1
|
Wüsthoff LEC, Lund-Johansen F, Henriksen K, Wildendahl G, Jacobsen JA, Gomes L, Anjum HS, Barlinn R, Kran AMB, Munthe LA, Vaage JT. Seroprevalence of SARS-CoV-2 and humoral immune responses to COVID-19 mRNA vaccines among people who use drugs - in the light of tailored mitigating strategies. Harm Reduct J 2024; 21:120. [PMID: 38890611 DOI: 10.1186/s12954-024-01023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND During the initial wave of the COVID-19 pandemic, there was a surprisingly low incidence of SARS-CoV-2 among People Who Use Drugs (PWUD) in Oslo, Norway, despite their heightened vulnerability regarding risk of infection and severe courses of the disease.This study aims to investigate the seroprevalence of SARS-CoV-2 antibodies among PWUD, their antibody responses to relevant virus infections and COVID-19 mRNA vaccines, and their vaccination coverage compared to the general population. METHODS Conducted as a prospective cohort study, data was collected from residents in six institutions for homeless PWUD and users of a low-threshold clinic for opioid agonist treatment. Ninety-seven participants were recruited for SARS-CoV-2 seroprevalence analysis. Additional two participants with known positive SARS-CoV-2 test results were recruited for further analyses. Twenty-five participants completed follow-up. Data included questionnaires, nasal swabs and blood samples. Data on vaccination coverage was obtained from the National Vaccine Register. Serologic methods included detection of antibodies to relevant virus proteins, neutralizing antibodies to SARS-CoV-2, antibodies to the full-length spike protein, and receptor-binding domain from SARS-CoV-2. RESULTS Among PWUD, antibodies to SARS-CoV-2 were detected in 2 out of 97 samples before vaccines against SARS-CoV-2 were available, comparable to a 2.8% frequency in population-based screening. Levels of serum antibodies to seasonal coronaviruses and Epstein-Barr-Virus (EBV) in PWUD were similar to population-based levels. After the second vaccine dose, binding and neutralizing antibody levels to SARS-CoV-2 in PWUD were comparable to controls. Eighty-four of PWUD received at least one dose of COVID-19 mRNA vaccine, compared to 89% in the general population. CONCLUSION Results indicate that PWUD did not exhibit increased SARS-CoV-2 seroprevalence or elevated serum antibodies to seasonal coronaviruses and EBV. Moreover, vaccine responses in PWUD were comparable to controls, suggesting that vaccination is effective in conferring protection against SARS-CoV-2 also in this population.
Collapse
Affiliation(s)
- Linda Elise Couëssurel Wüsthoff
- Unit for Clinical Research on Addictions, Oslo University Hospital, PO Box 4959 Nydalen, Oslo, 0424, Norway.
- Norwegian Centre for Addiction Reasearch, Institute of Clinical Medicine, University of Oslo, PO Box 1039 Blindern, Oslo, 0315, Norway.
| | - Fridtjof Lund-Johansen
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- ImmunoLingo Convergence Center, Institute of Clinical Medicine, University of Oslo, Gaustadalleen 21, Oslo, 0349, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, Oslo, 0318, Norway
- Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318, Oslo, Norway
| | - Kathleen Henriksen
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
- Student Health Services, Student Welfare Services in Oslo, Problemveien 9, Oslo, 0313, Norway
| | - Gull Wildendahl
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Jon-Aksel Jacobsen
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Leni Gomes
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Hina Sarwar Anjum
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Regine Barlinn
- Department of Microbiology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
| | - Anne-Marte Bakken Kran
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222 Skøyen, Oslo, 0213, Norway
| | - Ludvig Andre Munthe
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- KG Jebsen Centre for B cell Malignancies, and Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, PO Box 4950 Nydalen, Oslo, 0424, Norway
| | - John T Vaage
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, Oslo, 0318, Norway
| |
Collapse
|
2
|
Gainullin M, Federico L, Røkke Osen J, Chaban V, Kared H, Alirezaylavasani A, Lund-Johansen F, Wildendahl G, Jacobsen JA, Sarwar Anjum H, Stratford R, Tennøe S, Malone B, Clancy T, Vaage JT, Henriksen K, Wüsthoff L, Munthe LA. People who use drugs show no increase in pre-existing T-cell cross-reactivity toward SARS-CoV-2 but develop a normal polyfunctional T-cell response after standard mRNA vaccination. Front Immunol 2024; 14:1235210. [PMID: 38299149 PMCID: PMC10827924 DOI: 10.3389/fimmu.2023.1235210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
People who use drugs (PWUD) are at a high risk of contracting and developing severe coronavirus disease 2019 (COVID-19) and other infectious diseases due to their lifestyle, comorbidities, and the detrimental effects of opioids on cellular immunity. However, there is limited research on vaccine responses in PWUD, particularly regarding the role that T cells play in the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we show that before vaccination, PWUD did not exhibit an increased frequency of preexisting cross-reactive T cells to SARS-CoV-2 and that, despite the inhibitory effects that opioids have on T-cell immunity, standard vaccination can elicit robust polyfunctional CD4+ and CD8+ T-cell responses that were similar to those found in controls. Our findings indicate that vaccination stimulates an effective immune response in PWUD and highlight targeted vaccination as an essential public health instrument for the control of COVID-19 and other infectious diseases in this group of high-risk patients.
