1
|
Marinov GK, Mladenov M, Rangachev A, Alexiev I. SARS-CoV-2 reinfections during the first three major COVID-19 waves in Bulgaria. PLoS One 2022; 17:e0274509. [PMID: 36084070 PMCID: PMC9462809 DOI: 10.1371/journal.pone.0274509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a devastating impact on the world over the past two years (2020-2021). One of the key questions about its future trajectory is the protection from subsequent infections and disease conferred by a previous infection, as the SARS-CoV-2 virus belongs to the coronaviruses, a group of viruses the members of which are known for their ability to reinfect convalescent individuals. Bulgaria, with high rates of previous infections combined with low vaccination rates and an elderly population, presents a somewhat unique context to study this question. METHODS We use detailed governmental data on registered COVID-19 cases to evaluate the incidence and outcomes of COVID-19 reinfections in Bulgaria in the period between March 2020 and early December 2021. RESULTS For the period analyzed, a total of 4,106 cases of individuals infected more than once were observed, including 31 cases of three infections and one of four infections. The number of reinfections increased dramatically during the Delta variant-driven wave of the pandemic towards the end of 2021. We observe a moderate reduction of severe outcomes (hospitalization and death) in reinfections relative to primary infections, and a more substantial reduction of severe outcomes in breakthrough infections in vaccinated individuals. CONCLUSIONS In the available datasets from Bulgaria, prior infection appears to provide some protection from severe outcomes, but to a lower degree than the reduction in severity of breakthrough infections in the vaccinated compared to primary infections in the unvaccinated.
Collapse
Affiliation(s)
- Georgi K. Marinov
- Department of Genetics, Stanford University, Stanford, CA, United States of America
| | | | - Antoni Rangachev
- Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, Sofia, Bulgaria
- International Center for Mathematical Sciences-Sofia, Sofia, Bulgaria
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| |
Collapse
|
2
|
Abella E, Trigueros M, Pradenas E, Muñoz-Lopez F, Garcia-Pallarols F, Ben Azaiz Ben Lahsen R, Trinité B, Urrea V, Marfil S, Rovirosa C, Puig T, Grau E, Chamorro A, Toledo R, Font M, Palacín D, Lopez-Segui F, Carrillo J, Prat N, Mateu L, Clotet B, Blanco J, Massanella M. Efficacy of SARS-CoV-2 vaccination in patients with monoclonal gammopathies: A cross sectional study. Life Sci Alliance 2022; 5:e202201479. [PMID: 35961779 PMCID: PMC9375155 DOI: 10.26508/lsa.202201479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
SARS-CoV-2 vaccination is the most effective strategy to protect individuals with haematologic malignancies against severe COVID-19, while eliciting limited vaccine responses. We characterized the humoral responses following 3 mo after mRNA-based vaccines in individuals at different plasma-cell disease stages: monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma on first-line therapy (MM), compared with a healthy population. Plasma samples from uninfected MM patients showed lower SARS-CoV-2-specific antibody levels and neutralization capacity compared with MGUS, SMM, and healthy individuals. Importantly, COVID-19 recovered MM individuals presented significantly higher plasma neutralization capacity compared with their uninfected counterparts, highlighting that hybrid immunity elicit stronger immunity even in this immunocompromised population. No differences in the vaccine-induced humoral responses were observed between uninfected MGUS, SMM and healthy individuals. In conclusion, MGUS and SMM patients could be SARS-CoV-2 vaccinated following the vaccine recommendations for the general population, whereas a tailored monitoring of the vaccine-induced immune responses should be considered in uninfected MM patients.
