101
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Ranoa DRE, Holland RL, Alnaji FG, Green KJ, Wang L, Fredrickson RL, Wang T, Wong GN, Uelmen J, Maslov S, Weiner ZJ, Tkachenko AV, Zhang H, Liu Z, Ibrahim A, Patel SJ, Paul JM, Vance NP, Gulick JG, Satheesan SP, Galvan IJ, Miller A, Grohens J, Nelson TJ, Stevens MP, Hennessy PM, Parker RC, Santos E, Brackett C, Steinman JD, Fenner MR, Dohrer K, DeLorenzo M, Wilhelm-Barr L, Brauer BR, Best-Popescu C, Durack G, Wetter N, Kranz DM, Breitbarth J, Simpson C, Pryde JA, Kaler RN, Harris C, Vance AC, Silotto JL, Johnson M, Valera EA, Anton PK, Mwilambwe L, Bryan SP, Stone DS, Young DB, Ward WE, Lantz J, Vozenilek JA, Bashir R, Moore JS, Garg M, Cooper JC, Snyder G, Lore MH, Yocum DL, Cohen NJ, Novakofski JE, Loots MJ, Ballard RL, Band M, Banks KM, Barnes JD, Bentea I, Black J, Busch J, Conte A, Conte M, Curry M, Eardley J, Edwards A, Eggett T, Fleurimont J, Foster D, Fouke BW, Gallagher N, Gastala N, Genung SA, Glueck D, Gray B, Greta A, Healy RM, Hetrick A, Holterman AA, Ismail N, Jasenof I, Kelly P, Kielbasa A, Kiesel T, Kindle LM, Lipking RL, Manabe YC, Mayes J́, McGuffin R, McHenry KG, Mirza A, Moseley J, Mostafa HH, Mumford M, Munoz K, Murray AD, Nolan M, Parikh NA, Pekosz A, Pflugmacher J, Phillips JM, Pitts C, Potter MC, Quisenberry J, Rear J, Robinson ML, Rosillo E, Rye LN, Sherwood M, Simon A, Singson JM, Skadden C, Skelton TH, Smith C, Stech M, Thomas R, Tomaszewski MA, Tyburski EA, Vanwingerden S, Vlach E, Watkins RS, Watson K, White KC, Killeen TL, Jones RJ, Cangellaris AC, Martinis SA, Vaid A, Brooke CB, Walsh JT, Elbanna A, Sullivan WC, Smith RL, Goldenfeld N, Fan TM, Hergenrother PJ, Burke MD. Mitigation of SARS-CoV-2 transmission at a large public university. Nat Commun 2022. [DOI: doi.org/10.1038/s41467-022-30833-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AbstractIn Fall 2020, universities saw extensive transmission of SARS-CoV-2 among their populations, threatening health of the university and surrounding communities, and viability of in-person instruction. Here we report a case study at the University of Illinois at Urbana-Champaign, where a multimodal “SHIELD: Target, Test, and Tell” program, with other non-pharmaceutical interventions, was employed to keep classrooms and laboratories open. The program included epidemiological modeling and surveillance, fast/frequent testing using a novel low-cost and scalable saliva-based RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction, called covidSHIELD, and digital tools for communication and compliance. In Fall 2020, we performed >1,000,000 covidSHIELD tests, positivity rates remained low, we had zero COVID-19-related hospitalizations or deaths amongst our university community, and mortality in the surrounding Champaign County was reduced more than 4-fold relative to expected. This case study shows that fast/frequent testing and other interventions mitigated transmission of SARS-CoV-2 at a large public university.
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Ranoa DRE, Holland RL, Alnaji FG, Green KJ, Wang L, Fredrickson RL, Wang T, Wong GN, Uelmen J, Maslov S, Weiner ZJ, Tkachenko AV, Zhang H, Liu Z, Ibrahim A, Patel SJ, Paul JM, Vance NP, Gulick JG, Satheesan SP, Galvan IJ, Miller A, Grohens J, Nelson TJ, Stevens MP, Hennessy PM, Parker RC, Santos E, Brackett C, Steinman JD, Fenner MR, Dohrer K, DeLorenzo M, Wilhelm-Barr L, Brauer BR, Best-Popescu C, Durack G, Wetter N, Kranz DM, Breitbarth J, Simpson C, Pryde JA, Kaler RN, Harris C, Vance AC, Silotto JL, Johnson M, Valera EA, Anton PK, Mwilambwe L, Bryan SP, Stone DS, Young DB, Ward WE, Lantz J, Vozenilek JA, Bashir R, Moore JS, Garg M, Cooper JC, Snyder G, Lore MH, Yocum DL, Cohen NJ, Novakofski JE, Loots MJ, Ballard RL, Band M, Banks KM, Barnes JD, Bentea I, Black J, Busch J, Conte A, Conte M, Curry M, Eardley J, Edwards A, Eggett T, Fleurimont J, Foster D, Fouke BW, Gallagher N, Gastala N, Genung SA, Glueck D, Gray B, Greta A, Healy RM, Hetrick A, Holterman AA, Ismail N, Jasenof I, Kelly P, Kielbasa A, Kiesel T, Kindle LM, Lipking RL, Manabe YC, Mayes J, McGuffin R, McHenry KG, Mirza A, Moseley J, Mostafa HH, Mumford M, Munoz K, Murray AD, Nolan M, Parikh NA, Pekosz A, Pflugmacher J, Phillips JM, Pitts C, Potter MC, Quisenberry J, Rear J, Robinson ML, Rosillo E, Rye LN, Sherwood M, Simon A, Singson JM, Skadden C, Skelton TH, Smith C, Stech M, Thomas R, Tomaszewski MA, Tyburski EA, Vanwingerden S, Vlach E, Watkins RS, Watson K, White KC, Killeen TL, Jones RJ, Cangellaris AC, Martinis SA, Vaid A, Brooke CB, Walsh JT, Elbanna A, Sullivan WC, Smith RL, Goldenfeld N, Fan TM, Hergenrother PJ, Burke MD. Mitigation of SARS-CoV-2 transmission at a large public university. Nat Commun 2022; 13:3207. [PMID: 35680861 PMCID: PMC9184485 DOI: 10.1038/s41467-022-30833-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/19/2022] [Indexed: 11/09/2022] Open
Abstract
In Fall 2020, universities saw extensive transmission of SARS-CoV-2 among their populations, threatening health of the university and surrounding communities, and viability of in-person instruction. Here we report a case study at the University of Illinois at Urbana-Champaign, where a multimodal “SHIELD: Target, Test, and Tell” program, with other non-pharmaceutical interventions, was employed to keep classrooms and laboratories open. The program included epidemiological modeling and surveillance, fast/frequent testing using a novel low-cost and scalable saliva-based RT-qPCR assay for SARS-CoV-2 that bypasses RNA extraction, called covidSHIELD, and digital tools for communication and compliance. In Fall 2020, we performed >1,000,000 covidSHIELD tests, positivity rates remained low, we had zero COVID-19-related hospitalizations or deaths amongst our university community, and mortality in the surrounding Champaign County was reduced more than 4-fold relative to expected. This case study shows that fast/frequent testing and other interventions mitigated transmission of SARS-CoV-2 at a large public university. Safely opening university campuses has been a major challenge during the COVID-19 pandemic. Here, the authors describe a program of public health measures employed at a university in the United States which, combined with other non-pharmaceutical interventions, allowed the university to stay open in fall 2020 with limited evidence of transmission.
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Affiliation(s)
- Diana Rose E Ranoa
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Robin L Holland
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Fadi G Alnaji
- Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kelsie J Green
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Richard L Fredrickson
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Tong Wang
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - George N Wong
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Johnny Uelmen
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sergei Maslov
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA.,Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Zachary J Weiner
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Alexei V Tkachenko
- Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, NY, USA
| | - Hantao Zhang
- Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Zhiru Liu
- Department of Physics, Stanford University, Palo Alto, CA, USA
| | - Ahmed Ibrahim
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sanjay J Patel
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - John M Paul
- Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Nickolas P Vance
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joseph G Gulick
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Isaac J Galvan
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Andrew Miller
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joseph Grohens
- Department of English, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Todd J Nelson
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Mary P Stevens
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Robert C Parker
- McKinley Health Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | | | - Julie D Steinman
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Melvin R Fenner
- McKinley Health Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kirstin Dohrer
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Michael DeLorenzo
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Laura Wilhelm-Barr
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Catherine Best-Popescu
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Gary Durack
- Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA.,Tekmill, Champaign, IL, USA
| | | | - David M Kranz
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jessica Breitbarth
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Charlie Simpson
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Julie A Pryde
- Champaign-Urbana Public Health District, Champaign, IL, USA
| | - Robin N Kaler
- Public Affairs, College of Media, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Chris Harris
- Public Affairs, College of Media, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Allison C Vance
- Public Affairs, College of Media, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jodi L Silotto
- Public Affairs, College of Media, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Mark Johnson
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Enrique Andres Valera
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Patricia K Anton
- Housing Division, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Lowa Mwilambwe
- Office of the Vice Chancellor for Student Affairs, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Stephen P Bryan
- Office of the Dean of Students, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Deborah S Stone
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Danita B Young
- Office of the Vice Chancellor for Student Affairs, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Wanda E Ward
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - John Lantz
- Office of the Dean of Students, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - John A Vozenilek
- Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Rashid Bashir
- Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jeffrey S Moore
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Mayank Garg
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Julian C Cooper
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Gillian Snyder
- Interdisciplinary Health Sciences Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Michelle H Lore
- Interdisciplinary Health Sciences Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Dustin L Yocum
- Office for the Protection of Human Subjects, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Neal J Cohen
- Office of the Dean of Students, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Psychology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jan E Novakofski
- College of Agricultural, Consumer and Environmental Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Melanie J Loots
- Office of the Vice Chancellor for Research and Innovation, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Randy L Ballard
- Department of Intercollegiate Athletics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Mark Band
- Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kayla M Banks
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joseph D Barnes
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Iuliana Bentea
- Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Jessica Black
- Illinois Human Resources, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jeremy Busch
- Department of Intercollegiate Athletics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Abigail Conte
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Madison Conte
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michael Curry
- Illinois Human Resources, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jennifer Eardley
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - April Edwards
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Therese Eggett
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Judes Fleurimont
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Delaney Foster
- Division of Campus Recreation, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bruce W Fouke
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA.,Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Nicholas Gallagher
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicole Gastala
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Scott A Genung
- Office of the Chief Info Officer, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Declan Glueck
- Illinois Human Resources, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Brittani Gray
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Andrew Greta
- University of Illinois System Office, Urbana, IL, USA
| | - Robert M Healy
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ashley Hetrick
- University Health Services, University of Wisconsin-Madison, Madison, WI, USA
| | - Arianna A Holterman
- Office of the Dean of Students, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Nahed Ismail
- Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Ian Jasenof
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Patrick Kelly
- University Health Services, University of Wisconsin-Madison, Madison, WI, USA
| | - Aaron Kielbasa
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Teresa Kiesel
- University Health Services, University of Wisconsin-Madison, Madison, WI, USA
| | - Lorenzo M Kindle
- Technology Services, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rhonda L Lipking
- Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jade Mayes
- Department of Intercollegiate Athletics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Reubin McGuffin
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kenton G McHenry
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Agha Mirza
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jada Moseley
- Illinois Human Resources, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Heba H Mostafa
- Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melody Mumford
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Kathleen Munoz
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Arika D Murray
- Illinois Human Resources, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Moira Nolan
- Office of Corporate Relations, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Nil A Parikh
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Janna Pflugmacher
- University Administration, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Janise M Phillips
- McKinley Health Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Collin Pitts
- University Health Services, University of Wisconsin-Madison, Madison, WI, USA
| | - Mark C Potter
- Department of Family and Community Medicine, College of Medicine, University of Illinois at Chicago, Chicago, USA
| | - James Quisenberry
- Division of Student Affairs, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Janelle Rear
- Office of the Vice President for Economic Development and Innovation, University of Illinois System, Urbana, IL, USA
| | - Matthew L Robinson
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Edith Rosillo
- Library Department, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Leslie N Rye
- Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - MaryEllen Sherwood
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Anna Simon
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jamie M Singson
- Division of Student Affairs, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Carly Skadden
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Tina H Skelton
- Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Charlie Smith
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Mary Stech
- McKinley Health Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ryan Thomas
- Office of the Chief Info Officer, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Erika A Tyburski
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Emory University School of Medicine, Children's Healthcare of Atlanta, and Georgia Institute of Technology, Atlanta, GA, USA.,Georgia Institute of Technology, Institute for Electronics and Nanotechnology, Atlanta, GA, USA
| | - Scott Vanwingerden
- IT Service Delivery, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Evette Vlach
- Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ronald S Watkins
- University of Illinois System Office, Urbana, IL, USA.,Office of the President, University of Illinois System, Urbana, IL, USA
| | - Karriem Watson
- Mile Square Health Center, University of Illinois Health, Chicago, IL, USA
| | - Karen C White
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Timothy L Killeen
- Gies College of Business, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Robert J Jones
- Office of the Chancellor, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | | | - Susan A Martinis
- Office of the Vice Chancellor for Research and Innovation, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Awais Vaid
- Champaign-Urbana Public Health District, Champaign, IL, USA
| | - Christopher B Brooke
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA.,Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Joseph T Walsh
- Library Department, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ahmed Elbanna
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - William C Sullivan
- Department of Landscape Architecture, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Rebecca L Smith
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA. .,Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Nigel Goldenfeld
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA. .,Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Department of Physics, University of California San Diego, La Jolla, CA, 92093, USA.
| | - Timothy M Fan
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Paul J Hergenrother
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA. .,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Martin D Burke
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA. .,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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103
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Hesitancy towards the Third Dose of COVID-19 Vaccine among the Younger Generation in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127041. [PMID: 35742292 PMCID: PMC9222216 DOI: 10.3390/ijerph19127041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/28/2022] [Accepted: 06/07/2022] [Indexed: 12/19/2022]
Abstract
The younger generation's hesitancy towards the COVID-19 vaccine in Japan received significant attention during the early stages of vaccination. However, there is a lack of a comprehensive study in Japan that analyzes the apprehension towards the third dose of vaccine, commonly known as the booster dose, and its underlying causes. Using data from an online panel survey conducted by the Hiroshima Institute of Health Economics Research at Hiroshima University, we examined the severity of booster dose aversion among youths of different ages. Our findings indicate that a sizeable proportion of the Japanese population, particularly younger men, are hesitant to receive the booster dose. Furthermore, an inter-age group difference in booster dose aversion exists only among men. According to the probit regression results, subjective health status and future anxiety are associated with the booster vaccine hesitancy of men and women of various age groups. Moreover, few socioeconomic and behavioral factors like marital status, having children, household income and assets, and having a myopic view of the future, are also associated with the booster dose aversion among youths of certain ages. Given the diverse attitude of the younger generation, our findings suggest that public health authorities should develop effective communication strategies to reduce vaccine apprehension in the society.
