1
|
Albtoosh AS, Farah R, Al Oweidat K, Hussein OM, Obeid AA, Hamila HM, Radwan MNM, Ahmad RF, Masadeh HM, Hammad AI, Musleh AM, Fakhoury AA, Disi FM, Joudah YY, Obeidat N, Mason KP. Presenting clinical symptoms of post-COVID-19 breakthrough infection: Predictors of mortality in a Middle Eastern population. Vaccine X 2024; 18:100495. [PMID: 38746061 PMCID: PMC11091517 DOI: 10.1016/j.jvacx.2024.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 03/23/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024] Open
Abstract
Objective Breakthrough COVID-19 infections are common following immunisation with various types of vaccines. The patterns of infections have not been well established. We aimed to analyse the signs and symptoms of post vaccination infections in addition to the need for hospital admission, ER visit and supplemental oxygen in relation to age and gender. Methods A cross-sectional cohort study was conducted in JUH from March 2021 to August 2022, we interviewed 1479 individuals who are >15 years of age and got a breakthrough infection. The statistical analysis was performed using STATA statistical software. Results Out of the 1479 cases, 50.2 % and 69.4 % were females and less than 45 years of age respectively. Symptoms of cough, fever and headache were reported by nearly 50 % of the patients, while one-third complained of dyspnoea. We found that participants older than 45 years had worse clinical outcomes (P-value < 0.001). 13 deaths were identified in this study due to breakthrough infection, 92.3 % of them were older than 45 years (P-value < 0.001). Participants ≥45 years who experienced a breakthrough infection of COVID-19 were 0.7 times less likely to be females using adjusted logistic regression. Conclusion This study indicates that despite more severe symptoms reported in younger patients, the major clinical outcomes were worse among older patients, which makes age a major risk for poor outcomes regardless of symptoms. Thus, older people should be evaluated carefully when presenting with mild symptoms of COVID-19 breakthrough infection. The study also confirms that there is no difference in the incidence of COVID-19 breakthrough infections between males and females. Prospective studies are needed to risk stratify COVID-19 breakthrough infections, which should take into account variants of the virus and comorbidities.
Collapse
Affiliation(s)
- Asma S. Albtoosh
- Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Randa Farah
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Khaled Al Oweidat
- Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | | | | | - Radi Feras Ahmad
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | | | | | | | | | - Nathir Obeidat
- Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Keira P. Mason
- Department of Anesthesia, Boston Children’s Hospital, Boston, MA, USA
| |
Collapse
|
2
|
Freund O, Harish A, Breslavsky A, Wand O, Zacks N, Bilenko N, Bar-Shai A. The humoral response to COVID-19 vaccinations can predict the booster effect on health care workers-toward personalized vaccinations? J Public Health (Oxf) 2024; 46:e78-e83. [PMID: 37872715 DOI: 10.1093/pubmed/fdad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Waning immunity after the coronavirus disease 2019 (COVID-19) vaccinations creates the constant need of boosters. Predicting individual responses to booster vaccines can help in its timely administration. We hypothesized that the humoral response to the first two doses of the BNT162b2 vaccine can predict the response to the booster vaccine. METHODS A prospective cohort of hospital health care workers (HCW) that received three doses of the BNT162b2 vaccine. Participants completed serological tests at 1 and 6 months after the second vaccine dose and 1 month after the third. We analyzed predictive factors of antibody levels after the booster using multivariate regression analyses. RESULTS From 289 eligible HCW, 89 (31%) completed the follow-up. Mean age was 48 (±10) and 46 (52%) had daily interaction with patients. The mean (±standard deviation) antibody level 1 month after the second vaccine was 223 (±59) AU/ml, and 31 (35%) had a rapid antibody decline (>50%) in 6 months. Low antibody levels 1 month after the second vaccine and a rapid antibody decline were independent predictors of low antibody levels after the booster vaccine. CONCLUSIONS The characteristics of the humoral response to COVID-19 vaccinations show promise in predicting the humoral response to the booster vaccines.
