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Schmidt AL, Labaki C, Hsu CY, Bakouny Z, Balanchivadze N, Berg SA, Blau S, Daher A, El Zarif T, Friese CR, Griffiths EA, Hawley JE, Hayes-Lattin B, Karivedu V, Latif T, Mavromatis BH, McKay RR, Nagaraj G, Nguyen RH, Panagiotou OA, Portuguese AJ, Puc M, Santos Dutra M, Schroeder BA, Thakkar A, Wulff-Burchfield EM, Mishra S, Farmakiotis D, Shyr Y, Warner JL, Choueiri TK. COVID-19 vaccination and breakthrough infections in patients with cancer. Ann Oncol 2022; 33:340-346. [PMID: 34958894 PMCID: PMC8704021 DOI: 10.1016/j.annonc.2021.12.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vaccination is an important preventive health measure to protect against symptomatic and severe COVID-19. Impaired immunity secondary to an underlying malignancy or recent receipt of antineoplastic systemic therapies can result in less robust antibody titers following vaccination and possible risk of breakthrough infection. As clinical trials evaluating COVID-19 vaccines largely excluded patients with a history of cancer and those on active immunosuppression (including chemotherapy), limited evidence is available to inform the clinical efficacy of COVID-19 vaccination across the spectrum of patients with cancer. PATIENTS AND METHODS We describe the clinical features of patients with cancer who developed symptomatic COVID-19 following vaccination and compare weighted outcomes with those of contemporary unvaccinated patients, after adjustment for confounders, using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19). RESULTS Patients with cancer who develop COVID-19 following vaccination have substantial comorbidities and can present with severe and even lethal infection. Patients harboring hematologic malignancies are over-represented among vaccinated patients with cancer who develop symptomatic COVID-19. CONCLUSIONS Vaccination against COVID-19 remains an essential strategy in protecting vulnerable populations, including patients with cancer. Patients with cancer who develop breakthrough infection despite full vaccination, however, remain at risk of severe outcomes. A multilayered public health mitigation approach that includes vaccination of close contacts, boosters, social distancing, and mask-wearing should be continued for the foreseeable future.
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Affiliation(s)
- A L Schmidt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C Labaki
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C-Y Hsu
- Department of Biostatistics, Vanderbilt University, Nashville, USA
| | - Z Bakouny
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - N Balanchivadze
- Hematology and Oncology Fellowship Program, Henry Ford Cancer Institute, Detroit, USA
| | - S A Berg
- Department of Internal Medicine and Cancer Biology, Division of Hematology and Oncology, Cardinal Bernardin Cancer Centre, Loyola University Chicago, Maywood, USA
| | - S Blau
- Division of Oncology, Northwest Medical Specialties, Tacoma, USA; Division of Hematology, University of Washington, Seattle, USA
| | - A Daher
- Hartford HealthCare Medical Group, Hartford, USA
| | - T El Zarif
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C R Friese
- University of Michigan School of Nursing, School of Public Health, and Rogel Cancer Centre, Ann Arbor, USA
| | - E A Griffiths
- Leukemia Section, Roswell Park Comprehensive Cancer Centre, Buffalo, USA
| | - J E Hawley
- Herbert Irving Comprehensive Cancer Centre, Columbia University Irving Medical Centre, New York, USA; University of Washington/Fred Hutchinson Cancer Research Center, Seattle, USA
| | - B Hayes-Lattin
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, USA
| | - V Karivedu
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Wexner Medical Centre, Columbus, USA
| | - T Latif
- Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, USA
| | - B H Mavromatis
- Department of Cancer, Oncology, Hematology, UPMC Western Maryland, Cumberland, USA
| | - R R McKay
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, USA
| | - G Nagaraj
- Division of Medical Oncology & Hematology, Department of Medicine, Loma Linda University Cancer Centre, Loma Linda, USA
| | - R H Nguyen
- Department of Medicine, Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, USA
| | - O A Panagiotou
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, USA
| | - A J Portuguese
- Division of Hematology, University of Washington, Seattle, USA
| | - M Puc
- Department of Surgery, Section of Thoracic Surgery, Virtua Health, Marlton, USA
| | - M Santos Dutra
- Segal Cancer Centre of the Jewish General Hospital, Montréal, Canada
| | | | - A Thakkar
- Division of Oncology, Montefiore Medical Centre, Bronx, USA
| | - E M Wulff-Burchfield
- Department of Medicine, Divisions of Medical Oncology and Palliative Medicine, The University of Kansas Health System, Westwood, USA
| | - S Mishra
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA
| | - D Farmakiotis
- Department of Medicine, Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University, Nashville, USA; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA
| | - J L Warner
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, USA; Department of Biomedical Informatics, Vanderbilt University, Nashville, USA.
| | - T K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.