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104
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Ong SWX, Tham SM, Koh LP, Dugan C, Khoo BY, Ren D, Sutjipto S, Lee PH, Young BE, Lye DC. External validation of the PRIORITY model in predicting COVID-19 critical illness in vaccinated and unvaccinated patients. Clin Microbiol Infect 2022; 28:884.e1-884.e3. [PMID: 35150879 PMCID: PMC8828384 DOI: 10.1016/j.cmi.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Predictive scores are important tools for the triage of patients with coronavirus disease 2019. The PRIORITY score is advantageous because it does not require laboratory and radiologic information. However, the original development and validation cohorts studied only unvaccinated patients in early 2020. We aimed to externally validate the PRIORITY score in a cohort of patients with the novel delta and omicron variants of coronavirus disease 2019 and mixed vaccination status. METHODS A total of 410 patients were included in a cross-sectional sampling of all patients admitted to the National Centre of Infectious Diseases on October 27, 2021. A further 102 and 136 patients with vaccine-breakthrough Delta and Omicron variant infection from April to August and December 2021, respectively, were also included. Variables at the time of admission were collected retrospectively from medical records and used to calculate the probability of deterioration using the PRIORITY model. RESULTS Of the total 648 included patients, 447 (69.0%) were vaccinated. The mean age was 61.6 years (standard deviation ± 19.0 years), and 268 patients (41.4%) were female. A total of 112 patients (17.3%) met the primary outcome of developing critical illness or mortality. The performance of the score in this cohort was comparable with the original cohorts, with an area under the receiver operating characteristic curve for all patients of 0.794 (95% CI, 0.752-0.835; p < 0.001), regression coefficient of 1.069, and intercept of 0.04. Subgroup analysis of unvaccinated and vaccinated patients showed that performance was superior in vaccinated individuals, with an area under the receiver operating characteristic curve of 0.684 (95% CI, 0.608-0.760; p < 0.0001) and 0.831 (95% CI, 0.772-0.891; p < 0.0001), respectively. DISCUSSION Our data support the continued use of the PRIORITY score in this era of novel variants and increased vaccination uptake.
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Affiliation(s)
- Sean Wei Xiang Ong
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Sai Meng Tham
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Lin Pin Koh
- National Centre for Infectious Diseases, Singapore
| | - Christopher Dugan
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Bo Yan Khoo
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Dongdong Ren
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Stephanie Sutjipto
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Pei Hua Lee
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Barnaby Edward Young
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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105
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Alshukairi AN, Al-Omari A, Al-Tawfiq JA, El-Kafrawy SA, El-Daly MM, Hassan AM, Faizo AA, Alandijany TA, Dada A, Saeedi MF, Alhamlan FS, Al Hroub MK, Qushmaq I, Azhar EI. Active viral shedding in a vaccinated hospitalized patient infected with the delta variant (B.1.617.2) of SARS-CoV-2 and challenges of de-isolation. J Infect Public Health 2022; 15:628-630. [PMID: 35576779 PMCID: PMC9047479 DOI: 10.1016/j.jiph.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
In the era of SARS-CoV-2 variants and COVID-19 vaccination, the duration of infectious viral shedding and isolation in post vaccine breakthrough infections is challenging and depends on disease severity. The current study described a case of SARS-CoV-2 Delta variant pneumonia requiring hospitalization. The patient received two doses of BNT162b2 COVID-19 vaccines, and he had positive SARS-CoV-2 viral cultures 12 days post symptom onset. The time between the second dose of vaccine and the breakthrough infection was 6 months. While immunosuppression is a known risk factor for prolonged infectious viral shedding, age and time between vaccination and breakthrough infection are important risk factors that warrant further studies.
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Affiliation(s)
- Abeer N Alshukairi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; College of Medicine, AlFaisal University, Riyadh, Saudi Arabia.
| | - Awad Al-Omari
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia; Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sherif A El-Kafrawy
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Mai M El-Daly
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Ahmed M Hassan
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa A Faizo
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Thamir A Alandijany
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Ashraf Dada
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed F Saeedi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Fatma S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammad K Al Hroub
- Department of Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ismael Qushmaq
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Esam I Azhar
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
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Kent SJ, Khoury DS, Reynaldi A, Juno JA, Wheatley AK, Stadler E, John Wherry E, Triccas J, Sasson SC, Cromer D, Davenport MP. Disentangling the relative importance of T cell responses in COVID-19: leading actors or supporting cast? Nat Rev Immunol 2022; 22:387-397. [PMID: 35484322 PMCID: PMC9047577 DOI: 10.1038/s41577-022-00716-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
The rapid development of multiple vaccines providing strong protection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a major achievement. There is now compelling evidence for the role of neutralizing antibodies in protective immunity. T cells may play a role in resolution of primary SARS-CoV-2 infection, and there is a widely expressed view that T cell-mediated immunity also plays an important role in vaccine-mediated protection. Here we discuss the role of vaccine-induced T cells in two distinct stages of infection: firstly, in protection from acquisition of symptomatic SARS-CoV-2 infection following exposure; secondly, if infection does occur, the potential for T cells to reduce the risk of developing severe COVID-19. We describe several lines of evidence that argue against a direct impact of vaccine-induced memory T cells in preventing symptomatic SARS-CoV-2 infection. However, the contribution of T cell immunity in reducing the severity of infection, particularly in infection with SARS-CoV-2 variants, remains to be determined. A detailed understanding of the role of T cells in COVID-19 is critical for next-generation vaccine design and development. Here we discuss the challenges in determining a causal relationship between vaccine-induced T cell immunity and protection from COVID-19 and propose an approach to gather the necessary evidence to clarify any role for vaccine-induced T cell memory in protection from severe COVID-19.
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Affiliation(s)
- Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
- Melbourne Sexual Health Centre, Monash University, Melbourne, VIC, Australia.
- Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia.
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Arnold Reynaldi
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Jennifer A Juno
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Eva Stadler
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - E John Wherry
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - James Triccas
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Sarah C Sasson
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Deborah Cromer
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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107
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Liu C, Lee J, Ta C, Soroush A, Rogers JR, Kim JH, Natarajan K, Zucker J, Perl Y, Weng C. Risk Factors Associated With SARS-CoV-2 Breakthrough Infections in Fully mRNA-Vaccinated Individuals: Retrospective Analysis. JMIR Public Health Surveill 2022; 8:e35311. [PMID: 35486806 PMCID: PMC9132195 DOI: 10.2196/35311] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND COVID-19 messenger RNA (mRNA) vaccines have demonstrated efficacy and effectiveness in preventing symptomatic COVID-19, while being relatively safe in trial studies. However, vaccine breakthrough infections have been reported. OBJECTIVE This study aims to identify risk factors associated with COVID-19 breakthrough infections among fully mRNA-vaccinated individuals. METHODS We conducted a series of observational retrospective analyses using the electronic health records (EHRs) of the Columbia University Irving Medical Center/New York Presbyterian (CUIMC/NYP) up to September 21, 2021. New York City (NYC) adult residences with at least 1 polymerase chain reaction (PCR) record were included in this analysis. Poisson regression was performed to assess the association between the breakthrough infection rate in vaccinated individuals and multiple risk factors-including vaccine brand, demographics, and underlying conditions-while adjusting for calendar month, prior number of visits, and observational days in the EHR. RESULTS The overall estimated breakthrough infection rate was 0.16 (95% CI 0.14-0.18). Individuals who were vaccinated with Pfizer/BNT162b2 (incidence rate ratio [IRR] against Moderna/mRNA-1273=1.66, 95% CI 1.17-2.35) were male (IRR against female=1.47, 95% CI 1.11-1.94) and had compromised immune systems (IRR=1.48, 95% CI 1.09-2.00) were at the highest risk for breakthrough infections. Among all underlying conditions, those with primary immunodeficiency, a history of organ transplant, an active tumor, use of immunosuppressant medications, or Alzheimer disease were at the highest risk. CONCLUSIONS Although we found both mRNA vaccines were effective, Moderna/mRNA-1273 had a lower incidence rate of breakthrough infections. Immunocompromised and male individuals were among the highest risk groups experiencing breakthrough infections. Given the rapidly changing nature of the SARS-CoV-2 pandemic, continued monitoring and a generalizable analysis pipeline are warranted to inform quick updates on vaccine effectiveness in real time.
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Affiliation(s)
- Cong Liu
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Junghwan Lee
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Casey Ta
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Ali Soroush
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - James R Rogers
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Jae Hyun Kim
- School of Pharmacy, Jeonbuk National University, Jeonju, Republic of Korea
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
| | - Jason Zucker
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Yehoshua Perl
- Department of Computer Science, New Jersey Institute of Technology, Newark, NJ, United States
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, United States
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108
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Similar duration of viral shedding of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) delta variant between vaccinated and incompletely vaccinated individuals. Infect Control Hosp Epidemiol 2022:1-3. [PMID: 35598890 PMCID: PMC9237490 DOI: 10.1017/ice.2022.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Among outpatients with coronavirus disease 2019 (COVID-19) due to the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) δ (delta) variant who did and did not receive 2 vaccine doses at 7 days after symptom onset, there was no difference in viral shedding (cycle threshold difference 0.59, 95% CI, −4.68 to 3.50; P = .77) with SARS-CoV-2 cultured from 2 (7%) of 28 and 1 (4%) of 26 outpatients, respectively.
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109
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Lee CJ, Woo W, Kim AY, Yon DK, Lee SW, Koyanagi A, Kim MS, KalthoumTizaoui, Dragioti E, Radua J, Lee S, Smith L, Il Shin J. Clinical Manifestations of COVID-19 Breakthrough Infections: A Systematic Review and Meta-Analysis. J Med Virol 2022; 94:4234-4245. [PMID: 35588301 PMCID: PMC9348075 DOI: 10.1002/jmv.27871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 11/12/2022]
Abstract
To provide a comparative meta‐analysis and systematic review of the risk and clinical outcomes of coronavirus 2019 (COVID‐19) infection between fully vaccinated and unvaccinated groups. Eighteen studies of COVID‐19 infections in fully vaccinated (“breakthrough infections”) and unvaccinated individuals were reviewed from Medline/PubMed, Scopus, Embase, and Web of Science databases. The meta‐analysis examined the summary effects and between‐study heterogeneity regarding differences in the risk of infection, hospitalization, treatments, and mortality between vaccinated and unvaccinated individuals. he overall risk of infection was lower for the fully vaccinated compared to that of the unvaccinated (relative risk [RR] 0.20, 95% confidence interval [CI]: 0.19−0.21), especially for variants other than Delta (Delta: RR 0.29, 95% CI: 0.13−0.65; other variants: RR 0.06, 95% CI: 0.04−0.08). The risk of asymptomatic infection was not statistically significantly different between fully vaccinated and unvaccinated (RR 0.56, 95% CI: 0.27−1.19). There were neither statistically significant differences in risk of hospitalization (RR 1.06, 95% CI: 0.38−2.93), invasive mechanical ventilation (RR 1.65, 95% CI: 0.90−3.06), or mortality (RR 1.19, 95% CI: 0.79−1.78). Conversely, the risk of supplemental oxygen during hospitalization was significantly higher for the unvaccinated (RR 1.40, 95% CI: 1.08−1.82). Unvaccinated people were more vulnerable to COVID‐19 infection than fully vaccinated for all variants. Once infected, there were no statistically significant differences in the risk of hospitalization, invasive mechanical ventilation, or mortality. Still, unvaccinated showed an increased need for oxygen supplementation. Further prospective analysis, including patients’ risk factors, COVID‐19 variants, and the utilized treatment strategies, would be warranted.