Collapse
Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alma Harish
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
| |
Collapse
|
3
|
Sheng WH, Hsieh SM, Chang SC. Achievements of COVID-19 vaccination programs: Taiwanese perspective. J Formos Med Assoc 2024; 123 Suppl 1:S70-S76. [PMID: 37142477 PMCID: PMC10133881 DOI: 10.1016/j.jfma.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/06/2023] [Accepted: 04/23/2023] [Indexed: 05/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health crisis. The specific characteristics of aerosol transmission in the latent period and the contagiousness of SARS-CoV-2 lead to rapid spread of infection in the community. Vaccination is the most effective method for preventing infection and severe outcomes. As of December 1, 2022, 88% of the Taiwanese population had received at least two doses of COVID-19 vaccines. Heterologous vaccination with ChAdOx1-mRNA-based or ChAdOx1-protein-based vaccines has been found to elicit higher immunogenicity than homologous vaccination with ChAdOx1-ChAdOx1 vaccines. A longitudinal cohort study revealed that 8-12-week intervals between the two heterologous vaccine doses of the primary series led to good immunogenicity and that the vaccines were safe. A third booster dose of mRNA vaccine is being encouraged to evoke effective immune responses against variants of concern. A novel domestic recombinant protein subunit vaccine (MVC-COV1901) was manufactured and authorized for emergency use in Taiwan. It has shown a good safety profile, with promising neutralizing antibody titers against SARS-CoV-2. Given the global pandemic due to emerging novel variants of SARS-CoV-2, booster COVID-19 vaccines and appropriate intervals between booster doses need to be investigated.
Collapse
Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Szu-Min Hsieh
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.
| |
Collapse
|
4
|
Neale I, Ali M, Kronsteiner B, Longet S, Abraham P, Deeks AS, Brown A, Moore SC, Stafford L, Dobson SL, Plowright M, Newman TAH, Wu MY, Carr EJ, Beale R, Otter AD, Hopkins S, Hall V, Tomic A, Payne RP, Barnes E, Richter A, Duncan CJA, Turtle L, de Silva TI, Carroll M, Lambe T, Klenerman P, Dunachie S. CD4+ and CD8+ T cells and antibodies are associated with protection against Delta vaccine breakthrough infection: a nested case-control study within the PITCH study. mBio 2023; 14:e0121223. [PMID: 37655880 PMCID: PMC10653804 DOI: 10.1128/mbio.01212-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/26/2023] [Indexed: 09/02/2023] Open
Abstract
IMPORTANCE Defining correlates of protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine breakthrough infection informs vaccine policy for booster doses and future vaccine designs. Existing studies demonstrate humoral correlates of protection, but the role of T cells in protection is still unclear. In this study, we explore antibody and T cell immune responses associated with protection against Delta variant vaccine breakthrough infection in a well-characterized cohort of UK Healthcare Workers (HCWs). We demonstrate evidence to support a role for CD4+ and CD8+ T cells as well as antibodies against Delta vaccine breakthrough infection. In addition, our results suggest a potential role for cross-reactive T cells in vaccine breakthrough.
