89.74%) reached the levels of anti-SARS-CoV-2 IgG that qualified them for inclusion in CCP donation program. Further statistical analysis showed that male individuals (p = 0.034), older age groups (p < 0.001), existence of hypertension (p = 0.008), and severe COVID-19 (p = 0.000) are linked with higher levels of anti-SARS-CoV-2 Abs. These findings will guide the selection of CCP donors in Serbia. Further studies need to be conducted to assess the neutralization potency and clinical efficiency of CCP collected from Serbian donors with high anti-SARS-CoV-2 IgG reactivity.
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Affiliation(s)
- Jasmina Grujić
- Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia; (N.B.); (Z.B.-O.)
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (V.D.); (N.A.)
- Correspondence: (J.G.); (P.B.)
| | - Nevenka Bujandrić
- Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia; (N.B.); (Z.B.-O.)
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (V.D.); (N.A.)
| | - Zorana Budakov-Obradović
- Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia; (N.B.); (Z.B.-O.)
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (V.D.); (N.A.)
| | - Vladimir Dolinaj
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (V.D.); (N.A.)
- Department of Anesthesia and Intensive Care, Clinical Centre of Vojvodina, 21000 Novi Sad, Serbia
| | - Damir Bogdan
- Social Sciences and Computing, University of Belgrade, 11000 Belgrade, Serbia;
| | - Nebojša Savić
- Transfusion Medicine Department, Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, Laboratoire de Santé Animale, F-94700 Maisons-Alfort, France;
| | - Dragana Mijatović
- Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia;
| | - Verica Simin
- Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia;
| | - Nikola Anđelić
- Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (V.D.); (N.A.)
| | - Pavle Banović
- Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia;
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
- Correspondence: (J.G.); (P.B.)
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23
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Maier HE, Balmaseda A, Ojeda S, Cerpas C, Sanchez N, Plazaola M, van Bakel H, Kubale J, Lopez R, Saborio S, Barilla C, Harris E, Kuan G, Gordon A. An immune correlate of SARS-CoV-2 infection and severity of reinfections. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.11.23.21266767. [PMID: 34845458 PMCID: PMC8629202 DOI: 10.1101/2021.11.23.21266767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background An immune correlate of protection from SARS-CoV-2 infection is urgently needed. Methods We used an ongoing household cohort with an embedded transmission study that closely monitors participants regardless of symptom status. Real-time reverse-transcription polymerase chain reaction (RT-PCR) and Enzyme-linked immunosorbent assays (ELISAs) were used to measure infections and seropositivity. Sequencing was performed to determine circulating strains of SARS-CoV-2. We investigated the protection associated with seropositivity resulting from prior infection, the anti-spike antibody titers needed for protection, and we compared the severity of first and second infections. Results In March 2021, 62.3% of the cohort was seropositive. After March 2021, gamma and delta variants predominated. Seropositivity was associated with 69.2% protection from any infection (95% CI: 60.7%-75.9%), with higher protection against moderate or severe infection (79.4%, 95% CI: 64.9%-87.9%). Anti-spike titers of 327 and 2,551 were associated with 50% and 80% protection from any infection; titers of 284 and 656 were sufficient for protection against moderate or severe disease. Second infections were less severe than first infections (Relative Risk (RR) of moderated or severe disease: 0.6, 95% CI: 0.38-0.98; RR of subclinical disease:1.9, 95% CI: 1.33-2.73). Conclusions Prior infection-induced immunity is protective against infection when predominantly gamma and delta SARS-CoV-2 circulated. The protective antibody titers presented may be useful for vaccine policy and control measures. While second infections were somewhat less severe, they were not as mild as ideal. A strategy involving vaccination will be needed to ease the burden of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Hannah E. Maier
- Department of Epidemiology, School of Public Health, University of Michigan in Ann Arbor, Michigan, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia at the Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas at the Ministry of Health, Managua, Nicaragua
| | - Cristiam Cerpas
- Centro Nacional de Diagnóstico y Referencia at the Ministry of Health, Managua, Nicaragua
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan in Ann Arbor, Michigan, USA
| | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia at the Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia at the Ministry of Health, Managua, Nicaragua
| | | | | | | | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas at the Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan in Ann Arbor, Michigan, USA
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24