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Magnúsdóttir I, Lovik A, Unnarsdóttir AB, McCartney D, Ask H, Kõiv K, Christoffersen LAN, Johnson SU, Hauksdóttir A, Fawns-Ritchie C, Helenius D, González-Hijón J, Lu L, Ebrahimi OV, Hoffart A, Porteous DJ, Fang F, Jakobsdóttir J, Lehto K, Andreassen OA, Pedersen OBV, Aspelund T, Valdimarsdóttir UA. Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations: an observational study. Lancet Public Health 2022; 7:e406-e416. [PMID: 35298894 PMCID: PMC8920517 DOI: 10.1016/s2468-2667(22)00042-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 02/07/2023]
Abstract
Background Methods Findings Interpretation Funding
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Affiliation(s)
- Ingibjörg Magnúsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Anikó Lovik
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Bára Unnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Daniel McCartney
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Kadri Kõiv
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Estonia
| | | | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Center, Vikersund, Norway
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Chloe Fawns-Ritchie
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Dorte Helenius
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Juan González-Hijón
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Li Lu
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Center, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Center, Vikersund, Norway
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kelli Lehto
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Estonia
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole B V Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Koege, Denmark
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; The Icelandic Heart Association, Kopavogur, Iceland
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
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Christensen PA, Olsen RJ, Long SW, Snehal R, Davis JJ, Ojeda Saavedra M, Reppond K, Shyer MN, Cambric J, Gadd R, Thakur RM, Batajoo A, Mangham R, Pena S, Trinh T, Kinskey JC, Williams G, Olson R, Gollihar J, Musser JM. Signals of Significantly Increased Vaccine Breakthrough, Decreased Hospitalization Rates, and Less Severe Disease in Patients with Coronavirus Disease 2019 Caused by the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 in Houston, Texas. THE AMERICAN JOURNAL OF PATHOLOGY 2022; 192:642-652. [PMID: 35123975 PMCID: PMC8812084 DOI: 10.1016/j.ajpath.2022.01.007] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/19/2022]
Abstract
Genetic variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to dramatically alter the landscape of the coronavirus disease 2019 (COVID-19) pandemic. The recently described variant of concern designated Omicron (B.1.1.529) has rapidly spread worldwide and is now responsible for the majority of COVID-19 cases in many countries. Because Omicron was recognized recently, many knowledge gaps exist about its epidemiology, clinical severity, and disease course. A genome sequencing study of SARS-CoV-2 in the Houston Methodist health care system identified 4468 symptomatic patients with infections caused by Omicron from late November 2021 through January 5, 2022. Omicron rapidly increased in only 3 weeks to cause 90% of all new COVID-19 cases, and at the end of the study period caused 98% of new cases. Compared with patients infected with either Alpha or Delta variants in our health care system, Omicron patients were significantly younger, had significantly increased vaccine breakthrough rates, and were significantly less likely to be hospitalized. Omicron patients required less intense respiratory support and had a shorter length of hospital stay, consistent with on average decreased disease severity. Two patients with Omicron stealth sublineage BA.2 also were identified. The data document the unusually rapid spread and increased occurrence of COVID-19 caused by the Omicron variant in metropolitan Houston, Texas, and address the lack of information about disease character among US patients.