Collapse
Affiliation(s)
- Isabel Neale
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Mohammad Ali
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Barbara Kronsteiner
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Stephanie Longet
- Nuffield Department of Medicine, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Priyanka Abraham
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Alexandra S. Deeks
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Anthony Brown
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Shona C. Moore
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Lizzie Stafford
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Susan L. Dobson
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Megan Plowright
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Thomas A. H. Newman
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Mary Y. Wu
- Covid Surveillance Unit, The Francis Crick Institute, London, United Kingdom
| | - Crick COVID Immunity Pipeline
- Covid Surveillance Unit, The Francis Crick Institute, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
| | | | - Rupert Beale
- The Francis Crick Institute, London, United Kingdom
- UCL Department of Renal Medicine, Royal Free Hospital, London, United Kingdom
| | | | | | | | - Adriana Tomic
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | - Rebecca P. Payne
- Translational and Clinical Research Institute Immunity and Inflammation Theme, Newcastle University, Newcastle, United Kingdom
| | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Alex Richter
- Institute of Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Christopher J. A. Duncan
- Translational and Clinical Research Institute Immunity and Inflammation Theme, Newcastle University, Newcastle, United Kingdom
- Department of Infection and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - Lance Turtle
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Thushan I. de Silva
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Miles Carroll
- Nuffield Department of Medicine, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Teresa Lambe
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
- Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, United Kingdom
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Susanna Dunachie
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - On behalf of the PITCH Consortium
- Peter Medawar Building for Pathogen Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- NDM Centre For Global Health Research, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Nuffield Department of Medicine, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
- Covid Surveillance Unit, The Francis Crick Institute, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
- UCL Department of Renal Medicine, Royal Free Hospital, London, United Kingdom
- UK Health Security Agency, Porton Down, United Kingdom
- UK Health Security Agency, London, United Kingdom
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
- Translational and Clinical Research Institute Immunity and Inflammation Theme, Newcastle University, Newcastle, United Kingdom
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical and Dental Science, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Department of Infection and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Chinese Academy of Medical Science (CAMS) Oxford Institute (COI), University of Oxford, Oxford, United Kingdom
| |
Collapse
|
5
|
Hare D, Dembicka KM, Brennan C, Campbell C, Sutton-Fitzpatrick U, Stapleton PJ, De Gascun CF, Dunne CP. Whole-genome sequencing to investigate transmission of SARS-CoV-2 in the acute healthcare setting: a systematic review. J Hosp Infect 2023; 140:139-155. [PMID: 37562592 DOI: 10.1016/j.jhin.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Whole-genome sequencing (WGS) has been used widely to elucidate transmission of SARS-CoV-2 in acute healthcare settings, and to guide infection, prevention, and control (IPC) responses. AIM To systematically appraise available literature, published between January 1st, 2020 and June 30th, 2022, describing the implementation of WGS in acute healthcare settings to characterize nosocomial SARS-CoV-2 transmission. METHODS Searches of the PubMed, Embase, Ovid MEDLINE, EBSCO MEDLINE, and Cochrane Library databases identified studies in English reporting the use of WGS to investigate SARS-CoV-2 transmission in acute healthcare environments. Publications involved data collected up to December 31st, 2021, and findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. FINDINGS In all, 3088 non-duplicate records were retrieved; 97 met inclusion criteria, involving 62 outbreak analyses and 35 genomic surveillance studies. No publications from low-income countries were identified. In 87/97 (90%), WGS supported hypotheses for nosocomial transmission, while in 46 out of 97 (47%) suspected transmission events were excluded. An IPC intervention was attributed to the use of WGS in 18 out of 97 (18%); however, only three (3%) studies reported turnaround times ≤7 days facilitating near real-time IPC action, and none reported an impact on the incidence of nosocomial COVID-19 attributable to WGS. CONCLUSION WGS can elucidate transmission of SARS-CoV-2 in acute healthcare settings to enhance epidemiological investigations. However, evidence was not identified to support sequencing as an intervention to reduce the incidence of SARS-CoV-2 in hospital or to alter the trajectory of active outbreaks.
Collapse
Affiliation(s)
- D Hare
- UCD National Virus Reference Laboratory, University College Dublin, Ireland; School of Medicine, University of Limerick, Limerick, Ireland.