Collapse
Affiliation(s)
- Murat Gainullin
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- NEC OncoImmunity AS, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Lorenzo Federico
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Julie Røkke Osen
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Viktoriia Chaban
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Hassen Kared
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Amin Alirezaylavasani
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Fridtjof Lund-Johansen
- Department of Immunology, Oslo University Hospital, Oslo, Norway
- ImmunoLingo Convergence Center, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | | | | | | | | | | | - John T. Vaage
- Department of Immunology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kathleen Henriksen
- Agency for Social and Welfare Services, Oslo, Norway
- Student Health Services, University of Oslo, Oslo, Norway
| | - Linda Wüsthoff
- Unit for Clinical Research on Addictions, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Addiction Reasearch, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ludvig A. Munthe
- KG Jebsen Centre for B cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
3
|
Molero P, Reina G, Blom JD, Martínez-González MÁ, Reinken A, de Kloet ER, Molendijk ML. COVID-19 risk, course and outcome in people with mental disorders: a systematic review and meta-analyses. Epidemiol Psychiatr Sci 2023; 32:e61. [PMID: 37859501 PMCID: PMC10594644 DOI: 10.1017/s2045796023000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 10/21/2023] Open
Abstract
AIMS It has been suggested that people with mental disorders have an elevated risk to acquire severe acute respiratory syndrome coronavirus 2 and to be disproportionally affected by coronavirus disease 19 (COVID-19) once infected. We aimed to analyse the COVID-19 infection rate, course and outcome, including mortality and long COVID, in people with anxiety, depressive, neurodevelopmental, schizophrenia spectrum and substance use disorders relative to control subjects without these disorders. METHODS This study constitutes a preregistered systematic review and random-effects frequentist and Bayesian meta-analyses. Major databases were searched up until 27 June 2023. RESULTS Eighty-one original articles were included reporting 304 cross-sectional and prospective effect size estimates (median n per effect-size = 114837) regarding associations of interest. Infection risk was not significantly increased for any mental disorder that we investigated relative to samples of people without these disorders. The course of COVID-19, however, is relatively severe, and long COVID and COVID-19-related hospitalization are more likely in all patient samples that we investigated. The odds of dying from COVID-19 were high in people with most types of mental disorders, except for those with anxiety and neurodevelopmental disorders relative to non-patient samples (pooled ORs range, 1.26-2.57). Bayesian analyses confirmed the findings from the frequentist approach and complemented them with estimates of the strength of evidence. CONCLUSIONS Once infected, people with pre-existing mental disorders are at an elevated risk for a severe COVID-19 course and outcome, including long COVID and mortality, relative to people without pre-existing mental disorders, despite an infection risk not significantly increased.