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Affiliation(s)
- Paul A Christensen
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Randall J Olsen
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - S Wesley Long
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Richard Snehal
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - James J Davis
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, Illinois; Computing, Environment and Life Sciences, Argonne National Laboratory, Lemont, Illinois
| | - Matthew Ojeda Saavedra
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Kristina Reppond
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Madison N Shyer
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Jessica Cambric
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Ryan Gadd
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Rashi M Thakur
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Akanksha Batajoo
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Regan Mangham
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Sindy Pena
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Trina Trinh
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Jacob C Kinskey
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Guy Williams
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas
| | - Robert Olson
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, Illinois; Computing, Environment and Life Sciences, Argonne National Laboratory, Lemont, Illinois
| | - Jimmy Gollihar
- Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - James M Musser
- Laboratory of Molecular and Translational Human Infectious Diseases Research, Houston Methodist Hospital, Houston, Texas; Laboratory of Antibody Discovery and Accelerated Protein Therapeutics, Center for Infectious Diseases, Houston Methodist Research Institute and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.
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Vandegrift KJ, Yon M, Surendran-Nair M, Gontu A, Amirthalingam S, Nissly RH, Levine N, Stuber T, DeNicola AJ, Boulanger JR, Kotschwar N, Aucoin SG, Simon R, Toal K, Olsen RJ, Davis JJ, Bold D, Gaudreault NN, Richt JA, Musser JM, Hudson PJ, Kapur V, Kuchipudi SV. Detection of SARS-CoV-2 Omicron variant (B.1.1.529) infection of white-tailed deer. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.02.04.479189. [PMID: 35169802 PMCID: PMC8845426 DOI: 10.1101/2022.02.04.479189] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
White-tailed deer ( Odocoileus virginianus ) are highly susceptible to infection by SARS-CoV-2, with multiple reports of widespread spillover of virus from humans to free-living deer. While the recently emerged SARS-CoV-2 B.1.1.529 Omicron variant of concern (VoC) has been shown to be notably more transmissible amongst humans, its ability to cause infection and spillover to non-human animals remains a challenge of concern. We found that 19 of the 131 (14.5%; 95% CI: 0.10-0.22) white-tailed deer opportunistically sampled on Staten Island, New York, between December 12, 2021, and January 31, 2022, were positive for SARS-CoV-2 specific serum antibodies using a surrogate virus neutralization assay, indicating prior exposure. The results also revealed strong evidence of age-dependence in antibody prevalence. A significantly (χ 2 , p < 0.001) greater proportion of yearling deer possessed neutralizing antibodies as compared with fawns (OR=12.7; 95% CI 4-37.5). Importantly, SARS-CoV-2 nucleic acid was detected in nasal swabs from seven of 68 (10.29%; 95% CI: 0.0-0.20) of the sampled deer, and whole-genome sequencing identified the SARS-CoV-2 Omicron VoC (B.1.1.529) is circulating amongst the white-tailed deer on Staten Island. Phylogenetic analyses revealed the deer Omicron sequences clustered closely with other, recently reported Omicron sequences recovered from infected humans in New York City and elsewhere, consistent with human to deer spillover. Interestingly, one individual deer was positive for viral RNA and had a high level of neutralizing antibodies, suggesting either rapid serological conversion during an ongoing infection or a "breakthrough" infection in a previously exposed animal. Together, our findings show that the SARS-CoV-2 B.1.1.529 Omicron VoC can infect white-tailed deer and highlights an urgent need for comprehensive surveillance of susceptible animal species to identify ecological transmission networks and better assess the potential risks of spillback to humans. KEY FINDINGS These studies provide strong evidence of infection of free-living white-tailed deer with the SARS-CoV-2 B.1.1.529 Omicron variant of concern on Staten Island, New York, and highlight an urgent need for investigations on human-to-animal-to-human spillovers/spillbacks as well as on better defining the expanding host-range of SARS-CoV-2 in non-human animals and the environment.