| | - K M Dembicka
- School of Medicine, University of Limerick, Limerick, Ireland
| | - C Brennan
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | - C Campbell
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | | | | | - C F De Gascun
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | - C P Dunne
- School of Medicine, University of Limerick, Limerick, Ireland; Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| |
Collapse
|
6
|
Alp Çavuş S, Çelik M, Süner AF, Güzel I, Irmak Ç, Çağlayan D, Öztürk HG, Şiyve N, Appak Ö, Işık E, Ergör G, Ergör OA, Demiral Y, Sayıner AA, Kılıç B. Pre-infection antibody levels of vaccinated healthcare workers with SARS-CoV-2 breakthrough infection: A nested case-control study. Immunol Lett 2023; 262:1-6. [PMID: 37597753 DOI: 10.1016/j.imlet.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/24/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
AIM To evaluate anti-RBD IgG antibody levels and neutralizing antibody titers between the health care workers (HCWs) with breakthrough SARS-CoV-2 infection and controls. METHODS In this nested case-case control study, we followed 548 vaccinated HCWs with homologous (only with inactivated vaccine) or heterologous (both with inactivated and BNT162b2 vaccine) vaccination for 11 months, prospectively. We obtained blood samples from the participants for quantitative anti-RBD IgG and surrogate neutralization test. The participants with SARS-CoV-2 PCR positivity (at least 14 days after the last vaccination) were considered breakthrough infection. We chose 1:2 matched controls from the cohort, according to age, sex and vaccination status. We used R version 4.0.2 for the statistical analysis. RESULTS Sixty-five cases and 130 controls were included in the study. The number of the breakthrough infections in HCWs were correlated with the pandemic waves in Türkiye and peaked during Omicron outbreak. The median age of the cases was 39 and 78.5% were female. The cases had more comorbidities than controls, significantly (p = 0.021). All cases experienced no or mild symptoms and recovered completely. Both pre-infection anti-RBD antibody and neutralizing antibody titers did not differ between cases and matched controls (p = 0.767, p = 0.628). CONCLUSION In this study, we showed that there was no comparable difference in humoral response after homologous or heterologous vaccination between the cases of breakthrough infection and matched controls. Compliance with infection control measures should be ensured, in combination with vaccination.
Collapse
Affiliation(s)
- Sema Alp Çavuş
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye.
| | - Muammer Çelik
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Ahmet Furkan Süner
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Irmak Güzel
- Department of Medical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Çağlar Irmak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Derya Çağlayan
- Department of Public Health, Division of Epidemiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Huriye Gamze Öztürk
- Department of Medical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Neslişah Şiyve
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Özgür Appak
- Department of Medical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Elif Işık
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Gül Ergör
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Osman Alparslan Ergör
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Yücel Demiral
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Ayça Arzu Sayıner
- Department of Medical Microbiology, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Bülent Kılıç
- Department of Public Health, School of Medicine, Dokuz Eylul University, Izmir, Türkiye
| |
Collapse
|
7
|
Schiffner J, Eisemann N, Baltus H, Jensen S, Wunderlich K, Schuesseler S, Eicker C, Teegen B, Boniakowsky D, Solbach W, Mischnik A. Dynamics of immunity over time: decline of anti-SARS-CoV-2 IgG antibodies and T-cell responses after mRNA vaccination in residents and health care workers in nursing homes and homes with assisted living support. GMS INFECTIOUS DISEASES 2023; 11:Doc02. [PMID: 37830111 PMCID: PMC10565841 DOI: 10.3205/id000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background In the present study, we investigated the dynamics of immunity over time by measuring anti SARS-CoV-2 IgG antibodies and SARS-CoV-2 specific T-cell responses (interferon-gamma release assay) after two doses of vaccines in residents and health care workers (HCW). Mostly, 224 (98%) residents and 244 (89%) HCW received two doses of mRNA vaccine (BNT162b2, Pfizer-BioNTech); the rest of the participants received heterologous vaccinations with mRNA and vector vaccines. The study was conducted at the time when the Delta variant of SARS-CoV-2 prevailed. Methods We analyzed blood samples of 228 residents (median age 83.8 years) and of 273 HCW (median age 49.7 years) from five nursing homes and one home for the elderly with assisted living support at one specific time point. Participants received two vaccinations. The blood samples were analyzed for SARS-CoV-2 specific IgG antibody and T-cell responses. Results The initial immune responses in the younger participants were about 30% higher than in the older age group. Over time the estimated mean of the parameters (estimated from the study sample for the total population) decreased in all groups within the maximum observation period of 232 days. Comorbidities such as coronary heart disease or diabetes mellitus reduced the initial immune responses regardless of age. With regard to measured IgG antibody levels, absolute values decreased over time, whereas the interferon-gamma response remained at a constant level between day 120 and 180 and seemed to be less dependent on the time elapsed after vaccination. Conclusions Based on our data, it does not seem possible to determine a reliable threshold of robust immunity, but we suggest that high titres of neutralizing capacity and interferon-gamma response might be an indicator of protection against severe COVID-19 courses.