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Affiliation(s)
- Christine J Lee
- Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, USA
| | - Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ah Young Kim
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Min Seo Kim
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - KalthoumTizaoui
- Laboratory of Microoranismes and Active Biomolecules, Sciences Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE, 581 85, Linköping, Sweden
| | - Joaquim Radua
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Lee Smith
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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Jung J, Kim JY, Park H, Park S, Lim JS, Lim SY, Bae S, Lim YJ, Kim EO, Kim J, Park MS, Kim SH. Transmission and Infectious SARS-CoV-2 Shedding Kinetics in Vaccinated and Unvaccinated Individuals. JAMA Netw Open 2022; 5:e2213606. [PMID: 35608859 PMCID: PMC9131744 DOI: 10.1001/jamanetworkopen.2022.13606] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Data are limited on whether patients with breakthrough COVID-19 infection have the potential to significantly contribute to the spread of SARS-CoV-2. OBJECTIVE To compare the secondary attack rate and infectious viral shedding kinetics of SARS-CoV-2 between fully vaccinated individuals (breakthrough infection group) and partially or unvaccinated individuals (nonbreakthrough infection group). DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed secondary transmission by analyzing the epidemiologic data of health care workers, inpatients, and caregivers diagnosed with COVID-19 during hospitalization or residence in a tertiary care hospital between March 1, 2020, and November 6, 2021. To evaluate viral shedding kinetics, the genomic RNA of SARS-CoV-2 was measured using polymerase chain reaction and performed virus culture from daily saliva samples of individuals with mild COVID-19 infected with the Delta variant who were isolated in a community facility in Seoul, South Korea, between July 20 and August 20, 2021. EXPOSURES COVID-19 vaccination. MAIN OUTCOMES AND MEASURES The secondary attack rate and infectious viral shedding kinetics according to COVID-19 vaccination status. RESULTS A total of 173 individuals (median [IQR] age, 47 [32-59] years; 100 female [58%]) with COVID-19 were included in the secondary transmission study, of whom 50 (29%) had a breakthrough infection. Secondary transmission was significantly less common in the breakthrough infection group than in the nonbreakthrough infection group (3 of 43 [7%] vs 29 of 110 [26%]; P = .008). In the viral shedding kinetics study, 45 patients (median age, 37 years [IQR, 25-49 years]; 14 female [31%]) infected with the Delta variant were included, of whom 6 (13%) were fully vaccinated and 39 (87%) were partially or unvaccinated. Although the initial genomic viral load was comparable between the 2 groups, viable virus in cell culture was detected for a notably longer duration in partially vaccinated (8 days after symptom onset) or unvaccinated (10 days after symptom onset) individuals compared with fully vaccinated individuals (4 days after symptom onset). CONCLUSIONS AND RELEVANCE In this cohort study, although the initial genomic viral load was similar between vaccinated and unvaccinated individuals, fully vaccinated individuals had a shorter duration of viable viral shedding and a lower secondary attack rate than partially vaccinated or unvaccinated individuals. Data from this study provide important evidence that despite the possibility of breakthrough infections, COVID-19 vaccinations remain critically useful for controlling the spread of SARS-CoV-2.
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Affiliation(s)
- Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Heedo Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Sunghee Park
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Joon Seo Lim
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, South Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young-Ju Lim
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Eun Ok Kim
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
| | - Jineui Kim
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Man-Seong Park
- Department of Microbiology, Institute for Viral Diseases, Biosafety Center, College of Medicine, Korea University, Seoul, South Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
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111
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Koutsakos M, Lee WS, Reynaldi A, Tan HX, Gare G, Kinsella P, Liew KC, Taiaroa G, Williamson DA, Kent HE, Stadler E, Cromer D, Khoury DS, Wheatley AK, Juno JA, Davenport MP, Kent SJ. The magnitude and timing of recalled immunity after breakthrough infection is shaped by SARS-CoV-2 variants. Immunity 2022; 55:1316-1326.e4. [PMID: 35690062 PMCID: PMC9135796 DOI: 10.1016/j.immuni.2022.05.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/01/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
Abstract
Vaccination against SARS-CoV-2 protects from infection and improves clinical outcomes in breakthrough infections, likely reflecting residual vaccine-elicited immunity and recall of immunological memory. Here, we define the early kinetics of spike-specific humoral and cellular immunity after vaccination of seropositive individuals and after Delta or Omicron breakthrough infection in vaccinated individuals. Early longitudinal sampling revealed the timing and magnitude of recall, with the phenotypic activation of B cells preceding an increase in neutralizing antibody titers. While vaccination of seropositive individuals resulted in robust recall of humoral and T cell immunity, recall of vaccine-elicited responses was delayed and variable in magnitude during breakthrough infections and depended on the infecting variant of concern. While the delayed kinetics of immune recall provides a potential mechanism for the lack of early control of viral replication, the recall of antibodies coincided with viral clearance and likely underpins the protective effects of vaccination against severe COVID-19.
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Affiliation(s)
- Marios Koutsakos
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Wen Shi Lee
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Arnold Reynaldi
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Hyon-Xhi Tan
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Grace Gare
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Paul Kinsella
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Kwee Chin Liew
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - George Taiaroa
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Deborah A Williamson
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Helen E Kent
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Eva Stadler
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Deborah Cromer
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - David S Khoury
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
| | - Jennifer A Juno
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia.
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; Melbourne Sexual Health Centre and Department of Infectious Diseases, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia.
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112
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Acharya CB, Schrom J, Mitchell AM, Coil DA, Marquez C, Rojas S, Wang CY, Liu J, Pilarowski G, Solis L, Georgian E, Belafsky S, Petersen M, DeRisi J, Michelmore R, Havlir D. Viral Load Among Vaccinated and Unvaccinated, Asymptomatic and Symptomatic Persons Infected With the SARS-CoV-2 Delta Variant. Open Forum Infect Dis 2022; 9:ofac135. [PMID: 35479304 PMCID: PMC8992250 DOI: 10.1093/ofid/ofac135] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/16/2022] [Indexed: 07/21/2023] Open
Abstract
We found no significant difference in cycle threshold values between vaccinated and unvaccinated persons infected with severe acute respiratory syndrome coronavirus 2 Delta, overall or stratified by symptoms. Given the substantial proportion of asymptomatic vaccine breakthrough cases with high viral levels, interventions, including masking and testing, should be considered in settings with elevated coronavirus disease 2019 transmission.
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Affiliation(s)
| | - John Schrom
- Unidos en Salud, San Francisco, California, USA
| | - Anthea M Mitchell
- Chan Zuckerberg Biohub and Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, California, USA
| | - David A Coil
- Genome Center, University of California, Davis, Davis, California, USA
| | - Carina Marquez
- Unidos en Salud, San Francisco, California, USA
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Chung Yu Wang
- Chan Zuckerberg Biohub and Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, California, USA
| | - Jamin Liu
- Joint UCB/UCSF Bioengineering Program, University of California, Berkeley, and University of California, San Francisco, San Francisco, California, USA
| | - Genay Pilarowski
- Unidos en Salud, San Francisco, California, USA
- The Public Health Company, Oakland, California, USA
| | - Leslie Solis
- Genome Center, University of California, Davis, Davis, California, USA
| | | | - Sheri Belafsky
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Maya Petersen
- Unidos en Salud, San Francisco, California, USA
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Joseph DeRisi
- Chan Zuckerberg Biohub and Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, California, USA
| | | | - Diane Havlir
- Unidos en Salud, San Francisco, California, USA
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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113
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Brosh-Nissimov T, Maor Y, Elbaz M, Lipman-Arens S, Wiener-Well Y, Hussein K, Orenbuch-Harroch E, Cohen R, Zimhony O, Chazan B, Nesher L, Rahav G, Zayyad H, Hershman-Sarafov M, Weinberger M, Najjar-Debbiny R, Chowers M. Hospitalised patients with breakthrough COVID-19 following vaccination during two distinct waves in Israel, January to August 2021: a multicentre comparative cohort study. Euro Surveill 2022; 27:2101026. [PMID: 35593161 PMCID: PMC9121662 DOI: 10.2807/1560-7917.es.2022.27.20.2101026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/20/2022] [Indexed: 01/14/2023] Open
Abstract
BackgroundChanging patterns of vaccine breakthrough can clarify vaccine effectiveness.AimTo compare breakthrough infections during a SARS-CoV-2 Delta wave vs unvaccinated inpatients, and an earlier Alpha wave.MethodsIn an observational multicentre cohort study in Israel, hospitalised COVID-19 patients were divided into three cohorts: breakthrough infections in Comirnaty-vaccinated patients (VD; Jun-Aug 2021) and unvaccinated cases during the Delta wave (ND) and breakthrough infections during an earlier Alpha wave (VA; Jan-Apr 2021). Primary outcome was death or ventilation.ResultsWe included 343 VD, 162 ND and 172 VA patients. VD were more likely older (OR: 1.06; 95% CI: 1.05-1.08), men (OR: 1.6; 95% CI: 1.0-2.5) and immunosuppressed (OR: 2.5; 95% CI: 1.1-5.5) vs ND. Median time between second vaccine dose and admission was 179 days (IQR: 166-187) in VD vs 41 days (IQR: 28-57.5) in VA. VD patients were less likely to be men (OR: 0.6; 95% CI: 0.4-0.9), immunosuppressed (OR: 0.3; 95% CI: 0.2-0.5) or have congestive heart failure (OR: 0.6; 95% CI: 0.3-0.9) vs VA. The outcome was similar between all cohorts and affected by age and immunosuppression and not by vaccination, variant or time from vaccination.ConclusionsVaccination was protective during the Delta variant wave, as suggested by older age and greater immunosuppression in vaccinated breakthrough vs unvaccinated inpatients. Nevertheless, compared with an earlier post-vaccination period, breakthrough infections 6 months post-vaccination occurred in healthier patients. Thus, waning immunity increased vulnerability during the Delta wave, which suggests boosters as a countermeasure.
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Affiliation(s)
- Tal Brosh-Nissimov
- Infectious Diseases Unit, Samson Assuta Ashdod University Hospital, Ashdod, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel
| | - Yasmin Maor
- Infectious Disease Unit, Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meital Elbaz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Infectious Diseases, Tel Aviv Sourasky Medical Center
| | - Shelly Lipman-Arens
- Infectious Disease and Infection Control Unit, Hillel Yaffe Medical Center, Hadera, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yonit Wiener-Well
- Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Khetam Hussein
- Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Efrat Orenbuch-Harroch
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Regev Cohen
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Oren Zimhony
- Infectious Diseases Unit, Kaplan Medical Center, Rehovot, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Bibiana Chazan
- Infectious Diseases Unit, Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lior Nesher
- Infectious Disease Institute, Soroka Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel
| | - Galia Rahav
- Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hiba Zayyad
- Infectious Disease Unit, The Baruch Padeh Medical Center, Tiberias, Israel
- The Azrieli Faculty of Medicine in the Galilee, Bar Ilan university, Safed, Israel
| | - Mirit Hershman-Sarafov
- Bnai Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Miriam Weinberger
- Shamir (Assaf Harofe) Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronza Najjar-Debbiny
- Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michal Chowers
- Meir Medical Center, Kfar Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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114
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Cojocaru C, Cojocaru E, Turcanu A, Zaharia D. Clinical challenges of SARS‑CoV‑2 variants (Review). Exp Ther Med 2022; 23:416. [PMID: 35601074 PMCID: PMC9117961 DOI: 10.3892/etm.2022.11343] [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: 02/07/2022] [Accepted: 04/08/2022] [Indexed: 11/06/2022] Open
Abstract
Since the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there have been challenges recognizing the clinical features of SARS-CoV-2 and identifying therapeutic options. This has been compounded by viral mutations that affect clinical response and primary epidemiological indicators. Multiple variants of SARS-CoV-2 have been identified and classified on the basis of nomenclature implemented by scientific organizations and the World Health Organisation (WHO). A total of five variants of concern (VOCs) have been identified to date. The present study aimed to analyse clinical and epidemiological features of each variant. Based on these characteristics, predictions were made about potential future evolution. Considering the time and location of SARS-CoV-2 VOC emergence, it was hypothesised that mutations were not due to pressure caused by the vaccines introduced in December 2020 but were dependent on natural characteristics of the virus. In the process of adapting to the human body, SARS-CoV-2 is expected to undergo evolution to become more contagious but less deadly. SARS-CoV-2 was hypothesized to continue spread through isolated epidemic outbreaks due to the unimmunized population, mostly unvaccinated children and adults, and for coronaviruses to continue to present a public health problem.