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Sikaroudi MK, Zonooz SR, Ebrahimi Z, Jebraili H, Farsi F, Talebi A, Masoodi M. Assessment of anorexia and weight loss during the infection and recovery period of patients with coronavirus disease 2019 (COVID-19). CLINICAL NUTRITION OPEN SCIENCE 2021; 40:102-110. [PMID: 34806074 PMCID: PMC8590500 DOI: 10.1016/j.nutos.2021.11.001] [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: 07/04/2021] [Accepted: 11/06/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives Patients with coronavirus disease 2019 (COVID-19) can present anorexia and weight loss due to their symptoms and eating disorder which can lead to immune system weakness and increase the duration of recovery time. We aim to assess the severity and duration of anorexia and weight loss within the infection and recovery period in these patients. Method We retrospectively identified 233 COVID-19 patients (older than 18 years) were admitted to the Rasoul-e Akram Hospital, from August to December 2020. Their medical records were reviewed by researchers. Then, patients who had inclusion criteria were asked about duration and severity of anorexia, and also weight alternation during the infection and after the recovery period. Result Analyzed data were collected from 233 COVID-19 patients showed the mean duration of anorexia was 7.08 ± 10.41 days with a significant loss of appetite (- 75.55 ± 88.09, P-value < 0.001) at the period of anorexia compare to appetite improvement. Also, results demonstrated patients, especially males and severe illness subjects, significantly lost weight (P-value <0.001). Conclusion: anorexia and weight loss occur in people infected with the coronavirus and may affect the recovery process of these patients by reducing their food intake. The underlying mechanisms of SARS-CoV-2 related to interaction to the gastrointestinal tract and development of anorexia in these patients need to clarify in future studies.
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Key Words
- ARDS, acute respiratory distress syndrome
- Anorexia
- BMI, Body mass index
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, Coronavirus disease 2019
- GI, Gastrointestinal
- HADs, Hospital Anxiety and Depression Scales
- ICU, intensive care unit
- IgG, Immunoglobulin G
- IgM, Immunoglobulin M
- MERS-CoV, Middle East respiratory syndrome coronavirus
- PCR, Polymerase chain reaction
- PHEIC, public health emergency of international concern
- RNA, Ribonucleic acid
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SD, standard deviation
- VASs, visual analog scales
- WHO, World Health Organization
- Weight loss
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Affiliation(s)
| | - Sanaz Rezaei Zonooz
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Ebrahimi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hanieh Jebraili
- Department of Health Sciences and Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Farsi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Atefeh Talebi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Masoodi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
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25
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Ioannidis JPA. COVID-19 vaccination in children and university students. Eur J Clin Invest 2021; 51:e13678. [PMID: 34529274 PMCID: PMC8646734 DOI: 10.1111/eci.13678] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 12/19/2022]
Abstract
Strategies for the use of COVID-19 vaccines in children and young adults (in particular university students) are hotly debated and important to optimize. As of late August 2021, recommendations on the use of these vaccines in children vary across different countries. Recommendations are more uniform for vaccines in young adults, but vaccination uptake in this age group shows a large range across countries. Mandates for vaccination of university students are a particularly debated topic with many campuses endorsing mandates in the USA in contrast to European countries, at least as of August 2021. The commentary discusses the potential indirect impact of vaccination of youth on the COVID-19 burden of disease for other age groups and societal functioning at large, estimates of direct impact on reducing fatalities and nonlethal COVID-19-related events in youth, estimates of potential lethal and nonlethal adverse events from vaccines and differential considerations that may exist in the USA, European countries and nonhigh-income countries. Decision-making for deploying COVID-19 vaccines in young people is subject to residual uncertainty on the future course of the pandemic and potential evolution towards endemicity. Rational recommendations would also benefit from better understanding of the clinical and sociodemographic features of COVID-19 risk in young populations and from dissecting the role of re-infections and durability of natural vs. vaccine-induced immunity.
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Affiliation(s)
- John P A Ioannidis
- Departments of Medicine, Epidemiology and Population Health, Biomedical Data Science, and Statistics, Stanford University, Stanford, CA, USA.,Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
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