Collapse
Affiliation(s)
- Patricio Molero
- Department of Psychiatry and Clinical Psychology, Clínica Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Gabriel Reina
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Microbiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jan Dirk Blom
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Outpatient Clinic for Uncommon Psychiatric Syndromes, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Miguel Ángel Martínez-González
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
- CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Aischa Reinken
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - E. Ronald de Kloet
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Marc L. Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
4
|
Mehri A, Sotoodeh Ghorbani S, Farhadi-Babadi K, Rahimi E, Barati Z, Taherpour N, Izadi N, Shahbazi F, Mokhayeri Y, Seifi A, Fallah S, Feyzi R, Etemed K, Hashemi Nazari SS. Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study. J Intensive Care Med 2023; 38:825-837. [PMID: 36976873 PMCID: PMC10051011 DOI: 10.1177/08850666231166344] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 03/09/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023]
Abstract
Objectives: This study aims to investigate the risk factors associated with severity and death from COVID-19 through a systematic review and meta-analysis of the published documents in Iran. Methods: A systematic search was performed based on all articles indexed in Scopus, Embase, Web of Science (WOS), PubMed, and Google Scholar in English and Scientific Information Database (SID) and Iranian Research Institute for Information Science and Technology (IRA)NDOC indexes in Persian. To assess quality, we used the Newcastle Ottawa Scale. Publication bias was assessed using Egger's tests. Forest plots were used for a graphical description of the results. We used HRs, and ORs reported for the association between risk factors and COVID-19 severity and death. Results: Sixty-nine studies were included in the meta-analysis, of which 62 and 13 had assessed risk factors for death and severity, respectively. The results showed a significant association between death from COVID-19 and age, male gender, diabetes, hypertension, cardiovascular disease (CVD), cerebrovascular disease, chronic kidney disease (CKD), Headache, and Dyspnea. We observed a significant association between increased white blood cell (WBC), decreased Lymphocyte, increased blood urea nitrogen (BUN), increased creatinine, vitamin D deficiency, and death from COVID-19. There was only a significant relationship between CVD and disease severity. Conclusion: It is recommended that the predictive risk factors of COVID-19 severity and death mentioned in this study to be used for therapeutic and health interventions, to update clinical guidelines and determine patients' prognoses.
Collapse
Affiliation(s)
- Ahmad Mehri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Sotoodeh Ghorbani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kosar Farhadi-Babadi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Rahimi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Barati
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Taherpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shahbazi
- Department of Epidemiology, School of Health, Hamadan University of Medical Sciences Hamadan, Iran
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yaser Mokhayeri
- Department of Infectious Disease, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Seifi
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeid Fallah
- Department of Epidemiology, School of Public Health and Safety, Prevention of Cardiovascular Disease Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rezvan Feyzi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koorosh Etemed
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Saeed Hashemi Nazari
- Department of Epidemiology, School of Public Health and Safety, Prevention of Cardiovascular Disease Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Takakura K, Suka M, Kajihara M, Koido S. Clinical features, therapeutic outcomes, and recovery period of long COVID. J Med Virol 2023; 95:e28316. [PMID: 36412057 PMCID: PMC10108287 DOI: 10.1002/jmv.28316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022]
Abstract
To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May to December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue, and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID-19 severity, the number of manifestations, and the delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, the smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs.
Collapse
Affiliation(s)
- Kazuki Takakura
- Department of Internal Medicine, UnMed Clinic Motomachi, Yokohama, Kanagawa, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mikio Kajihara
- Department of Internal Medicine, Kajihara Clinic, Hiratsuka, Kanagawa, Japan
| | - Shigeo Koido
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, The Jikei University Kashiwa Hospital, Chiba, Japan
| |
Collapse
|
6
|
Monireh R, Kiana K. Prevalence of the Clinical Symptoms and PCR Test Results on Patients With COVID-19 in South of Tehran. Microbiol Insights 2022; 15:11786361221097680. [PMID: 35903755 PMCID: PMC9315899 DOI: 10.1177/11786361221097680] [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: 02/20/2022] [Accepted: 04/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The first human case of COVID-19 was reported on 19 February 2020 in Iran,
since then the number of infected cases has dramatically increased to about
1.800 million and about 62 000 deaths, also elderly people have accounted
for the largest frequency of mortality. Objective: This study aims to evaluate the prevalence of Covid-19 RT-PCR positive among
Iranian patients and to evaluate the most important clinical symptoms of
identified patients based on age, gender, and their background diseases to
be used as an aid for early diagnosis. Methods: During 9 months, swab samples of 11 034 patients’ nasopharynx and oropharynx
secretions were obtained and were referred to the laboratory for Covid-19
RT-PCR test. In addition, the history of signs and symptoms from patients
was recorded. Results: In total, 11 034 Covid-19 RT-PCR tests that performed, 3358 samples had
positive results (30.4%). Headache was the most commonly reported, which was
found in 42.5% of our cases. Fever was the second most common symptom among
the patients studied, with a prevalence rate of 36.2%. Conclusion: In this study, almost 30% of symptomatic patients had positive Covid-19
RT-PCR test results. Headache was the most common symptom; also diarrhea and
nausea were the least common symptoms among patients under this study.
Collapse
Affiliation(s)
- Rahimkhani Monireh
- Faculty of allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazemian Kiana
- EMROOZ Laboratory, Vice Chancellor of Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|