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Affiliation(s)
- Cristian Cojocaru
- Medical III Department, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Cojocaru
- Morpho‑Functional Sciences II Department, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adina Turcanu
- Medical III Department, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dragos Zaharia
- Department 4 Cardio‑thoracic Pathology, Faculty of Medicine, University of Medicine and Pharmacy ‘Carol Davila’, 050471 Bucharest, Romania
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115
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Using high-resolution contact networks to evaluate SARS-CoV-2 transmission and control in large-scale multi-day events. Nat Commun 2022; 13:1956. [PMID: 35414056 PMCID: PMC9005731 DOI: 10.1038/s41467-022-29522-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/11/2022] [Indexed: 11/12/2022] Open
Abstract
The emergence of highly transmissible SARS-CoV-2 variants has created a need to reassess the risk posed by increasing social contacts as countries resume pre-pandemic activities, particularly in the context of resuming large-scale events over multiple days. To examine how social contacts formed in different activity settings influences interventions required to control Delta variant outbreaks, we collected high-resolution data on contacts among passengers and crew on cruise ships and combined the data with network transmission models. We found passengers had a median of 20 (IQR 10-36) unique close contacts per day, and over 60% of their contact episodes were made in dining or sports areas where mask wearing is typically limited. In simulated outbreaks, we found that vaccination coverage and rapid antigen tests had a larger effect than mask mandates alone, indicating the importance of combined interventions against Delta to reduce event risk in the vaccine era.
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116
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Zachreson C, Shearer FM, Price DJ, Lydeamore MJ, McVernon J, McCaw J, Geard N. COVID-19 in low-tolerance border quarantine systems: Impact of the Delta variant of SARS-CoV-2. SCIENCE ADVANCES 2022; 8:eabm3624. [PMID: 35394833 PMCID: PMC8993115 DOI: 10.1126/sciadv.abm3624] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/16/2022] [Indexed: 05/25/2023]
Abstract
In controlling transmission of coronavirus disease 2019 (COVID-19), the effectiveness of border quarantine strategies is a key concern for jurisdictions in which the local prevalence of disease and immunity is low. In settings like this such as China, Australia, and New Zealand, rare outbreak events can lead to escalating epidemics and trigger the imposition of large-scale lockdown policies. Here, we develop and apply an individual-based model of COVID-19 to simulate case importation from managed quarantine under various vaccination scenarios. We then use the output of the individual-based model as input to a branching process model to assess community transmission risk. For parameters corresponding to the Delta variant, our results demonstrate that vaccination effectively counteracts the pathogen's increased infectiousness. To prevent outbreaks, heightened vaccination in border quarantine systems must be combined with mass vaccination. The ultimate success of these programs will depend sensitively on the efficacy of vaccines against viral transmission.
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Affiliation(s)
- Cameron Zachreson
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Freya M. Shearer
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - David J. Price
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Michael J. Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
| | - Jodie McVernon
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Laboratory Epidemiology Unit, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - James McCaw
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- School of Mathematics and Statistics, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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117
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Puhach O, Adea K, Hulo N, Sattonnet P, Genecand C, Iten A, Bausch FJ, Kaiser L, Vetter P, Eckerle I, Meyer B. Infectious viral load in unvaccinated and vaccinated individuals infected with ancestral, Delta or Omicron SARS-CoV-2. Nat Med 2022; 28:1491-1500. [PMID: 35395151 DOI: 10.1038/s41591-022-01816-0] [Citation(s) in RCA: 177] [Impact Index Per Article: 88.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022]
Abstract
Infectious viral load (VL) expelled as droplets and aerosols by infected individuals partly determines SARS-CoV-2 transmission. RNA VL measured by qRT-PCR is only a weak proxy for infectiousness. Studies on the kinetics of infectious VL are important to understand the mechanisms behind the different transmissibility of SARS-CoV-2 variants and the effect of vaccination on transmission, which allows to guide public health measures. In this study we quantified infectious VL in SARS-CoV-2 infected individuals during the first 5 symptomatic days by in vitro culturability assay in unvaccinated or vaccinated individuals infected with pre-variant of concern (pre-VOC) SARS-CoV-2, Delta, or Omicron. Unvaccinated individuals infected with pre-VOC SARS-CoV-2 had lower infectious VL compared to Delta-infected unvaccinated individuals. Full vaccination (defined as >2weeks after reception of 2nd dose during primary vaccination series) significantly reduced infectious VL for Delta breakthrough cases compared to unvaccinated individuals. For Omicron breakthrough cases, reduced infectious VL was only observed in boosted but not in fully vaccinated individuals compared to unvaccinated subjects. In addition, infectious VL was lower in fully vaccinated Omicron- compared to fully vaccinated Delta-infected individuals, suggesting that other mechanisms than increased infectious VL contribute to the high infectiousness of SARS-CoV-2 Omicron. Our findings indicate that vaccines may lower transmission risk and therefore have a public health benefit beyond the individual protection from severe disease.
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Affiliation(s)
- Olha Puhach
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Kenneth Adea
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Hulo
- Service for Biomathematical and Biostatistical Analyses, Institute of Genetics and Genomics, University of Geneva, Geneva, Switzerland
| | - Pascale Sattonnet
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Camille Genecand
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Anne Iten
- Service of Prevention and Infection Control, Directorate of Medicine and Quality, University Hospital Geneva, HUG, Geneva, Switzerland
| | - Frédérique Jacquérioz Bausch
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Primary Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Vetter
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland. .,Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - Isabella Eckerle
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland. .,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
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118
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Colijn C, Earn DJD, Dushoff J, Ogden NH, Li M, Knox N, Van Domselaar G, Franklin K, Jolly G, Otto SP. The need for linked genomic surveillance of SARS-CoV-2. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2022; 48:131-139. [PMID: 35480703 PMCID: PMC9017802 DOI: 10.14745/ccdr.v48i04a03] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genomic surveillance during the coronavirus disease 2019 (COVID-19) pandemic has been key to the timely identification of virus variants with important public health consequences, such as variants that can transmit among and cause severe disease in both vaccinated or recovered individuals. The rapid emergence of the Omicron variant highlighted the speed with which the extent of a threat must be assessed. Rapid sequencing and public health institutions' openness to sharing sequence data internationally give an unprecedented opportunity to do this; however, assessing the epidemiological and clinical properties of any new variant remains challenging. Here we highlight a "band of four" key data sources that can help to detect viral variants that threaten COVID-19 management: 1) genetic (virus sequence) data; 2) epidemiological and geographic data; 3) clinical and demographic data; and 4) immunization data. We emphasize the benefits that can be achieved by linking data from these sources and by combining data from these sources with virus sequence data. The considerable challenges of making genomic data available and linked with virus and patient attributes must be balanced against major consequences of not doing so, especially if new variants of concern emerge and spread without timely detection and action.
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Affiliation(s)
- Caroline Colijn
- Department of Mathematics, Simon Fraser University, Burnaby, BC
| | - David JD Earn
- Department of Mathematics & Statistics and M. G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON
| | - Jonathan Dushoff
- Department of Biology and M. G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St.-Hyacinthe, QC
| | - Michael Li
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Guelph, ON
| | - Natalie Knox
- National Microbiology Laboratory, Public Health Agency of Canada and Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, MB
| | - Gary Van Domselaar
- National Microbiology Laboratory, Public Health Agency of Canada and Department of Medical Microbiology & Infectious Diseases, University of Manitoba, Winnipeg, MB
| | - Kristyn Franklin
- Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Calgary, AB
| | - Gordon Jolly
- Public Health Genomics, Public Health Agency of Canada
| | - Sarah P Otto
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC
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119
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Zdravkovic M, Popadic V, Nikolic V, Klasnja S, Brajkovic M, Manojlovic A, Nikolic N, Markovic-Denic L. COVID-19 Vaccination Willingness and Vaccine Uptake among Healthcare Workers: A Single-Center Experience. Vaccines (Basel) 2022; 10:500. [PMID: 35455249 PMCID: PMC9024424 DOI: 10.3390/vaccines10040500] [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: 12/31/2021] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers (HCWs) are at higher risk of developing COVID-19 due to their professional exposition to the SARS-CoV-2 virus. This study assesses the intention of vaccination against COVID-19 before the vaccines were approved, and the rate of vaccine uptake during the first nine months of immunization among HCWs. A cross-sectional seroprevalence study was carried out during July 2020 in University Clinical Hospital Center Bezanijska Kosa in Belgrade, Serbia that included 62.8% of all HCWs. Besides serological testing for IgG antibodies, data about HCWs' intention to accept COVID-19 vaccination if a vaccine became available were collected. This cohort of HCWs was followed up until the end of October 2021 to assess the number of vaccinated and PCR-positive staff. In the cross-sectional study, 18.3% HCWs had positive SARS-CoV-2 IgG antibodies without difference with IgG-negative HCWs regarding age, gender, profession type, and years of service. Before vaccines became available, a significantly higher percentage of IgG-positive HCWs compared to IgG-negative HCWs was unsure whether to be vaccinated (62.5% vs. 49.0%), and significantly fewer stated that they would not be vaccinated (16.7% vs. 25.1%). When the vaccines became available in Serbia, among IgG-negative HCWs, those who stated clear positive (yes) and clear negative (no) attitude toward vaccination before the immunization period had begun were vaccinated at 28% and 20%, respectively, while 51% of unsure HCWs received a vaccine (p = 0.006). Among IgG-positive HCWs, there was no statistical difference in vaccine uptake regarding those with previous negative, positive, and unsure opinions about vaccination (p = 0.498). In multivariate analysis, independent factors associated with uptake were being female (OR = 1.92; 95%CI: 1.04-3.55), age of 30-59 years, previously vaccine-unsure (OR = 1.84; 95%CI: 1.04-3.25), and those with previous positive vaccine attitudes (OR = 2.48; 95%CI:1.23-5.01), while nurses were less likely to become vaccinated (OR = 0.39 95% CI: 0.20-0.75) These findings indicate a positive change in attitudes of HCWs towards COVID-19 vaccination.
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Affiliation(s)
- Marija Zdravkovic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
- Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia
| | - Viseslav Popadic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
| | - Vladimir Nikolic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, 11 000 Belgrade, Serbia;
| | - Slobodan Klasnja
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
| | - Milica Brajkovic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
| | - Andrea Manojlovic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
| | - Novica Nikolic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
| | - Ljiljana Markovic-Denic
- University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia; (M.Z.); (V.P.); (S.K.); (M.B.); (A.M.); (N.N.)
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, 11 000 Belgrade, Serbia;
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120
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Au J. Higher vaccination rates predict reduction in SARS-CoV-2 transmission across the United States. Infection 2022; 50:1255-1266. [PMID: 35314944 PMCID: PMC8938221 DOI: 10.1007/s15010-022-01802-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/07/2022] [Indexed: 11/27/2022]
Abstract
Purpose The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began proliferating widely throughout the world in late 2019/early 2020, creating a global pandemic and health crisis. Although vaccines became available to the public approximately 1 year after the onset of the pandemic, there still remains much hesitancy surrounding vaccination. One key concern comes from reports of breakthrough infections among the vaccinated that show comparable levels of peak viral load as the unvaccinated, calling into question the ability of vaccines to prevent transmission. Therefore young, healthy individuals who are at low risk of serious complications themselves have little incentive to receive a vaccine that they are not convinced will protect others around them. To address this important concern, this study aimed to evaluate the extent to which vaccination rates are associated with reduced SARS-CoV-2 transmission among the unvaccinated population. Methods An observational study was conducted in the United States of America throughout the months of June through September, 2021. Vaccination rate and incidence of coronavirus disease 2019 (COVID-19) were obtained for each state, along with a number of important control variables. Panel data regression was used to predict incidence among the unvaccinated based on each state’s vaccination rate. Results States with a higher proportion of fully vaccinated individuals reported fewer new cases among the remaining unvaccinated population. Conclusion These data add to accumulating evidence that COVID-19 vaccinations can indeed slow the spread of SARS-CoV-2, and are an important tool in society’s arsenal to put this pandemic behind us. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-022-01802-1.
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Affiliation(s)
- Jacky Au
- School of Education, University of California, Irvine, 3200 Education Building, Irvine, CA, 92697, USA.
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Samieefar N, Rashedi R, 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] [MESH Headings] [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)
| | | | | | | | | | - Nima Rezaei
- University of Medical Sciences, Tehran, Iran.
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122
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Sikora D, Rzymski P. COVID-19 Vaccination and Rates of Infections, Hospitalizations, ICU Admissions, and Deaths in the European Economic Area during Autumn 2021 Wave of SARS-CoV-2. Vaccines (Basel) 2022; 10:437. [PMID: 35335069 PMCID: PMC8955952 DOI: 10.3390/vaccines10030437] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 vaccination campaigns were met with a varying level of vaccine hesitancy in Europe. We analyzed the potential relationships between COVID-19 vaccine coverage in different countries of the European Economic Area and rates of infection, hospitalizations, admissions to intensive care units (ICU), and deaths during the autumn 2021 SARS-CoV-2 wave (September-December). Significant negative correlations between infection rates and the percentage of fully vaccinated individuals were found during September, October, and November, but not December. The loss of this protective effect in December is likely due to the emergence of the omicron (B.1.1.529) variant, better adapted to evade vaccine-induced humoral immunity. For every considered month, the negative linear associations between the vaccine coverage and mean number of hospitalizations (r= -0.61 to -0.88), the mean number of ICU admissions (r= -0.62 to -0.81), and death rate (r= -0.64 to -0.84) were observed. The results highlight that vaccines provided significant benefits during autumn 2021. The vaccination of unvaccinated individuals should remain the primary strategy to decrease the hospital overloads, severe consequences of COVID-19, and deaths.
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Affiliation(s)
- Dominika Sikora
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
- Doctoral School, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznań, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland
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123
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Dal-Ré R, Camps V. [August 2021 and the Delta variant: is mandatory vaccination of individuals against SARS-CoV-2 acceptable?]. Med Clin (Barc) 2022; 158:233-236. [PMID: 34895889 PMCID: PMC8585632 DOI: 10.1016/j.medcli.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Rafael Dal-Ré
- Unidad de Epidemiología, Instituto de Investigación Sanitaria-Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
| | - Victoria Camps
- Departamento de Filosofía, Universidad Autónoma de Barcelona, Barcelona, España
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Abstract
We have come a long way since the start of the COVID-19 pandemic-from hoarding toilet paper and wiping down groceries to sending our children back to school and vaccinating billions. Over this period, the global community of epidemiologists and evolutionary biologists has also come a long way in understanding the complex and changing dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. In this Review, we retrace our steps through the questions that this community faced as the pandemic unfolded. We focus on the key roles that mathematical modeling and quantitative analyses of empirical data have played in allowing us to address these questions and ultimately to better understand and control the pandemic.
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Affiliation(s)
- Katia Koelle
- Department of Biology, O. Wayne Rollins Research Center, Emory University, Atlanta, GA 30322, USA
| | - Michael A. Martin
- Department of Biology, O. Wayne Rollins Research Center, Emory University, Atlanta, GA 30322, USA
- Graduate Program in Population Biology, Ecology, and Evolution, Emory University, Atlanta, GA 30322, USA
| | - Rustom Antia
- Department of Biology, O. Wayne Rollins Research Center, Emory University, Atlanta, GA 30322, USA
| | - Ben Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Natalie E. Dean
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Abhiram K, Tan BYQ, Tan M, Tan L, Sia CH, Chua YX, Lim LJH, Suppiah CM, Sim K, Chan YH, Ooi SBS. The Effect of COVID-19 Endemicity on the Mental Health of Health Workers. J Am Med Dir Assoc 2022; 23:405-413.e3. [PMID: 35219506 PMCID: PMC8863564 DOI: 10.1016/j.jamda.2022.01.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
Abstract
Objectives A major surge in COVID-19 cases despite Singapore's high vaccination has strained the health care system in October 2021. Our aim was to assess and compare Healthcare Worker (HCW) mental well-being in 2021 against a previously published cohort in 2020. Design Cross-sectional survey study. Setting and Participants HCWs from 4 public hospitals and a primary health care system over a 4-week duration in 2021 coinciding with a major surge compared with a similar period in 2020. Methods A survey comprising of the Oldenburg Burnout Inventory (OLBI), Hospital Anxiety and Depression Scale (HADS), and Safety Attitudes Questionnaire (SAQ) was distributed via email. Primary endpoints were the proportion meeting OLBI thresholds for both disengagement and exhaustion and being at risk for both Anxiety and Depression using HADS. Multivariate analysis identified significant predictors among demographic, workplace, and SAQ data. Subgroup analysis of overseas HCWs was performed. Results We surveyed 1475 HCWs. Significantly more HCWs met primary outcomes using OLBI and HADS than in 2020 (84.1% and 39.6% vs 68.2% and 23.3%, respectively; P < .001). Burnout levels were uniformly high. A HADS score ≥8 in either subscale was significantly associated with meeting burnout thresholds (P < .001). Overseas HCWs (P = .002), South Asian ethnicity (P = .004), preuniversity educational qualifications (P = .026), and longer shift workhours of 8 to <12 (P = .015) and ≥12 (P = .001) were significantly associated with meeting HADS thresholds. Among overseas HCWs (n=407), seeing family more than a year ago was significantly associated with worse OLBI disengagement scores and a greater proportion meeting HADS thresholds vs seeing them within a year or being local HCWs (47.2% vs 37.2% and 35.6%, respectively; P = .001). Conclusions and Implications HCW mental health has objectively worsened between 2020 and 2021 in the pandemic’s second year. Avoiding prolonged shifts, adopting preventive mental health strategies, improving patient safety, and attention to HCWs of minority ethnicity, from overseas, and with preuniversity education may help.
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Affiliation(s)
- Kanneganti Abhiram
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Benjamin Y Q Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore.
| | - Melanie Tan
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Lifeng Tan
- Division of Healthy Ageing, Alexandra Hospital, Singapore
| | - Ching-Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore
| | - Ying Xian Chua
- Pioneer Polyclinic, National University Polyclinics, National University Health System, Singapore
| | - Lucas J H Lim
- Psychiatry Residency Programme, National Healthcare Group, Singapore
| | | | - Kang Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; West Region, Institute of Mental Health, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shirley B S Ooi
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Emergency Medicine Department, National University Hospital, Singapore
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Saied AA. Africa is going to develop their own health capabilities for future challenges - Correspondence. Int J Surg 2022; 99:106585. [PMID: 35231633 PMCID: PMC8881288 DOI: 10.1016/j.ijsu.2022.106585] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/20/2022]
Affiliation(s)
- AbdulRahman A. Saied
- Department of Food Establishments Licensing (Aswan Branch), National Food Safety Authority (NFSA), Aswan, 81511, Egypt,Touristic Activities and Interior Offices Sector (Aswan Office), Ministry of Tourism and Antiquities, Aswan, 81511, Egypt,Corresponding author. Department of Food Establishments Licensing (Aswan Branch), National Food Safety Authority (NFSA), Aswan, 81511, Egypt
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127
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Venekamp RP, Veldhuijzen IK, Moons KGM, van den Bijllaardt W, Pas SD, Lodder EB, Molenkamp R, Igloi Z, Wijers C, Dos Santos CO, Debast SB, Bruins MJ, Polad K, Nagel-Imming CRS, Han WGH, van de Wijgert JHHM, van den Hof S, Schuit E. Detection of SARS-CoV-2 infection in the general population by three prevailing rapid antigen tests: cross-sectional diagnostic accuracy study. BMC Med 2022; 20:97. [PMID: 35197052 PMCID: PMC8866040 DOI: 10.1186/s12916-022-02300-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Rapid antigen diagnostic tests (Ag-RDTs) are the most widely used point-of-care tests for detecting SARS-CoV-2 infection. Since the accuracy may have altered by changes in SARS-CoV-2 epidemiology, indications for testing, sampling and testing procedures, and roll-out of COVID-19 vaccination, we evaluated the performance of three prevailing SARS-CoV-2 Ag-RDTs. METHODS In this cross-sectional study, we consecutively enrolled individuals aged >16 years presenting for SARS-CoV-2 testing at three Dutch public health service COVID-19 test sites. In the first phase, participants underwent either BD-Veritor System (Becton Dickinson), PanBio (Abbott), or SD-Biosensor (Roche Diagnostics) testing with routine sampling procedures. In a subsequent phase, participants underwent SD-Biosensor testing with a less invasive sampling method (combined oropharyngeal-nasal [OP-N] swab). Diagnostic accuracies were assessed against molecular testing. RESULTS Six thousand nine hundred fifty-five of 7005 participants (99%) with results from both an Ag-RDT and a molecular reference test were analysed. SARS-CoV-2 prevalence and overall sensitivities were 13% (188/1441) and 69% (129/188, 95% CI 62-75) for BD-Veritor, 8% (173/2056) and 69% (119/173, 61-76) for PanBio, and 12% (215/1769) and 74% (160/215, 68-80) for SD-Biosensor with routine sampling and 10% (164/1689) and 75% (123/164, 68-81) for SD-Biosensor with OP-N sampling. In those symptomatic or asymptomatic at sampling, sensitivities were 72-83% and 54-56%, respectively. Above a viral load cut-off (≥5.2 log10 SARS-CoV-2 E-gene copies/mL), sensitivities were 86% (125/146, 79-91) for BD-Veritor, 89% (108/121, 82-94) for PanBio, and 88% (160/182, 82-92) for SD-Biosensor with routine sampling and 84% (118/141, 77-89) with OP-N sampling. Specificities were >99% for all tests in most analyses. Sixty-one per cent of false-negative Ag-RDT participants returned for testing within 14 days (median: 3 days, interquartile range 3) of whom 90% tested positive. CONCLUSIONS Overall sensitivities of three SARS-CoV-2 Ag-RDTs were 69-75%, increasing to ≥86% above a viral load cut-off. The decreased sensitivity among asymptomatic participants and high positivity rate during follow-up in false-negative Ag-RDT participants emphasise the need for education of the public about the importance of re-testing after an initial negative Ag-RDT should symptoms develop. For SD-Biosensor, the diagnostic accuracy with OP-N and deep nasopharyngeal sampling was similar; adopting the more convenient sampling method might reduce the threshold for professional testing.
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Affiliation(s)
- Roderick P Venekamp
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Irene K Veldhuijzen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Karel G M Moons
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Suzan D Pas
- Microvida Laboratory for Medical Microbiology, Amphia Hospital, Breda, The Netherlands
- Microvida Laboratory for Medical Microbiology, Bravis Hospital, Roosendaal, The Netherlands
| | | | | | - Zsofi Igloi
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Sylvia B Debast
- Laboratory of Medical Microbiology and Infectious Diseases, Isala Hospital, Zwolle, The Netherlands
| | - Marjan J Bruins
- Laboratory of Medical Microbiology and Infectious Diseases, Isala Hospital, Zwolle, The Netherlands
| | - Khaled Polad
- Public Health Service IJsselland, Zwolle, The Netherlands
| | - Carla R S Nagel-Imming
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wanda G H Han
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Janneke H H M van de Wijgert
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Cochrane Netherlands, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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128
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Laing ED, Weiss CD, Samuels EC, Coggins SA, Wang W, Wang R, Vassell R, Sterling SL, Tso MS, Conner T, Goguet E, Moser M, Jackson-Thompson BM, Illinik L, Davies J, Ortega O, Parmelee E, Hollis-Perry M, Maiolatesi SE, Wang G, Ramsey KF, Reyes AE, Alcorta Y, Wong MA, Lindrose AR, Duplessis CA, Tribble DR, Malloy AMW, Burgess TH, Pollett SD, Olsen CH, Broder CC, Mitre E. Durability of Antibody Response and Frequency of SARS-CoV-2 Infection 6 Months after COVID-19 Vaccination in Healthcare Workers. Emerg Infect Dis 2022; 28:828-832. [PMID: 35203111 PMCID: PMC8962883 DOI: 10.3201/eid2804.212037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies decay but persist 6 months postvaccination; lower levels of neutralizing titers persist against Delta than wild-type virus. Of 227 vaccinated healthcare workers tested, only 2 experienced outpatient symptomatic breakthrough infections, despite 59/227 exhibiting serologic evidence of SARS-CoV-2 infection, defined as presence of nucleocapsid protein antibodies.
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129
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Wang LF, Tan CW, Chia WN, Zhu F, Young B, Chantasrisawad N, Hwa SH, Yeoh AYY, Lim BL, Yap WC, Pada SK, Tan SY, Jantarabenjakul W, Chen S, Zhang J, Mah YY, Chen V, Chen M, Wacharapluesadee S, Putcharoen O, Lye D. Differential escape of neutralizing antibodies by SARS-CoV-2 Omicron and pre-emergent sarbecoviruses. RESEARCH SQUARE 2022:rs.3.rs-1362541. [PMID: 35233568 PMCID: PMC8887082 DOI: 10.21203/rs.3.rs-1362541/v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The SARS-CoV-2 B.1.1.529 lineage, Omicron variant, was first detected in November 2021 and carries 32 amino acid mutations in the spike protein (15 in RBD) and exhibits significant escape of neutralizing antibodies targeting the parental SARS-CoV-2 virus. Here, we performed a high-resolution multiplex (16-plex) surrogate virus neutralization assay covering all major SARS-CoV-2 variants and pre-emergent ACE2-binding sarbecoviruses against 20 different human serum panels from infected, vaccinated and hybrid immune individuals which had vaccine-breakthrough infections or infection followed by vaccination. Among all sarbecoviruses tested, we observed 1.1 to 4.7-, 2.3 to 10.3- and 0.7 to 33.3-fold reduction in neutralization activities to SARS-CoV-2 Beta, Omicron and SARS-CoV-1, respectively. Among the SARS-CoV-2 related sarbecoviruses, it is found that the genetically more distant bat RaTG13 and pangolin GX-P5L sarbecoviruses had less neutralization escape than Omicron. Our data suggest that the SARS-CoV-2 variants emerged from the changed immune landscape of human populations are more potent in escaping neutralizing antibodies, from infection or vaccination, than pre-emergent sarbecoviruses naturally evolved in animal populations with no or less immune selection pressure.