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Affiliation(s)
- Kurt J. Vandegrift
- The Center for Infectious Disease Dynamics, Department of Biology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Michele Yon
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
| | - Meera Surendran-Nair
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
| | - Abhinay Gontu
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
| | - Saranya Amirthalingam
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
| | - Ruth H. Nissly
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
| | - Nicole Levine
- Department of Animal Science and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Tod Stuber
- National Veterinary Services Laboratories, Veterinary Services, U.S. Department of Agriculture, Ames, Iowa, USA
| | | | | | | | - Sarah Grimké Aucoin
- City of New York Parks & Recreation, 1234 5 Avenue, 5 Floor, New York, NY 10029, USA
| | - Richard Simon
- City of New York Parks & Recreation, 1234 5 Avenue, 5 Floor, New York, NY 10029, USA
| | - Katrina Toal
- City of New York Parks & Recreation, 1234 5 Avenue, 5 Floor, New York, NY 10029, USA
| | - Randall J. Olsen
- Laboratory of Molecular and Translational Human Infectious Disease Research, Center for Infectious Diseases, Department of Pathology and Genomic Medicine, Houston Methodist Research Institute and Houston Methodist Hospital, Houston, TX 77030, USA
- Departments of Pathology and Laboratory Medicine and Microbiology and Immunology, Weill Cornell Medical College, NY 10021, USA
| | - James J. Davis
- University of Chicago Consortium for Advanced Science and Engineering, University of Chicago and Division of Data Science and Learning, Argonne National Laboratory, Argonne, Illinois, USA
| | - Dashzeveg Bold
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Natasha N. Gaudreault
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Juergen A. Richt
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - James M. Musser
- Laboratory of Molecular and Translational Human Infectious Disease Research, Center for Infectious Diseases, Department of Pathology and Genomic Medicine, Houston Methodist Research Institute and Houston Methodist Hospital, Houston, TX 77030, USA
- Departments of Pathology and Laboratory Medicine and Microbiology and Immunology, Weill Cornell Medical College, NY 10021, USA
| | - Peter J. Hudson
- The Center for Infectious Disease Dynamics, Department of Biology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Vivek Kapur
- Department of Animal Science and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Suresh V. Kuchipudi
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences and Huck Institutes of the Life Sciences, The Pennsylvania State University, PA,16802, USA
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Multiple spillovers from humans and onward transmission of SARS-CoV-2 in white-tailed deer. Proc Natl Acad Sci U S A 2022; 119:2121644119. [PMID: 35078920 PMCID: PMC8833191 DOI: 10.1073/pnas.2121644119] [Citation(s) in RCA: 111] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 12/25/2022] Open
Abstract
The results provide strong evidence of extensive SARS-CoV-2 infection of white-tailed deer, a free-living wild animal species with widespread distribution across North, Central, and South America. The analysis shows infection of deer resulted from multiple spillovers from humans, followed by efficient deer-to-deer transmission. The discovery of widespread infection of white-tailed deer indicates their establishment as potential reservoir hosts for SARS-CoV-2, a finding with important implications for the ecology, long-term persistence, and evolution of the virus, including the potential for spillback to humans. Many animal species are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and could act as reservoirs; however, transmission in free-living animals has not been documented. White-tailed deer, the predominant cervid in North America, are susceptible to SARS-CoV-2 infection, and experimentally infected fawns can transmit the virus. To test the hypothesis that SARS-CoV-2 is circulating in deer, 283 retropharyngeal lymph node (RPLN) samples collected from 151 free-living and 132 captive deer in Iowa from April 2020 through January of 2021 were assayed for the presence of SARS-CoV-2 RNA. Ninety-four of the 283 (33.2%) deer samples were positive for SARS-CoV-2 RNA as assessed by RT-PCR. Notably, following the November 2020 peak of human cases in Iowa, and coinciding with the onset of winter and the peak deer hunting season, SARS-CoV-2 RNA was detected in 80 of 97 (82.5%) RPLN samples collected over a 7-wk period. Whole genome sequencing of all 94 positive RPLN samples identified 12 SARS-CoV-2 lineages, with B.1.2 (n = 51; 54.5%) and B.1.311 (n = 19; 20%) accounting for ∼75% of all samples. The geographic distribution and nesting of clusters of deer and human lineages strongly suggest multiple human-to-deer transmission events followed by subsequent deer-to-deer spread. These discoveries have important implications for the long-term persistence of the SARS-CoV-2 pandemic. Our findings highlight an urgent need for a robust and proactive “One Health” approach to obtain enhanced understanding of the ecology, molecular evolution, and dissemination of SARS-CoV-2.