Collapse
Affiliation(s)
- Eugenia Abella
- Department of Hematology, Hospital del Mar-IMIM, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Macedonia Trigueros
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Edwards Pradenas
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Francisco Muñoz-Lopez
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | | | | | - Benjamin Trinité
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Victor Urrea
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Silvia Marfil
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Carla Rovirosa
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Teresa Puig
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Eulàlia Grau
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Anna Chamorro
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Ruth Toledo
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Marta Font
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Dolors Palacín
- Direcció d'Atenció Primària-Metropolitana Nord, Sabadell, Spain
| | - Francesc Lopez-Segui
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Jorge Carrillo
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
| | - Nuria Prat
- Direcció d'Atenció Primària-Metropolitana Nord, Sabadell, Spain
| | - Lourdes Mateu
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - Bonaventura Clotet
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
| | - Julià Blanco
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona Barcelona, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
| |
Collapse
|
3
|
Trigueros M, Pradenas E, Palacín D, Muñoz-López F, Ávila-Nieto C, Trinité B, Bonet-Simó JM, Isnard M, Moreno N, Marfil S, Rovirosa C, Puig T, Grau E, Chamorro A, Martinez A, Toledo R, Font M, Ara J, Carrillo J, Mateu L, Blanco J, Clotet B, Prat N, Massanella M. Reduced humoral response 3 months following BNT162b2 vaccination in SARS-CoV-2 uninfected residents of long-term care facilities. Age Ageing 2022; 51:6589805. [PMID: 35595256 PMCID: PMC9122645 DOI: 10.1093/ageing/afac101] [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: 12/22/2021] [Indexed: 12/12/2022] Open
Abstract
Background SARS-CoV-2 vaccination is the most effective strategy to protect older residents of long-term care facilities (LTCF) against severe COVID-19, but primary vaccine responses are less effective in older adults. Here, we characterised the humoral responses of institutionalised seniors 3 months after they had received the mRNA/BNT162b2 vaccine. Methods plasma levels of SARS-CoV-2-specific total IgG, IgM and IgA antibodies were measured before and 3 months after vaccination in older residents of LTCF. Neutralisation capacity was assessed in a pseudovirus neutralisation assay against the original WH1 and later B.1.617.2/Delta variants. A group of younger adults was used as a reference group. Results three months after vaccination, uninfected older adults presented reduced SARS-CoV-2-specific IgG levels and a significantly lower neutralisation capacity against the WH1 and Delta variants compared with vaccinated uninfected younger individuals. In contrast, COVID-19-recovered older adults showed significantly higher SARS-CoV-2-specific IgG levels after vaccination than their younger counterparts, whereas showing similar neutralisation activity against the WH1 virus and an increased neutralisation capacity against the Delta variant. Although, similarly to younger individuals, previously infected older adults elicit potent cross-reactive immune responses, higher quantities of SARS-CoV-2-specific IgG antibodies are required to reach the same neutralisation levels. Conclusions although hybrid immunity seems to be active in previously infected older adults 3 months after mRNA/BNT162b2 vaccination, humoral immune responses are diminished in COVID-19 uninfected but vaccinated older residents of LTCF. These results suggest that a vaccine booster dose should be prioritised for this particularly vulnerable population.
Collapse
Affiliation(s)
- Macedonia Trigueros
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Edwards Pradenas
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Dolors Palacín
- Direcció d'Atenció Primària - Metropolitana Nord, 08023 Sabadell, Catalonia, Spain
| | - Francisco Muñoz-López
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Carlos Ávila-Nieto
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Benjamin Trinité
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | | | - Mar Isnard
- Direcció d'Atenció Primària - Metropolitana Nord, 08023 Sabadell, Catalonia, Spain
| | - Nemesio Moreno
- Direcció d'Atenció Primària - Metropolitana Nord, 08023 Sabadell, Catalonia, Spain
| | - Silvia Marfil
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Carla Rovirosa
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Teresa Puig
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Eulàlia Grau
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain
| | - Anna Chamorro
- Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain
| | - Ana Martinez
- Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain
| | - Ruth Toledo
- Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain
| | - Marta Font
- Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain
| | - Jordi Ara
- Gerencia Territorial de la Metropolitana Nord, Germans Trias i Pujol Hospital, 08916 Badalona, Spain
| | - Jorge Carrillo
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
| | - Lourdes Mateu
- Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain.,Infectious Diseases Department, Germans Trias i Pujol Hospital and Universitat Autònoma de Barcelona, 08916 Badalona, Spain.,University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, 28029 Madrid, Spain
| | - Julià Blanco
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain.,University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Catalonia, Spain
| | - Bonaventura Clotet