Collapse
Affiliation(s)
| | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Hannah Baltus
- Institute of Social Medicine and Epidemiology, University of Luebeck, Germany
| | - Sina Jensen
- Health Protection Authority, Luebeck, Germany
| | | | | | | | - Bianca Teegen
- Klinisch-Immunologisches Labor Stoecker, Luebeck, Germany
| | | | - Werner Solbach
- Center for Infection and Inflammation Research, University of Luebeck, Germany
- German Center for Infection Research (DZIF), Luebeck, Germany
| | | |
Collapse
|
8
|
Seekircher L, Bánki Z, Kimpel J, Rössler A, Schäfer H, Falkensammer B, Bante D, Forer L, Schönherr S, Harthaller T, Sacher M, Ower C, Tschiderer L, Ulmer H, Krammer F, von Laer D, Borena W, Willeit P. Immune response after two doses of the BNT162b2 COVID-19 vaccine and risk of SARS-CoV-2 breakthrough infection in Tyrol, Austria: an open-label, observational phase 4 trial. THE LANCET. MICROBE 2023; 4:e612-e621. [PMID: 37354911 PMCID: PMC10284585 DOI: 10.1016/s2666-5247(23)00107-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Correlates of protection could help to assess the extent to which a person is protected from SARS-CoV-2 infection after vaccination (so-called breakthrough infection). We aimed to clarify associations of antibody and T-cell responses after vaccination against COVID-19 with risk of a SARS-CoV-2 breakthrough infection and whether measurement of these responses enhances risk prediction. METHODS We did an open-label, phase 4 trial in two community centres in the Schwaz district of the Federal State of Tyrol, Austria, before the emergence of the omicron (B.1.1.529) variant of SARS-CoV-2. We included individuals (aged ≥16 years) a mean of 35 days (range 27-43) after they had received a second dose of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. We quantified associations between immunological parameters and breakthrough infection and assessed whether information on these parameters improves risk discrimination. The study is registered with the European Union Drug Regulating Authorities Clinical Trials Database, 2021-002030-16. FINDINGS 2760 individuals (1682 [60·9%] female, 1078 [39·1%] male, mean age 47·4 years [SD 14·5]) were enrolled into this study between May 15 and May 21, 2021, 712 (25·8%) of whom had a previous SARS-CoV-2 infection. Over a median follow-up of 5·9 months, 68 (2·5%) participants had a breakthrough infection. In models adjusted for age, sex, and previous infection, hazard ratios for breakthrough infection for having twice the immunological parameter level at baseline were 0·72 (95% CI 0·60-0·86) for anti-spike IgG, 0·80 (0·70-0·92) for neutralising antibodies in a surrogate virus neutralisation assay, 0·84 (0·58-1·21) for T-cell response after stimulation with a CD4 peptide pool, and 0·77 (0·54-1·08) for T-cell response after stimulation with a combined CD4 and CD8 peptide pool. For neutralising antibodies measured in a nested case-control sample using a pseudotyped virus neutralisation assay, the corresponding odds ratio was 0·78 (0·62-1·00). Among participants with previous infection, the corresponding hazard ratio was 0·73 (0·61-0·88) for anti-nucleocapsid Ig. Addition of anti-spike IgG information to a model containing information on age and sex improved the C-index by 0·085 (0·027-0·143). INTERPRETATION In contrast to T-cell response, higher levels of binding and neutralising antibodies were associated with a reduced risk of breakthrough SARS-CoV-2 infection. The assessment of anti-spike IgG enhances the prediction of incident breakthrough SARS-CoV-2 infection and could therefore be a suitable correlate of protection in practice. Our phase 4 trial measured both humoral and cellular immunity and had a 6-month follow-up period; however, the longer-term protection against emerging variants of SARS-CoV-2 remains unclear. FUNDING None.