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Echinacea as a Potential Force against Coronavirus Infections? A Mini-Review of Randomized Controlled Trials in Adults and Children. Microorganisms 2022; 10:microorganisms10020211. [PMID: 35208665 PMCID: PMC8879308 DOI: 10.3390/microorganisms10020211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 01/03/2023] Open
Abstract
Echinacea purpurea has been shown to broadly inhibit coronaviruses and SARS-CoV-2 in vitro. This review discusses the available clinical evidence from randomized, blinded and controlled human studies. Two RCTs capturing incidence of viral respiratory tract infections during Echinacea preventative treatment were identified including coronavirus infections. Incidence and/or viral loads were measured by RT-PCR and symptom severity was recorded. In a first study, Jawad et al. collected nasopharyngeal swabs from adults (N = 755) over 4 months of continuous prevention. Overall, 24 and 47 enveloped virus infections occurred, including 21 and 33 coronavirus detections (229E; HKU1; OC43) with Echinaforce® extract (2400 mg daily) and placebo, respectively (p = 0.0114). In a separate study, Ogal et al. administered the same extract (1200 mg) or control for 4 months to children (4–12 years) (N = 203). Echinacea reduced the incidence of enveloped virus infections from 47 to 29 (p = 0.0038) whereas 11 and 13 coronavirus detections (229E, OC43, NL63) were counted (p > 0.05). Respiratory symptoms during coronavirus infections were significantly lower with area-under-curve AUC = 75.8 (+/−50.24) versus 27.1 (+/−21.27) score points (p = 0.0036). Importantly, viral loads in nasal secretions were significantly reduced by 98.5% in the Echinacea group, with Ct-values 31.1 [95% CI 26.3; 35.9] versus 25.0 [95% CI 20.5; 29.5] in the control group (p = 0.0479). Results from clinical studies confirm the antiviral activity found for Echinacea in vitro, embracing enveloped respiratory pathogens and therefore coronaviruses as well. Substantiating results from a new, completed study seem to extrapolate these effects to the prevention of SARS-CoV-2 infections. As hypothesized, the established broad antiviral activity of Echinacea extract appears to be inclusive for SARS-CoV-2.
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Analysis of Experiences in Preventing COVID-19 in Hemodialysis Centers of the North of Poland before the Era of Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020684. [PMID: 35055503 PMCID: PMC8776023 DOI: 10.3390/ijerph19020684] [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] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/30/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The appearance of very contagious SARS-CoV-2 variants and waning vaccine immunity may indicate the need to return to using universal methods of preventing the spread of COVID-19. METHODS We performed a multicenter retrospective cohort survey study to describe the methods used in dialysis units to prevent and control the spread of SARS-CoV-2 and also the association between these methods and the incidence of COVID-19 among hemodialyzed (HD) patients before the era of vaccination. The study population included all maintenance HD patients (n = 1569) in 14 dialysis units in the Pomeranian Voivodeship. RESULTS The group of 352 patients (199 men, 153 female) were confirmed for COVID-19. The absolute cumulative incidence in the studied period was 22.4%. It varied widely by dialysis units, ranging from 9.4% to 36.9%. Universal preventive methods were applied by all units. Different additional methods were implemented in some stations with varying frequency (36-86%). In order to quantify the scale of the applied additional preventive methods, we calculated a summary prevention index (PI), i.e., one point for one additional method. Lower incidence was found in centers applying dialysis in isolation of patients hospitalized due to diseases requiring hospitalization (17.42% ± 6.89 vs. 26.54 ± 6.34; p = 0.028) and higher incidence in medium-size dialysis centers (ANOVA F: p = 0.017). Significant inverse correlation between PI and incidence was demonstrated as well (r = -0.759; p = 0.002). CONCLUSIONS The higher the number of implemented preventive measures, the lower the risk of COVID-19 infection in HD patients. Among applied procedures the isolation of hospitalized patients is of significant importance. The measures proved to be effective in prevention before the vaccination era should be continued, as the threat of SARS-CoV-2 still exists.
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Tian W, Ren X, Han M, Zhang Y, Gao X, Chen Z, Zhang W. Epidemiological and clinical characteristics of vaccinated COVID-19 patients: A meta-analysis and systematic review. Int J Immunopathol Pharmacol 2022; 36:3946320221141802. [PMID: 36412572 PMCID: PMC9692180 DOI: 10.1177/03946320221141802] [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] [Indexed: 11/23/2022] Open
Abstract
Objective: With the global epidemic of coronavirus disease 2019 (COVID-19),
vaccination rates are increasing globally. This study evaluated the relevant
clinical manifestations of vaccinated COVID-19 patients. Methods: We searched
carefully in 11 databases such as PubMed, Embase, Scopus, Cochrane Library, Web
of Science, Ovid, China National Knowledge Infrastructure Database, Wan Fang
Data, Sinomed, VIP Database, and Reading Showing Database up to 26 March 2022.