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain.,Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, 08916 Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain.,University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Catalonia, Spain
| | - Nuria Prat
- Direcció d'Atenció Primària - Metropolitana Nord, 08023 Sabadell, Catalonia, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), 08916 Badalona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
| | | |
Collapse
|
4
|
Ren X, Zhou J, Guo J, Hao C, Zheng M, Zhang R, Huang Q, Yao X, Li R, Jin Y. Reinfection in patients with COVID-19: a systematic review. Glob Health Res Policy 2022; 7:12. [PMID: 35488305 PMCID: PMC9051013 DOI: 10.1186/s41256-022-00245-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND With the continuation of the COVID-19 pandemic, some COVID-19 patients have become reinfected with the virus. Viral gene sequencing has found that some of these patients were reinfected by the different and others by same strains. This has raised concerns about the effectiveness of immunity after infection and the reliability of vaccines. To this end, we conducted a systematic review to assess the characteristics of patients with reinfection and possible causes. METHODS A systematic search was conducted across eight databases: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and SinoMed from December 1, 2019 to September 1, 2021. The quality of included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. RESULTS This study included 50 studies from 20 countries. There were 118 cases of reinfection. Twenty-five patients were reported to have at least one complication. The shortest duration between the first infection and reinfection was 19 days and the longest was 293 days. During the first infection and reinfection, cough (51.6% and 43.9%) and fever (50% and 30.3%) were the most common symptoms respectively. Nine patients recovered, seven patients died, and five patients were hospitalized, but 97 patients' prognosis were unknown. B.1 is the most common variant strain at the first infection. B.1.1.7, B.1.128 and B.1.351 were the most common variant strains at reinfection. Thirty-three patients were infected by different strains and 9 patients were reported as being infected with the same strain. CONCLUSIONS Our research shows that it is possible for rehabilitated patients to be reinfected by SARS-COV-2. To date, the causes and risk factors of COVID-19 reinfection are not fully understood. For patients with reinfection, the diagnosis and management should be consistent with the treatment of the first infection. The public, including rehabilitated patients, should be fully vaccinated, wear masks in public places, and pay attention to maintaining social distance to avoid reinfection with the virus.
Collapse
Affiliation(s)
- Xiangying Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China
| | - Jing Guo
- Department of Acupuncture Rehabilitation, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunmei Hao
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Mengxue Zheng
- The First Clinical College of Wuhan University, Wuhan, Hubei China
| | - Rong Zhang
- Department of Neurotumor Disease Diagnosis and Treatment Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaomei Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON Canada
- Center for Clinical Practice Guideline Conduction and Evaluation, Children’s Hospital of Fudan University, Shanghai, China
| | - Ruiling Li
- College of Nursing and Health, Henan University, Kaifeng, Henan China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
5
|
Multiple drugs. REACTIONS WEEKLY 2021. [PMCID: PMC8642204 DOI: 10.1007/s40278-021-06628-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Lo Muzio L, Ambosino M, Lo Muzio E, Quadri MFA. SARS-CoV-2 Reinfection Is a New Challenge for the Effectiveness of Global Vaccination Campaign: A Systematic Review of Cases Reported in Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11001. [PMID: 34682746 PMCID: PMC8535385 DOI: 10.3390/ijerph182011001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/03/2021] [Accepted: 10/09/2021] [Indexed: 12/28/2022]
Abstract
Reinfection with SARS-CoV-2 seems to be a rare phenomenon. The objective of this study is to carry out a systematic search of literature on the SARS-CoV-2 reinfection in order to understand the success of the global vaccine campaigns. A systematic search was performed. Inclusion criteria included a positive RT-PCR test of more than 90 days after the initial test and the confirmed recovery or a positive RT-PCR test of more than 45 days after the initial test that is accompanied by compatible symptoms or epidemiological exposure, naturally after the confirmed recovery. Only 117 articles were included in the final review with 260 confirmed cases. The severity of the reinfection episode was more severe in 92/260 (35.3%) with death only in 14 cases. The observation that many reinfection cases were less severe than initial cases is interesting because it may suggest partial protection from disease. Another interesting line of data is the detection of different clades or lineages by genome sequencing between initial infection and reinfection in 52/260 cases (20%). The findings are useful and contribute towards the role of vaccination in response to the COVID-19 infections. Due to the reinfection cases with SARS-CoV-2, it is evident that the level of immunity is not 100% for all individuals. These data highlight how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all people after healing from COVID-19 or becoming asymptomatic positive.
Collapse
Affiliation(s)
- Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 70122 Foggia, Italy;
- Consorzio Interuniversitario Nazionale per la Bio-Oncologia (C.I.N.B.O.), 66100 Chieti, Italy
| | - Mariateresa Ambosino
- Department of Clinical and Experimental Medicine, University of Foggia, 70122 Foggia, Italy;
| | - Eleonora Lo Muzio
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy;
| | - Mir Faeq Ali Quadri
- Department of Preventive Dental Sciences, Jazan University, Jazan 82511, Saudi Arabia;
| |
Collapse
|