Collapse
Affiliation(s)
- Lisa Seekircher
- Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Zoltán Bánki
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Janine Kimpel
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Annika Rössler
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helena Schäfer
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - David Bante
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Forer
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Schönherr
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Teresa Harthaller
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Sacher
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Cornelia Ower
- Department of Surgery, University Hospital of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Lena Tschiderer
- Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Hanno Ulmer
- Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Krammer
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Vaccine Research and Pandemic Preparedness, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dorothee von Laer
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wegene Borena
- Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Peter Willeit
- Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria; Ignaz Semmelweis Institute, Interuniversity Institute for Infection Research, Vienna, Austria; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| |
Collapse
|
9
|
Ruggieri S, Aiello A, Tortorella C, Navarra A, Vanini V, Meschi S, Lapa D, Haggiag S, Prosperini L, Cuzzi G, Salmi A, Quartuccio ME, Altera AMG, Garbuglia AR, Ascoli Bartoli T, Galgani S, Notari S, Agrati C, Puro V, Nicastri E, Gasperini C, Goletti D. Dynamic Evolution of Humoral and T-Cell Specific Immune Response to COVID-19 mRNA Vaccine in Patients with Multiple Sclerosis Followed until the Booster Dose. Int J Mol Sci 2023; 24:ijms24108525. [PMID: 37239872 DOI: 10.3390/ijms24108525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
This study characterizes antibody and T-cell immune responses over time until the booster dose of COronaVIrus Disease 2019 (COVID-19) vaccines in patients with multiple sclerosis (PwMS) undergoing different disease-modifying treatments (DMTs). We prospectively enrolled 134 PwMS and 99 health care workers (HCWs) having completed the two-dose schedule of a COVID-19 mRNA vaccine within the last 2-4 weeks (T0) and followed them 24 weeks after the first dose (T1) and 4-6 weeks after the booster (T2). PwMS presented a significant reduction in the seroconversion rate and anti-receptor-binding domain (RBD)-Immunoglobulin (IgG) titers from T0 to T1 (p < 0.0001) and a significant increase from T1 to T2 (p < 0.0001). The booster dose in PwMS showed a good improvement in the serologic response, even greater than HCWs, as it promoted a significant five-fold increase of anti-RBD-IgG titers compared with T0 (p < 0.0001). Similarly, the T-cell response showed a significant 1.5- and 3.8-fold increase in PwMS at T2 compared with T0 (p = 0.013) and T1 (p < 0.0001), respectively, without significant modulation in the number of responders. Regardless of the time elapsed since vaccination, most ocrelizumab- (77.3%) and fingolimod-treated patients (93.3%) showed only a T-cell-specific or humoral-specific response, respectively. The booster dose reinforces humoral- and cell-mediated-specific immune responses and highlights specific DMT-induced immune frailties, suggesting the need for specifically tailored strategies for immune-compromised patients to provide primary prophylaxis, early SARS-CoV-2 detection and the timely management of COVID-19 antiviral treatments.
Collapse
Affiliation(s)
- Serena Ruggieri
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandra Aiello
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Carla Tortorella
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Disease Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
- UOS Professioni Sanitarie Tecniche, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Silvia Meschi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Shalom Haggiag
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Luca Prosperini
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Andrea Salmi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | | | - Anna Maria Gerarda Altera
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Tommaso Ascoli Bartoli
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Simonetta Galgani
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Stefania Notari
- Cellular Immunology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Chiara Agrati
- Cellular Immunology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
- Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, 00146 Rome, Italy
| | - