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Matsuda EM, Oliveira IPD, Campos IBD, Ahagon CM, Castejon MJ, Silva VO, Manzoni FM, López-Lopes GI, Brígido LFDM. SARS-CoV-2 testing among patients and healthcare professionals in an HIV outpatient clinic in Brazil. Rev Inst Med Trop Sao Paulo 2022; 64:e3. [PMID: 35137897 PMCID: PMC8815856 DOI: 10.1590/s1678-9946202264003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/08/2021] [Indexed: 11/22/2022] Open
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102
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Yadav B, Prasad N, Yadav D, Singh A, Gautam S, Kushwaha R, Patel M, Bhadauria D, Behera M, Yachha M, Kaul A. Human Leukocyte Antigen Association with anti-SARS-CoV-2 spike protein antibody seroconversion in renal allograft recipients - An observational study. INDIAN JOURNAL OF TRANSPLANTATION 2022. [DOI: 10.4103/ijot.ijot_28_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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103
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Lipsitch M, Krammer F, Regev-Yochay G, Lustig Y, Balicer RD. SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact. Nat Rev Immunol 2022; 22:57-65. [PMID: 34876702 PMCID: PMC8649989 DOI: 10.1038/s41577-021-00662-4] [Citation(s) in RCA: 180] [Impact Index Per Article: 90.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 02/04/2023]
Abstract
Breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fully vaccinated individuals are receiving intense scrutiny because of their importance in determining how long restrictions to control virus transmission will need to remain in place in highly vaccinated populations as well as in determining the need for additional vaccine doses or changes to the vaccine formulations and/or dosing intervals. Measurement of breakthrough infections is challenging outside of randomized, placebo-controlled, double-blind field trials. However, laboratory and observational studies are necessary to understand the impact of waning immunity, viral variants and other determinants of changing vaccine effectiveness against various levels of coronavirus disease 2019 (COVID-19) severity. Here, we describe the approaches being used to measure vaccine effectiveness and provide a synthesis of the burgeoning literature on the determinants of vaccine effectiveness and breakthrough rates. We argue that, rather than trying to tease apart the contributions of factors such as age, viral variants and time since vaccination, the rates of breakthrough infection are best seen as a consequence of the level of immunity at any moment in an individual, the variant to which that individual is exposed and the severity of disease being considered. We also address key open questions concerning the transition to endemicity, the potential need for altered vaccine formulations to track viral variants, the need to identify immune correlates of protection, and the public health challenges of using various tools to counter breakthrough infections, including boosters in an era of global vaccine shortages.
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Affiliation(s)
- Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology and Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gili Regev-Yochay
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaniv Lustig
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Central Virology Laboratory, Public Health Services, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ran D Balicer
- Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel
- The School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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104
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Khan NA, Al-Thani H, El-Menyar A. The emergence of new SARS-CoV-2 variant (Omicron) and increasing calls for COVID-19 vaccine boosters-The debate continues. Travel Med Infect Dis 2021; 45:102246. [PMID: 34942376 PMCID: PMC8687713 DOI: 10.1016/j.tmaid.2021.102246] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Naushad Ahmad Khan
- Department of Surgery, Trauma and Vascular Surgery Clinical Research, Hamad General Hospital, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Department of Surgery, Trauma and Vascular Surgery Clinical Research, Hamad General Hospital, Doha, Qatar; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
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105
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Hmadcha A, Soria B, Zhao RC, Smani T, Valverde I. Editorial: A Compendium of Recent Research on Stem Cell-Based Therapy for Covid-19. Front Cell Dev Biol 2021; 9:813384. [PMID: 34970555 PMCID: PMC8713248 DOI: 10.3389/fcell.2021.813384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Abdelkrim Hmadcha
- Department of Biotechnology, University of Alicante, Alicante, Spain
- University of Pablo de Olavide, Seville, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- *Correspondence: Abdelkrim Hmadcha,
| | - Bernat Soria
- University of Pablo de Olavide, Seville, Spain
- Department of Physiology, Institute of Bioengineering-ISABIAL, University Miguel Hernández School of Medicine, Alicante, Spain
| | - Robert C. Zhao
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- School of Life Sciences, Shanghai University, Shanghai, China