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Affiliation(s)
| | | | | | | | | | - Napaporn Chantasrisawad
- Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David Lye
- National Centre for Infectious Diseases
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130
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Migueres M, Dimeglio C, Trémeaux P, Raymond S, Lhomme S, Da Silva I, Oliveira Mendes K, Abravanel F, Félicé MP, Mansuy JM, Izopet J. Influence of the Delta Variant and Vaccination on the SARS-CoV-2 Viral Load. Viruses 2022; 14:323. [PMID: 35215916 PMCID: PMC8879069 DOI: 10.3390/v14020323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 12/04/2022] Open
Abstract
Studies comparing SARS-CoV-2 nasopharyngeal (NP) viral load (VL) according to virus variant and host vaccination status have yielded inconsistent results. We conducted a single center prospective study between July and September 2021 at the drive-through testing center of the Toulouse University Hospital. We compared the NP VL of 3775 patients infected by the Delta (n = 3637) and Alpha (n = 138) variants, respectively. Patient's symptoms and vaccination status (2619 unvaccinated, 636 one dose and 520 two doses) were recorded. SARS-CoV-2 RNA testing and variant screening were assessed by using Thermo Fisher® TaqPath™ COVID-19 and ID solutions® ID™ SARS-CoV-2/VOC evolution Pentaplex assays. Delta SARS-CoV-2 infections were associated with higher VL than Alpha (coef = 0.68; p ≤ 0.01) independently of patient's vaccination status, symptoms, age and sex. This difference was higher for patients diagnosed late after symptom onset (coef = 0.88; p = 0.01) than for those diagnosed early (coef = 0.43; p = 0.03). Infections in vaccinated patients were associated with lower VL (coef = -0.18; p ≤ 0.01) independently of virus variant, symptom, age and sex. Our results suggest that Delta infections could lead to higher VL and for a longer period compared to Alpha infections. By effectively reducing the NP VL, vaccination could allow for limiting viral spread, even with the Delta variant.
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Affiliation(s)
- Marion Migueres
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
| | - Chloé Dimeglio
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
| | - Pauline Trémeaux
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
| | - Stéphanie Raymond
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
| | - Sébastien Lhomme
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
| | - Isabelle Da Silva
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
| | - Kévin Oliveira Mendes
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
| | - Florence Abravanel
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
| | - Marie-Pierre Félicé
- Centre de prélèvement, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France;
| | - Jean-Michel Mansuy
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
| | - Jacques Izopet
- Laboratoire de virologie, Institut fédératif de Biologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 31300 Toulouse, France; (C.D.); (P.T.); (S.R.); (S.L.); (I.D.S.); (K.O.M.); (F.A.); (J.-M.M.); (J.I.)
- INFINITy (Toulouse Institute for Infectious and Inflammatory Diseases) INSERM UMR1291/CNRS UMR5051/Université Toulouse III, 31300 Toulouse, France
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131
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Siddle KJ, Krasilnikova LA, Moreno GK, Schaffner SF, Vostok J, Fitzgerald NA, Lemieux JE, Barkas N, Loreth C, Specht I, Tomkins-Tinch CH, Paull JS, Schaeffer B, Taylor BP, Loftness B, Johnson H, Schubert PL, Shephard HM, Doucette M, Fink T, Lang AS, Baez S, Beauchamp J, Hennigan S, Buzby E, Ash S, Brown J, Clancy S, Cofsky S, Gagne L, Hall J, Harrington R, Gionet GL, DeRuff KC, Vodzak ME, Adams GC, Dobbins ST, Slack SD, Reilly SK, Anderson LM, Cipicchio MC, DeFelice MT, Grimsby JL, Anderson SE, Blumenstiel BS, Meldrim JC, Rooke HM, Vicente G, Smith NL, Messer KS, Reagan FL, Mandese ZM, Lee MD, Ray MC, Fisher ME, Ulcena MA, Nolet CM, English SE, Larkin KL, Vernest K, Chaluvadi S, Arvidson D, Melchiono M, Covell T, Harik V, Brock-Fisher T, Dunn M, Kearns A, Hanage WP, Bernard C, Philippakis A, Lennon NJ, Gabriel SB, Gallagher GR, Smole S, Madoff LC, Brown CM, Park DJ, MacInnis BL, Sabeti PC. Transmission from vaccinated individuals in a large SARS-CoV-2 Delta variant outbreak. Cell 2022; 185:485-492.e10. [PMID: 35051367 PMCID: PMC8695126 DOI: 10.1016/j.cell.2021.12.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 12/17/2021] [Indexed: 02/08/2023]
Abstract
An outbreak of over 1,000 COVID-19 cases in Provincetown, Massachusetts (MA), in July 2021-the first large outbreak mostly in vaccinated individuals in the US-prompted a comprehensive public health response, motivating changes to national masking recommendations and raising questions about infection and transmission among vaccinated individuals. To address these questions, we combined viral genomic and epidemiological data from 467 individuals, including 40% of outbreak-associated cases. The Delta variant accounted for 99% of cases in this dataset; it was introduced from at least 40 sources, but 83% of cases derived from a single source, likely through transmission across multiple settings over a short time rather than a single event. Genomic and epidemiological data supported multiple transmissions of Delta from and between fully vaccinated individuals. However, despite its magnitude, the outbreak had limited onward impact in MA and the US overall, likely due to high vaccination rates and a robust public health response.
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Affiliation(s)
| | - Lydia A Krasilnikova
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Gage K Moreno
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Stephen F Schaffner
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Johanna Vostok
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | | | - Jacob E Lemieux
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nikolaos Barkas
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Ivan Specht
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Faculty of Arts and Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Christopher H Tomkins-Tinch
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Jillian S Paull
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Beau Schaeffer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA; Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Bradford P Taylor
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA; Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Bryn Loftness
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Hillary Johnson
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Petra L Schubert
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Hanna M Shephard
- Massachusetts Department of Public Health, Boston, MA 02199, USA; Applied Epidemiology Fellowship, Council of State and Territorial Epidemiologists, Atlanta, GA 30345, USA
| | - Matthew Doucette
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Timelia Fink
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Andrew S Lang
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Stephanie Baez
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - John Beauchamp
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Scott Hennigan
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Erika Buzby
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Stephanie Ash
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Jessica Brown
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Selina Clancy
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Seana Cofsky
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Luc Gagne
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Joshua Hall
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | | | | | | | - Megan E Vodzak
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Gordon C Adams
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Sarah D Slack
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Steven K Reilly
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Lisa M Anderson
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | | | - Jonna L Grimsby
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | | | - James C Meldrim
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Heather M Rooke
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Gina Vicente
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Natasha L Smith
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Faye L Reagan
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Zoe M Mandese
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Matthew D Lee
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Marianne C Ray
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Maesha A Ulcena
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Corey M Nolet
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Sean E English
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Katie L Larkin
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Kyle Vernest
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Deirdre Arvidson
- Barnstable County Department of Health and the Environment, Barnstable, MA 02630, USA
| | - Maurice Melchiono
- Barnstable County Department of Health and the Environment, Barnstable, MA 02630, USA
| | - Theresa Covell
- Barnstable County Department of Health and the Environment, Barnstable, MA 02630, USA
| | - Vaira Harik
- Barnstable County Department of Human Services, Barnstable, MA 02630, USA
| | - Taylor Brock-Fisher
- Community Tracing Collaborative, Commonwealth of Massachusetts, Boston, MA 02199, USA
| | - Molly Dunn
- Community Tracing Collaborative, Commonwealth of Massachusetts, Boston, MA 02199, USA
| | - Amanda Kearns
- Community Tracing Collaborative, Commonwealth of Massachusetts, Boston, MA 02199, USA
| | - William P Hanage
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA; Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Clare Bernard
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Niall J Lennon
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | | | - Glen R Gallagher
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | - Sandra Smole
- Massachusetts Department of Public Health, Boston, MA 02199, USA
| | | | | | - Daniel J Park
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - Bronwyn L MacInnis
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA; Massachusetts Consortium for Pathogen Readiness, Boston, MA 02115, USA.
| | - Pardis C Sabeti
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Massachusetts Consortium for Pathogen Readiness, Boston, MA 02115, USA
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132
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Ong SWX, Sutjipto S, Lee PH, Dugan C, Khoo BY, Ren D, Young BE, Lye DC. Validation of ISARIC 4C Mortality and Deterioration Scores in a Mixed Vaccination Status Cohort of Hospitalized Coronavirus Disease 2019 (COVID-19) Patients in Singapore. Clin Infect Dis 2022; 75:e874-e877. [PMID: 35134143 PMCID: PMC8903389 DOI: 10.1093/cid/ciac087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Indexed: 01/19/2023] Open
Abstract
In this cross-sectional study, we studied performance of the International Severe Acute Respiratory and Emerging Infections Consortium mortality and deterioration scores in a cohort of 410 hospitalized patients (51.2% fully vaccinated). area under the receiver operating characteristic curves were 0.778 and 0.764, respectively, comparable to originally published validation cohorts. Subgroup analysis showed equally good performance in vaccinated and partially or unvaccinated patients.
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Affiliation(s)
- Sean Wei Xiang Ong
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Stephanie Sutjipto
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Pei Hua Lee
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Christopher Dugan
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Bo Yan Khoo
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Dongdong Ren
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Barnaby Edward Young
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singaporeand
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singaporeand,Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Correspondence: D. C. Lye, National Centre for Infectious Diseases, 16 Jln Tan Tock Seng, Singapore 308442 ()
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133
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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] [MESH Headings] [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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134
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da Silva SJR, de Lima SC, da Silva RC, Kohl A, Pena L. Viral Load in COVID-19 Patients: Implications for Prognosis and Vaccine Efficacy in the Context of Emerging SARS-CoV-2 Variants. Front Med (Lausanne) 2022; 8:836826. [PMID: 35174189 PMCID: PMC8841511 DOI: 10.3389/fmed.2021.836826] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/29/2021] [Indexed: 12/14/2022] Open
Abstract
The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an unprecedented public health crisis in the 21st century. As the pandemic evolves, the emergence of SARS-CoV-2 has been characterized by the emergence of new variants of concern (VOCs), which resulted in a catastrophic impact on SARS-CoV-2 infection. In light of this, research groups around the world are unraveling key aspects of the associated illness, coronavirus disease 2019 (COVID-19). A cumulative body of data has indicated that the SARS-CoV-2 viral load may be a determinant of the COVID-19 severity. Here we summarize the main characteristics of the emerging variants of SARS-CoV-2, discussing their impact on viral transmissibility, viral load, disease severity, vaccine breakthrough, and lethality among COVID-19 patients. We also provide a rundown of the rapidly expanding scientific evidence from clinical studies and animal models that indicate how viral load could be linked to COVID-19 prognosis and vaccine efficacy among vaccinated individuals, highlighting the differences compared to unvaccinated individuals.
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Affiliation(s)
- Severino Jefferson Ribeiro da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Suelen Cristina de Lima
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
| | - Ronaldo Celerino da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Lindomar Pena
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
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135
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Jeong YD, Ejima K, Kim KS, Joohyeon W, Iwanami S, Fujita Y, Jung IH, Shibuya K, Iwami S, Bento AI, Ajelli M. Designing isolation guidelines for COVID-19 patients utilizing rapid antigen tests: a simulation study using viral dynamics models. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.24.22269769. [PMID: 35118478 PMCID: PMC8811911 DOI: 10.1101/2022.01.24.22269769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Appropriate isolation guidelines for COVID-19 patients are warranted. Currently, isolating for fixed time is adapted in most countries. However, given the variability in viral dynamics between patients, some patients may no longer be infectious by the end of isolation (thus they are redundantly isolated), whereas others may still be infectious. Utilizing viral test results to determine ending isolation would minimize both the risk of ending isolation of infectious patients and the burden due to redundant isolation of noninfectious patients. In our previous study, we proposed a computational framework using SARS-CoV-2 viral dynamics models to compute the risk and the burden of different isolation guidelines with PCR tests. In this study, we extend the computational framework to design isolation guidelines for COVID-19 patients utilizing rapid antigen tests. Time interval of tests and number of consecutive negative tests to minimize the risk and the burden of isolation were explored. Furthermore, the approach was extended for asymptomatic cases. We found the guideline should be designed considering various factors: the infectiousness threshold values, the detection limit of antigen tests, symptom presence, and an acceptable level of releasing infectious patients. Especially, when detection limit is higher than the infectiousness threshold values, more consecutive negative results are needed to ascertain loss of infectiousness. To control the risk of releasing of infectious individuals under certain levels, rapid antigen tests should be designed to have lower detection limits than infectiousness threshold values to minimize the length of prolonged isolation, and the length of prolonged isolation increases when the detection limit is higher than the infectiousness threshold values, even though the guidelines are optimized for given conditions.
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Affiliation(s)
- Yong Dam Jeong
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Keisuke Ejima
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, IN, USA
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Kwang Su Kim
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Woo Joohyeon
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Shoya Iwanami
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Yasuhisa Fujita
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Il Hyo Jung
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Kenji Shibuya
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Shingo Iwami
- interdisciplinary Biology Laboratory (iBLab), Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Institute of Mathematics for Industry, Kyushu University, Fukuoka, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
- NEXT-Ganken Program, Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
- Science Groove Inc., Fukuoka, Japan
| | - Ana I. Bento
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, IN, USA
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, IN, USA
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136
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Affiliation(s)
- Anna Wald
- Department of Medicine, Epidemiology, and Laboratory Medicine & Pathology, University of Washington, Seattle
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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137
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Jin Y, Hou C, Li Y, Zheng K, Wang C. mRNA Vaccine: How to Meet the Challenge of SARS-CoV-2. Front Immunol 2022; 12:821538. [PMID: 35126377 PMCID: PMC8813741 DOI: 10.3389/fimmu.2021.821538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/27/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with high infectivity, pathogenicity, and variability, is a global pandemic that severely affected public health and the world economy. The development of safe and effective vaccines is crucial to the prevention and control of an epidemic. As an emerging technology, mRNA vaccine is widely used for infectious disease prevention and control and has significant safety, efficacy, and high production. It has received support and funding from many pharmaceutical enterprises and becomes one of the main technologies for preventing COVID-19. This review introduces the current status of SARS-CoV-2 vaccines, specifically mRNA vaccines, focusing on the challenges of developing mRNA vaccines against SARS-CoV-2, and discusses the relevant strategies.