To search for articles that have described the characteristics of vaccinated
patients including epidemiological and clinical symptoms. Statistical analysis
of the extracted data using STATA 14.0. Results: A total of 58 articles and
263,708 laboratory-confirmed COVID-19 patients were included. Most of the
patients in the vaccinated group had more asymptomatic infection and fewer
severe illnesses. There were significant differences in ethnicity, and strain
infected with COVID-19, and comorbidities (hyperlipidemia, diabetes, obesity,
kidney disease, immunocompromised, cardiovascular disease, and tumor) and
symptoms (fever, cough, gastrointestinal symptoms, neurological symptoms, and
dysgeusia/anosmia) between vaccinated group and unvaccinated group. Oxygen
support, use of steroid, days in hospital, hospital treatment, ICU treatment,
death, and poor prognosis were also significantly different. Conclusion:
Compared with the vaccinated group, patients in the unvaccinated group had a
more severe clinical manifestations. Vaccines are also protective for infected
people.
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Affiliation(s)
- Wen Tian
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xingxiang Ren
- Department of Endocrinology, Peking University International Hospital, Beijing, China
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Emerging Infectious Disease, Beijing Ditan Hospital, Captital Medical University, Beijing, China
| | - Xu Gao
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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Rashedi R, Samieefar N, Akhlaghdoust M, Mashhadi M, Darzi P, Rezaei N. Delta Variant: The New Challenge of COVID-19 Pandemic, an Overview of Epidemiological, Clinical, and Immune Characteristics. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022179. [PMID: 35315394 PMCID: PMC8972886 DOI: 10.23750/abm.v93i1.12210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
The SARS-CoV-2 genome has undergone several mutations since the beginning of the pandemic in December 2019. A number of these mutants were associated with higher transmissibility, higher mortality, or hospitalization rates, which were named the variants of concern. B.1.617.2 or the Delta variant has made a lot of concern as it has been responsible for the most recent COVID-19 outbreaks throughout the world. Higher transmissibility, a 60 percent increase in hospitalization rates compared to the wild type, higher viral loads, and reduced response to available vaccines are among the key factors why this variant has become a variant of concern. 148 countries are currently fighting with this variant, hoping to better understand the epidemiological, immunological, and clinical characteristics of this disease in order to find the best way to overcome these new outbreaks. Although reduced efficiency of vaccines on this variant and its higher pre-symptomatic transmissibility have made it complicated to control the disease, higher vaccination coverage and following sanitation rules can help control the outbreaks.
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Affiliation(s)
- Ronak Rashedi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Noosha Samieefar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Meisam Akhlaghdoust
- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, USERN Office, Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Melika Mashhadi
- USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran, Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pouya Darzi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran, USERN Office, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran, Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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60
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Haque A, Pant AB. Mitigating Covid-19 in the face of emerging virus variants, breakthrough infections and vaccine hesitancy. J Autoimmun 2022; 127:102792. [PMID: 34995958 PMCID: PMC8719928 DOI: 10.1016/j.jaut.2021.102792] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 01/06/2023]
Abstract
The emergence and rapid global spread of the new Delta and, more recently, Omicron variants of SARS-CoV-2 pose a daunting public health emergency. Being an RNA virus, the Covid-19 virus is continuing to mutate, resulting in the emergence of new variants with high transmissibility, such as the recently discovered Omicron variant. In this paper, we consider the conditions that may facilitate viral mutations and the emergence of variants with the ability to evade immunity. Here, we have discussed the importance of vaccination with the currently available vaccines. These vaccines are highly effective at preventing serious disease, hospitalization, and death from Covid-19. However, the antibody response induced by these vaccines is short-lasting and there are reports of breakthrough infections. A stable and persistent interaction between T follicular helper cells and germinal center B cells is needed for robust B cell memory response. We discussed the potential reasons behind the breakthrough infections and underscored the importance of developing better second-generation vaccines that may not necessitate frequent booster immunizations and are preventive in nature. This may involve the development of multivalent vaccines and creating vaccines against other viral proteins including conserved proteins. Vaccine hesitancy remains a notable hurdle for implementing vaccination. Furthermore, we recommend different approaches to increase vaccine acceptance, which is a critical translational component of a successful vaccine strategy. These perspectives on overcoming the pandemic's current challenges provide strategies to contain SARS-CoV-2 globally.
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Affiliation(s)
- Azizul Haque
- One Medical Center Drive, Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, 03756, USA.
| | - Anudeep B Pant
- New Orleans East Hospital, 5620 Read Blvd, New Orleans, LA, 70127, USA.
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61
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Forde JE, Ciupe SM. Modeling the Influence of Vaccine Administration on COVID-19 Testing Strategies. Viruses 2021; 13:2546. [PMID: 34960814 PMCID: PMC8708841 DOI: 10.3390/v13122546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 01/01/2023] Open
Abstract
Vaccination is considered the best strategy for limiting and eliminating the COVID-19 pandemic. The success of this strategy relies on the rate of vaccine deployment and acceptance across the globe. As these efforts are being conducted, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously mutating, which leads to the emergence of variants with increased transmissibility, virulence, and resistance to vaccines. One important question is whether surveillance testing is still needed in order to limit SARS-CoV-2 transmission in a vaccinated population. In this study, we developed a multi-scale mathematical model of SARS-CoV-2 transmission in a vaccinated population and used it to predict the role of testing in an outbreak with variants of increased transmissibility. We found that, for low transmissibility variants, testing was most effective when vaccination levels were low to moderate and its impact was diminished when vaccination levels were high. For high transmissibility variants, widespread vaccination was necessary in order for testing to have a significant impact on preventing outbreaks, with the impact of testing having maximum effects when focused on the non-vaccinated population.
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Affiliation(s)
- Jonathan E. Forde
- Department of Mathematics and Computer Sciences, Hobart and William Smith Colleges, Geneva, NY 14456, USA
| | - Stanca M. Ciupe
- Department of Mathematics, Virginia Tech, Blacksburg, VA 24060, USA;
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62
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Sariol CA, Serrano-Collazo C, Ortiz EJ, Pantoja P, Cruz L, Arana T, Atehortua D, Pabon-Carrero C, Espino AM. Limited Impact of Delta Variant's Mutations on the Effectiveness of Neutralization Conferred by Natural Infection or COVID-19 Vaccines in a Latino Population. Viruses 2021; 13:2405. [PMID: 34960674 PMCID: PMC8707683 DOI: 10.3390/v13122405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 12/23/2022] Open
Abstract
The SARS-CoV-2 pandemic has impacted public health systems all over the world. The Delta variant seems to possess enhanced transmissibility, but no clear evidence suggests it has increased virulence. Our data show that pre-exposed individuals had similar neutralizing activity against the authentic COVID-19 strain and the Delta and Epsilon variants. After only one vaccine dose, the neutralization capacity expanded to all tested variants in pre-exposed individuals. Healthy vaccinated individuals showed a limited breadth of neutralization. One vaccine dose did induce similar neutralizing antibodies against the Delta as against the authentic strain. However, even after two doses, this capacity only expanded to the Epsilon variant.
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Affiliation(s)
- Carlos A. Sariol
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (L.C.); (T.A.); (A.M.E.)
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
- Department of Internal Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA
| | - Crisanta Serrano-Collazo
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
| | - Edwin J. Ortiz
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
- Puerto Rico Science, Technology and Research Trust, San Juan, PR 00927, USA; (D.A.); (C.P.-C.)
| | - Petraleigh Pantoja
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
| | - Lorna Cruz
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (L.C.); (T.A.); (A.M.E.)
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
| | - Teresa Arana
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (L.C.); (T.A.); (A.M.E.)
- Unit of Comparative Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (C.S.-C.); (E.J.O.); (P.P.)
| | - Dianne Atehortua
- Puerto Rico Science, Technology and Research Trust, San Juan, PR 00927, USA; (D.A.); (C.P.-C.)
| | - Christina Pabon-Carrero
- Puerto Rico Science, Technology and Research Trust, San Juan, PR 00927, USA; (D.A.); (C.P.-C.)
| | - Ana M. Espino
- Department of Microbiology and Medical Zoology, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA; (L.C.); (T.A.); (A.M.E.)
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