- International Society on Aging and Disease, Bryan, TX, United States
| | - Tarik Smani
- Cardiovascular Pathophysiology, Institute of Biomedicine of Seville, University Hospital of Virgen del Rocío, University of Seville, CSIC, Seville, Spain
- Department of Medical Physiology and Biophysics, University of Seville, Seville, Spain
| | - Israel Valverde
- Pediatric Cardiology Unit, Virgen del Rocio University Hospital, Seville, Spain
- Institute of Biomedicine of Seville, University Hospital of Virgen del Rocío, University of Seville, CSIC, Seville, Spain
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106
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Karim SSA, Karim QA. Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic. Lancet 2021; 398:2126-2128. [PMID: 34871545 PMCID: PMC8640673 DOI: 10.1016/s0140-6736(21)02758-6] [Citation(s) in RCA: 836] [Impact Index Per Article: 278.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, Durban 4001, South Africa; Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, Durban 4001, South Africa; Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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107
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Abstract
In an unprecedented collaborative effort, basic and clinical scientists have provided us with an effective COVID-19 vaccine within less than one year after SARS CoV-2 emergence. Virus or vaccine induced immunity may offer different degrees of protection against infection, transmission and pathology (disease). Immunity decides on the outcome of COVID-19, both at an individual as well as a population level. In this literature analysis, emphasis is put first on the gold standard for evaluating human antiviral immunity: data from high quality, well-designed trials centered on patient outcome as clinical endpoint (morbidity, e. g. severe COVID-19). Next, case reports or case series on humans with inborn errors of immunity (IEI) may provide unique insights into human CoV-2 immunity. Surrogate markers in blood (e. g. antibody titers) are extensively employed for the evaluation of SARS CoV-2 immunity, but are not useful. SARS CoV-2 antibody titers neither indicate local immunity in the nasopharynx/respiratory tract nor do they reliably reflect systemic immunity. Systemic and tissue resident SARS CoV-2 specific effector and memory T-cells are key to immunity but cannot routinely be measured in blood. Based largely on clinical data, this literature analysis suggests that antiviral immunity against Coronaviruses including SARS CoV-2 is waning significantly over time regarding infection and transmission protection. However, in individuals who have recovered from infections with human Coronaviruses (including SARS CoV-2) or been vaccinated against SARS CoV-2, immunity is robust in its most critical quality: protection against pathology/severe disease. Thus, immunologists see the glass half-full and envisage the transition of COVID-19 from an epidemic to an endemic state with semiannual peaks of incidence but, most importantly, protection from severe COVID-19 or death in the vast majority of individuals (as observed in other human Coronavirus infections).
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108
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Kim P, Gordon SM, Sheehan MM, Rothberg MB. Duration of SARS-CoV-2 Natural Immunity and Protection against the Delta Variant: A Retrospective Cohort Study. Clin Infect Dis 2021; 75:e185-e190. [PMID: 34864907 PMCID: PMC8690283 DOI: 10.1093/cid/ciab999] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Infection with SARS-CoV-2 has been shown to be highly protective against reinfection and symptomatic disease. However, effectiveness against the highly transmissible Delta variant and duration of natural immunity remain unknown. Methods This retrospective cohort study included 325,157 patients tested for coronavirus disease 2019 (COVID-19) via polymerase chain reaction (PCR) from 09 March 2020 to 31 December 2020 (Delta variant analysis) and 152,656 patients tested from 09 March 2020 to 30 August 2020 (long-term effectiveness analysis) with subsequent testing through 09 September 2021. The primary outcome was reinfection, defined as a positive PCR test >90 days after initial positive test. Results Among 325,157 patients tested before 31 December 2020, 50,327 (15.5%) tested positive. After 01 July 2021 (Delta dominant period), 40 (0.08%) of the initially positive and 1,494 (0.5%) of the initially negative patients tested positive. Protection of prior infection against reinfection with Delta was 85.4% (95% CI, 80.0-89.3). For the long-term effectiveness analysis, among 152,656 patients tested before 30 August 2020, 11,186 (7.3%) tested positive. After at least 90 days, 81 (0.7%) of the initially positive patients and 7,167 (5.1%) of the initially negative patients tested positive. Overall protection of previous infection was 85.7% (95% CI, 82.2-88.5) and lasted up to 13 months. Patients over age 65 had slightly lower protection. Conclusions SARS-CoV-2 infection is highly protective against reinfection with the Delta variant. Immunity from prior infection lasts for at least 13 months. Countries facing vaccine shortages should consider delaying vaccinations for previously infected patients to increase access.
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Affiliation(s)
- Priscilla Kim
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Steven M Gordon
- Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio, USA
| | - Megan M Sheehan
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael B Rothberg
- Center for Value-Based Care Research, Cleveland Clinic, Cleveland, Ohio, USA
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109
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Harris JE. COVID-19 Incidence and Hospitalization During the Delta Surge Were Inversely Related to Vaccination Coverage Among the Most Populous U.S. Counties. HEALTH POLICY AND TECHNOLOGY 2021; 11:100583. [PMID: 34868833 PMCID: PMC8629773 DOI: 10.1016/j.hlpt.2021.100583] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective We tested whether COVID-19 incidence and hospitalization rates during the Delta surge were inversely related to vaccination coverage among the 112 most populous counties in the United States, comprising 44 percent of the country's total population. Methods We measured vaccination coverage as the percent of the county population fully vaccinated as of July 15, 2021. We measured COVID-19 incidence as the number of confirmed cases per 100,000 population during the 14-day period ending August 12, 2021 and hospitalization rates as the number of confirmed COVID-19 admissions per 100,000 population during the same 14-day period. Results In log-linear regression models, a 10-percentage-point increase in vaccination coverage was associated with a 28.3% decrease in COVID-19 incidence (95% confidence interval, 16.8 - 39.7%), a 44.9 percent decrease in the rate of COVID-19 hospitalization (95% CI, 28.8 - 61.0%), and a 16.6% decrease in COVID-19 hospitalizations per 100 cases (95% CI, 8.4 - 24.8%). Inclusion of demographic covariables, as well as county-specific diabetes prevalence, did not weaken the observed inverse relationship with vaccination coverage. A significant inverse relationship between vaccination coverage and COVID-19 deaths per 100,000 during August 20 – September 16 was also observed. The cumulative incidence of COVID-19 through June 30, 2021, a potential indicator of acquired immunity due to past infection, had no significant relation to subsequent case incidence or hospitalization rates in August. Conclusion Higher vaccination coverage was associated not only with significantly lower COVID-19 incidence during the Delta surge, but also significantly less severe cases of the disease. Public Interest Summary We tested whether COVID-19 incidence and hospitalization rates during the Delta variant-related surge were inversely related to vaccination coverage among the 112 most populous counties in the United States, together comprising 44 percent of the country's total population. A 10-percentage-point increase in vaccination coverage was associated with a 28.3% decrease in COVID-19 incidence, a 44.9 percent decrease in the rate of COVID-19 hospitalization, and a 16.6% decrease in COVID-19 hospitalizations per 100 cases. Inclusion of demographic covariables, as well as county-specific diabetes prevalence, did not weaken the observed inverse relationship with vaccination coverage. A significant inverse relationship between vaccination coverage and COVID-19 deaths per 100,000 during August 20 – September 16 was also observed. Higher vaccination coverage was associated not only with significantly lower COVID-19 incidence during the Delta surge, but also significantly less severe cases of the disease.
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Affiliation(s)
- Jeffrey E Harris
- Professor of Economics, Emeritus, Massachusetts Institute of Technology, Cambridge MA 02139 USA.,Physician, Eisner Health, Los Angeles CA 90015 USA
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110
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Abstract
Waning vaccine-induced immunity coupled with the emergence of SARS-CoV-2 variants has led to increases in breakthrough infections, prompting consideration for vaccine booster doses. Boosters have been reported to be safe and increase SARS-CoV-2-specific neutralizing antibody levels, but how these doses impact the trajectory of the global pandemic and herd immunity is unknown. Information on immunology, epidemiology, and equitable vaccine distribution should be considered when deciding the timing and eligibility for COVID-19 vaccine boosters.
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111
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Turabelidze G, Womack AJ, Mobley E, Garikapaty V, Finley S. SARS-CoV-2 Reinfections during the Delta Variant Surge - Missouri, June-October, 2021. MISSOURI MEDICINE 2021; 118:539. [PMID: 34924621 PMCID: PMC8672959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | - A J Womack
- Division of Community and Public Health, Missouri Department of Health and Senior Services Jefferson City, Missouri
| | - Evan Mobley
- Division of Community and Public Health, Missouri Department of Health and Senior Services Jefferson City, Missouri
| | - Venkata Garikapaty
- Division of Community and Public Health, Missouri Department of Health and Senior Services Jefferson City, Missouri
| | - Sarah Finley
- Division of Community and Public Health, Missouri Department of Health and Senior Services Jefferson City, Missouri
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