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Affiliation(s)
- Yingqi Jin
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Chen Hou
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Yonghao Li
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
| | - Kang Zheng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, China
| | - Chuan Wang
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, China
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
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138
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Smallwood N, Harrex W, Rees M, Willis K, Bennett CM. COVID-19 infection and the broader impacts of the pandemic on healthcare workers. Respirology 2022; 27:411-426. [PMID: 35048469 DOI: 10.1111/resp.14208] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/05/2021] [Accepted: 12/12/2021] [Indexed: 12/14/2022]
Abstract
The severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease or COVID-19 pandemic is associated with more than 230 million cases and has challenged healthcare systems globally. Many healthcare workers (HCWs) have acquired the infection, often through their workplace, with a significant number dying. The epidemiology of COVID-19 infection in HCWs continues to be explored, with manifold exposure risks identified, leading to COVID-19 being recognised as an occupational disease for HCWs. The physical illness due to COVID-19 in HCWs is similar to the general population, with some HCWs experiencing a long-term illness, which may impact their ability to return to work. HCWs have also been affected by the immense workplace and psychosocial disruption caused by the pandemic. The impacts on the psychological well-being of HCWs globally have been profound, with high prevalence estimates for mental health symptoms, including emotional exhaustion. Globally, governments, healthcare organisations and employers have key responsibilities, including: to be better prepared for crises with comprehensive disaster response management plans, and to protect and preserve the health workforce from the physical and psychological impacts of the pandemic. While prioritising HCWs in vaccine rollouts globally has been critical, managing exposures and outbreaks occurring in healthcare settings remains challenging and continues to lead to substantial disruption to the health workforce. Safeguarding healthcare workforces during crises is critical as we move forward on the new path of 'COVID normal'.
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Affiliation(s)
- Natasha Smallwood
- Department of Respiratory Medicine, The Alfred Hospital, Prahran, Victoria, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Warren Harrex
- Consultant Occupational & Environmental Physician, Woden, Australian Capital Territory, Australia
| | - Megan Rees
- Department of Respiratory and Sleep Disorders Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, RMH, Faculty of Medicine, Dentistry and Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Willis
- Public Health, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.,Division of Critical Care and Investigative Services, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Catherine M Bennett
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
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139
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Klompas M. New Insights into the Prevention of Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia Caused by Viruses. Semin Respir Crit Care Med 2022; 43:295-303. [PMID: 35042261 DOI: 10.1055/s-0041-1740582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A fifth or more of hospital-acquired pneumonias may be attributable to respiratory viruses. The SARS-CoV-2 pandemic has clearly demonstrated the potential morbidity and mortality of respiratory viruses and the constant threat of nosocomial transmission and hospital-based clusters. Data from before the pandemic suggest the same can be true of influenza, respiratory syncytial virus, and other respiratory viruses. The pandemic has also helped clarify the primary mechanisms and risk factors for viral transmission. Respiratory viruses are primarily transmitted by respiratory aerosols that are routinely emitted when people exhale, talk, and cough. Labored breathing and coughing increase aerosol generation to a much greater extent than intubation, extubation, positive pressure ventilation, and other so-called aerosol-generating procedures. Transmission risk is proportional to the amount of viral exposure. Most transmissions take place over short distances because respiratory emissions are densest immediately adjacent to the source but then rapidly dilute and diffuse with distance leading to less viral exposure. The primary risk factors for transmission then are high viral loads, proximity, sustained exposure, and poor ventilation as these all increase net viral exposure. Poor ventilation increases the risk of long-distance transmission by allowing aerosol-borne viruses to accumulate over time leading to higher levels of exposure throughout an enclosed space. Surgical and procedural masks reduce viral exposure but do not eradicate it and thus lower but do not eliminate transmission risk. Most hospital-based clusters have been attributed to delayed diagnoses, transmission between roommates, and staff-to-patient infections. Strategies to prevent nosocomial respiratory viral infections include testing all patients upon admission, preventing healthcare providers from working while sick, assuring adequate ventilation, universal masking, and vaccinating both patients and healthcare workers.
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Affiliation(s)
- Michael Klompas
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, Massachusetts.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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140
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Stein M, Ashkenazi-Hoffnung L, Greenberg D, Dalal I, Livni G, Chapnick G, Stein-Zamir C, Ashkenazi S, Hecht-Sagie L, Grossman Z. The Burden of COVID-19 in Children and Its Prevention by Vaccination: A Joint Statement of the Israeli Pediatric Association and the Israeli Society for Pediatric Infectious Diseases. Vaccines (Basel) 2022; 10:81. [PMID: 35062742 PMCID: PMC8781684 DOI: 10.3390/vaccines10010081] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023] Open
Abstract
As of October 2021, SARS-CoV-2 infections were reported among 512,613 children and adolescents in Israel (~33% of all COVID-19 cases). The 5-11-year age group accounted for about 43% (223,850) of affected children and adolescents. In light of the availability of the Pfizer-BioNTech BNT162b2 vaccine against COVID-19 for children aged 5-11 years, we aimed to write a position paper for pediatricians, policymakers and families regarding the clinical aspects of COVID-19 and the vaccination of children against COVID-19. The first objective of this review was to describe the diverse facets of the burden of COVID-19 in children, including the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the indirect effects of social isolation and interruption in education. In addition, we aimed to provide an update regarding the efficacy and safety of childhood mRNA COVID-19 vaccination and to instill confidence in pediatricians regarding the benefits of vaccinating children against COVID-19. We reviewed up-to-date Israeli and international epidemiological data and literature regarding COVID-19 morbidity and its sequelae in children, vaccine efficacy in reducing COVID-19-related morbidity and SARS-CoV-2 transmission and vaccine safety data. We conducted a risk-benefit analysis regarding the vaccination of children and adolescents. We concluded that vaccines are safe and effective and are recommended for all children aged 5 to 11 years to protect them from COVID-19 and its complications and to reduce community transmissions. Based on these data, after weighing the benefits of vaccination versus the harm, the Israeli Ministry of Health decided to recommend vaccination for children aged 5-11 years.
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Affiliation(s)
- Michal Stein
- Infectious Diseases and Infection Control Unit, Hillel Yaffe Medical Center, Hadera 3810101, Israel
- Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel
| | - Liat Ashkenazi-Hoffnung
- Department of Day Care Hospitalization, Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
| | - David Greenberg
- The Pediatric Infectious Disease Unit, Soroka Medical Center, Be’er Sheva 8458900, Israel;
- The Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Ilan Dalal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Pediatric Department, E. Wolfson Medical Center, Holon 5822012, Israel
| | - Gilat Livni
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo 6997801, Israel; (I.D.); (G.L.)
- Department of Pediatrics A, Schneider Children’s Medical Center, Petah Tikva 4920245, Israel
| | - Gil Chapnick
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Chen Stein-Zamir
- Jerusalem District Health Office, Jerusalem 9137001, Israel;
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Shai Ashkenazi
- Schneider Children’s Medical Center, Petah Tikva 4920235, Israel;
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
| | - Lior Hecht-Sagie
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
| | - Zachi Grossman
- Maccabi Healthcare Services, Tel Aviv-Yafo 6812509, Israel; (G.C.); (L.H.-S.); (Z.G.)
- Adelson School of Medicine, Ariel University, Ari’el 4070000, Israel
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141
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Mistry P, Barmania F, Mellet J, Peta K, Strydom A, Viljoen IM, James W, Gordon S, Pepper MS. SARS-CoV-2 Variants, Vaccines, and Host Immunity. Front Immunol 2022; 12:809244. [PMID: 35046961 PMCID: PMC8761766 DOI: 10.3389/fimmu.2021.809244] [Citation(s) in RCA: 160] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new beta coronavirus that emerged at the end of 2019 in the Hubei province of China. SARS-CoV-2 causes coronavirus disease 2019 (COVID-19) and was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. Herd or community immunity has been proposed as a strategy to protect the vulnerable, and can be established through immunity from past infection or vaccination. Whether SARS-CoV-2 infection results in the development of a reservoir of resilient memory cells is under investigation. Vaccines have been developed at an unprecedented rate and 7 408 870 760 vaccine doses have been administered worldwide. Recently emerged SARS-CoV-2 variants are more transmissible with a reduced sensitivity to immune mechanisms. This is due to the presence of amino acid substitutions in the spike protein, which confer a selective advantage. The emergence of variants therefore poses a risk for vaccine effectiveness and long-term immunity, and it is crucial therefore to determine the effectiveness of vaccines against currently circulating variants. Here we review both SARS-CoV-2-induced host immune activation and vaccine-induced immune responses, highlighting the responses of immune memory cells that are key indicators of host immunity. We further discuss how variants emerge and the currently circulating variants of concern (VOC), with particular focus on implications for vaccine effectiveness. Finally, we describe new antibody treatments and future vaccine approaches that will be important as we navigate through the COVID-19 pandemic.
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Affiliation(s)
- Priyal Mistry
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fatima Barmania
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Juanita Mellet
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Kimberly Peta
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Adéle Strydom
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ignatius M. Viljoen
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - William James
- James and Lillian Martin Centre, Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Siamon Gordon
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Michael S. Pepper
- Department of Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
- South African Medical Research Council (SAMRC) Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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142
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Li H, Wang L, Zhang M, Lu Y, Wang W. Effects of vaccination and non-pharmaceutical interventions and their lag times on the COVID-19 pandemic: Comparison of eight countries. PLoS Negl Trop Dis 2022; 16:e0010101. [PMID: 35025865 PMCID: PMC8757886 DOI: 10.1371/journal.pntd.0010101] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
Many countries implemented measures to control the COVID-19 pandemic, but the effects of these measures have varied greatly. We evaluated the effects of different policies, the prevalence of dominant variants (e.g., Delta), and vaccination on the characteristics of the COVID-19 pandemic in eight countries. We quantified the lag times of different non-pharmaceutical interventions (NPIs) and vaccination using a distributed lag non-linear model (DLNM). We also tested whether these lag times were reasonable by analyzing changes in daily cases and the effective reproductive number (Rt)over time. Our results indicated that the response to vaccination in countries with continuous vaccination programs lagged by at least 40 days, and the lag time for a response to NPIs was at least 14 days. A rebound was most likely to occur during the 40 days after the first vaccine dose. We also found that the combination of school closure, workplace closure, restrictions on mass gatherings, and stay-at-home requirements were successful in containing the pandemic. Our results thus demonstrated that vaccination was effective, although some regions were adversely affected by new variants and low vaccination coverage. Importantly, relaxation of NPIs soon after implementation of a vaccination program may lead to a rebound.
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Affiliation(s)
- Hao Li
- School of Public Health, Fudan University, Shanghai, China
| | - Luqi Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Mengxi Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Yihan Lu
- School of Public Health, Fudan University, Shanghai, China
| | - Weibing Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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143
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Santi T, Sungono V, Kamarga L, Samakto BD, Hidayat F, Hidayat FK, Satolom M, Permana A, Yusuf I, Suriapranata IM, Jo J. Heterologous prime-boost with the mRNA-1273 vaccine among CoronaVac-vaccinated healthcare workers in Indonesia. Clin Exp Vaccine Res 2022; 11:209-216. [PMID: 35799870 PMCID: PMC9200645 DOI: 10.7774/cevr.2022.11.2.209] [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: 11/23/2021] [Accepted: 04/29/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose This study was performed to investigate humoral immune response and adverse events upon the heterologous prime-boost with a single dose of the mRNA-1273 vaccine among fully CoronaVac-vaccinated, infection-naïve healthcare workers in Indonesia. Materials and Methods One hundred twenty-five eligible healthcare workers were recruited from one hospital for this prospective cohort study. Blood collection was conducted twice, i.e., on 7 days before and 28 days after the booster vaccination. The titer of anti-SARS-CoV-2 receptor-binding domain (RBD) antibodies was quantified accordingly. The post-vaccination adverse event was recorded for both CoronaVac and mRNA-1273 vaccinations. Any breakthrough infection was monitored during the follow-up period. Wilcoxon matched-pairs signed rank test was used to test differences between groups. Results A significant increase was observed in the titer of anti-SARS-CoV-2 RBD antibodies upon receiving the mRNA-1273 booster (geometric mean titers of 65.57 and 47,445 U/mL in pre- and post-booster, respectively), supporting the argument to use heterologous prime-boost vaccination to improve the protection against COVID-19 in a high-risk population. The mRNA-1273 vaccine, however, caused a higher frequency of adverse events than the CoronaVac vaccine. Nonetheless, the adverse events were considered minor medical events and temporary as all subjects were not hospitalized and fully recovered. Of note, no breakthrough infection was observed during the follow-up to 12 weeks post-booster. Conclusion The heterologous prime-boost vaccination of healthcare workers with a single dose of the mRNA-1273 vaccine generated a significant elevation in humoral immune response towards RBD of SARS-CoV-2 and was associated with a higher frequency, but minor and transient, adverse events.
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Affiliation(s)
| | - Veli Sungono
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Lina Kamarga
- Siloam Hospitals Lippo Cikarang, Bekasi, Indonesia
| | | | | | | | - Magy Satolom
- Siloam Hospitals Lippo Cikarang, Bekasi, Indonesia
| | | | - Irawan Yusuf
- Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
- Mochtar Riady Institute for Nanotechnology, Tangerang, Indonesia
| | - Ivet Marita Suriapranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Mochtar Riady Institute for Nanotechnology, Tangerang, Indonesia
| | - Juandy Jo
- Mochtar Riady Institute for Nanotechnology, Tangerang, Indonesia
- Department of Biology, Faculty of Science and Technology, Universitas Pelita Harapan, Tangerang, Indonesia
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144
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Heinemann S, Bludau A, Kaba H, Knolle P, Grundmann H, Scheithauer S. SARS-CoV-2 surveillance and testing: results of a survey from the Network of University Hospitals (NUM), B-FAST. GMS HYGIENE AND INFECTION CONTROL 2021; 16:Doc31. [PMID: 34956823 PMCID: PMC8662743 DOI: 10.3205/dgkh000402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: The B-FAST project of the National University Network (NUM) examines and records applied surveillance strategies implemented in hospitals i.a., to protect patients and employees from SARS-CoV-2 infection. Methods: Infection control physicians in German university hospitals (UK), as well as non-university hospitals (NUK; Bavaria, Lower Saxony) were surveyed in March 2021 regarding SARS-CoV-2 testing/surveillance strategies in a cross-sectional study using a standardized online questionnaire. The focus was on screening strategies taking into account the “test” methods used (case history, PCR, antigen, antibody test). Results: The response rate was 91.7% (33/36) in UK and 11.3%–32.2% in NUK. Almost all hospitals (95.0%) performed a symptom and exposure check and/or testing upon inpatient admission. Non-cause-related testing (screening) of health care workers in COVID wards was preferably done by PCR in UK (69.7% PCR; 12.1% antigen), while NUK (29.9% PCR; 49.3% antigen) used antigen testing more frequently. Regardless of the type of facility, about half of the respondents rated the benefit of screening higher than the effort (patients: 49%; employees: 45%). Conclusion: Testing/surveillance strategies find a high level of acceptance at German hospitals and are generally carried out in accordance with the national testing strategy with differences depending on the level of care.
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Affiliation(s)
- Stephanie Heinemann
- Institute of General Medicine, University Medical Center Göttingen, Germany.,Local Task Force Network University Medicine (NUM), University Medical Center Göttingen, Germany
| | - Anna Bludau
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Germany
| | - Hani Kaba
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Germany
| | - Percy Knolle
- Institute of Molecular Immunology and Experimental Oncology Klinikum rechts der Isar of the Technical University of Munich, Germany
| | - Hajo Grundmann
- Institute for Infection Prevention and Hospital Hygiene University Medical Center Freiburg, Germany
| | - Simone Scheithauer
- Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, Germany
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145
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Kriegel M, Hartmann A, Buchholz U, Seifried J, Baumgarte S, Gastmeier P. SARS-CoV-2 Aerosol Transmission Indoors: A Closer Look at Viral Load, Infectivity, the Effectiveness of Preventive Measures and a Simple Approach for Practical Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:220. [PMID: 35010484 PMCID: PMC8750733 DOI: 10.3390/ijerph19010220] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022]
Abstract
There is uncertainty about the viral loads of infectious individuals required to transmit COVID-19 via aerosol. In addition, there is a lack of both quantification of the influencing parameters on airborne transmission and simple-to-use models for assessing the risk of infection in practice, which furthermore quantify the influence of non-medical preventive measures. In this study, a dose-response model was adopted to analyze 25 documented outbreaks at infection rates of 4-100%. We show that infection was only possible if the viral load was higher than 108 viral copies/mL. Based on mathematical simplifications of our approach to predict the probable situational attack rate (PARs) of a group of persons in a room, and valid assumptions, we provide simplified equations to calculate, among others, the maximum possible number of persons and the person-related virus-free air supply flow necessary to keep the number of newly infected persons to less than one. A comparison of different preventive measures revealed that testing contributes the most to the joint protective effect, besides wearing masks and increasing ventilation. In addition, we conclude that absolute volume flow rate or person-related volume flow rate are more intuitive parameters for evaluating ventilation for infection prevention than air exchange rate.
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Affiliation(s)
- Martin Kriegel
- Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany;
| | - Anne Hartmann
- Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany;
| | - Udo Buchholz
- Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany; (U.B.); (J.S.)
| | - Janna Seifried
- Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany; (U.B.); (J.S.)
| | | | - Petra Gastmeier
- Institute for Hygiene and Environmental Medicine, Charité-University Medicine Berlin, 12203 Berlin, Germany;
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146
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Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Aghayari Sheikh Neshin S, Khatami A, Turner DL, Djalalinia S, Mousavi SA, Mardani-Fard HA, Kasaeian A, Turner RJ. Effectiveness of COVID-19 Vaccines against Delta (B.1.617.2) Variant: A Systematic Review and Meta-Analysis of Clinical Studies. Vaccines (Basel) 2021; 10:23. [PMID: 35062684 PMCID: PMC8778641 DOI: 10.3390/vaccines10010023] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 12/30/2022] Open
Abstract
The high transmissibility, mortality, and morbidity rate of the SARS-CoV-2 Delta (B.1.617.2) variant have raised concerns regarding vaccine effectiveness (VE). To address this issue, all publications relevant to the effectiveness of vaccines against the Delta variant were searched in the Web of Science, Scopus, EMBASE, and Medline (via PubMed) databases up to 15 October 2021. A total of 15 studies (36 datasets) were included in the meta-analysis. After the first dose, the VE against the Delta variant for each vaccine was 0.567 (95% CI 0.520-0.613) for Pfizer-BioNTech, 0.72 (95% CI 0.589-0.822) for Moderna, 0.44 (95% CI 0.301-0.588) for AstraZeneca, and 0.138 (95% CI 0.076-0.237) for CoronaVac. Meta-analysis of 2,375,957 vaccinated cases showed that the Pfizer-BioNTech vaccine had the highest VE against the infection after the second dose, at 0.837 (95% CI 0.672-0.928), and third dose, at 0.972 (95% CI 0.96-0.978), as well as the highest VE for the prevention of severe infection or death, at 0.985 (95% CI 0.95-0.99), amongst all COVID-19 vaccines. The short-term effectiveness of vaccines, especially mRNA-based vaccines, for the prevention of the Delta variant infection, hospitalization, severe infection, and death is supported by this study. Limitations include a lack of long-term efficacy data, and under-reporting of COVID-19 infection cases in observational studies, which has the potential to falsely skew VE rates. Overall, this study supports the decisions by public health decision makers to promote the population vaccination rate to control the Delta variant infection and the emergence of further variants.
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Affiliation(s)
- Ali Pormohammad
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Mohammad Zarei
- Renal Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- John B. Little Center for Radiation Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Saied Ghorbani
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran 1449614535, Iran
| | - Mehdi Mohammadi
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | - Alireza Khatami
- Department of Virology, Faculty of Medicine, Iran University of Medical Science, Tehran 1449614535, Iran
| | - Diana L Turner
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran 1467664961, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713139, Iran
| | - Seied Asadollah Mousavi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran 1411713131, Iran
| | | | - Amir Kasaeian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran 1411713131, Iran
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran
- Inflammation Research Center, Tehran University of Medical Sciences, Tehran 1411713137, Iran
| | - Raymond J Turner
- Department of Biological Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
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147
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Kissler SM, Fauver JR, Mack C, Tai CG, Breban MI, Watkins AE, Samant RM, Anderson DJ, Metti J, Khullar G, Baits R, MacKay M, Salgado D, Baker T, Dudley JT, Mason CE, Ho DD, Grubaugh ND, Grad YH. Viral Dynamics of SARS-CoV-2 Variants in Vaccinated and Unvaccinated Persons. N Engl J Med 2021; 385:2489-2491. [PMID: 34941024 PMCID: PMC8693673 DOI: 10.1056/nejmc2102507] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC
| | | | | | | | | | | | | | | | | | - David D Ho
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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148
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Bruxvoort KJ, Sy LS, Qian L, Ackerson BK, Luo Y, Lee GS, Tian Y, Florea A, Aragones M, Tubert JE, Takhar HS, Ku JH, Paila YD, Talarico CA, Tseng HF. Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study. BMJ 2021; 375:e068848. [PMID: 34911691 PMCID: PMC8671836 DOI: 10.1136/bmj-2021-068848] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of the mRNA-1273 vaccine against SARS-CoV-2 variants and assess its effectiveness against the delta variant by time since vaccination. DESIGN Test negative case-control study. SETTING Kaiser Permanente Southern California (KPSC), an integrated healthcare system. PARTICIPANTS Adult KPSC members with a SARS-CoV-2 positive test sent for whole genome sequencing or a negative test from 1 March 2021 to 27 July 2021. INTERVENTIONS Two dose or one dose vaccination with mRNA-1273 (Moderna covid-19 vaccine) ≥14 days before specimen collection versus no covid-19 vaccination. MAIN OUTCOME MEASURES Outcomes included infection with SARS-CoV-2 and hospital admission with covid-19. In pre-specified analyses for each variant type, test positive cases were matched 1:5 to test negative controls on age, sex, race/ethnicity, and specimen collection date. Conditional logistic regression was used to compare odds of vaccination among cases versus controls, with adjustment for confounders. Vaccine effectiveness was calculated as (1-odds ratio)×100%. RESULTS The study included 8153 cases and their matched controls. Two dose vaccine effectiveness was 86.7% (95% confidence interval 84.3% to 88.7%) against infection with the delta variant, 98.4% (96.9% to 99.1%) against alpha, 90.4% (73.9% to 96.5%) against mu, 96-98% against other identified variants, and 79.9% (76.9% to 82.5%) against unidentified variants (that is, specimens that failed sequencing). Vaccine effectiveness against hospital admission with the delta variant was 97.5% (92.7% to 99.2%). Vaccine effectiveness against infection with the delta variant declined from 94.1% (90.5% to 96.3%) 14-60 days after vaccination to 80.0% (70.2% to 86.6%) 151-180 days after vaccination. Waning was less pronounced for non-delta variants. Vaccine effectiveness against delta infection was lower among people aged ≥65 years (75.2%, 59.6% to 84.8%) than those aged 18-64 years (87.9%, 85.5% to 89.9%). One dose vaccine effectiveness was 77.0% (60.7% to 86.5%) against infection with delta. CONCLUSIONS Two doses of mRNA-1273 were highly effective against all SARS-CoV-2 variants, especially against hospital admission with covid-19. However, vaccine effectiveness against infection with the delta variant moderately declined with increasing time since vaccination.
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Affiliation(s)
- Katia J Bruxvoort
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
- University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Lina S Sy
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | - Lei Qian
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | | | - Yi Luo
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | - Gina S Lee
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | - Yun Tian
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | - Ana Florea
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | | | - Julia E Tubert
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | | | - Jennifer H Ku
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
| | | | | | - Hung Fu Tseng
- Kaiser Permanente Southern California, Pasadena, CA 91101, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, USA
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149
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Antibody Response of BNT162b2 and CoronaVac Platforms in Recovered Individuals Previously Infected by COVID-19 against SARS-CoV-2 Wild Type and Delta Variant. Vaccines (Basel) 2021; 9:vaccines9121442. [PMID: 34960189 PMCID: PMC8705363 DOI: 10.3390/vaccines9121442] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 12/29/2022] Open
Abstract
Vaccinating recovered patients previously infected by COVID-19 with mRNA vaccines to boost their immune response against wild-type viruses (WT), we aimed to investigate whether vaccine platform and time of vaccination affect immunogenicity against the SARS-CoV-2 WT and Delta variant (DV). Convalescent patients infected by COVID-19 were recruited and received one booster dose of the BNT162b2 (PC-B) or CoronaVac (PC-C) vaccines, while SARS-CoV-2 naïve subjects received two doses of the BNT162b2 (CN-B) or CoronaVac (CN-C) vaccines. The neutralizing antibody in sera against the WT and DV was determined with live virus neutralization assay (vMN). The vMN geometric mean titre (GMT) against WT in recovered individuals previously infected by COVID-19 reduced significantly from 60.0 (95% confidence interval (CI), 46.5-77.4) to 33.9 (95% CI, 26.3-43.7) at 6 months post recovery. In the PC-B group, the BNT162b2 vaccine enhanced antibody response against WT and DV, with 22.3-fold and 20.4-fold increases, respectively. The PC-C group also showed 1.8-fold and 2.2-fold increases for WT and DV, respectively, after receiving the CoronaVac vaccine. There was a 10.6-fold increase in GMT in the CN-B group and a 1.3-fold increase in the CN-C group against DV after full vaccination. In both the PC-B and PC-C groups, there was no difference between GMT against WT and DV after vaccination. Subjects in the CN-B and CN-C groups showed inferior GMT against DV compared with GMT against WT after vaccination. In this study, one booster shot effectively enhanced the pre-existing neutralizing activity against WT and DV in recovered subjects.
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Affiliation(s)
- Michael Klompas
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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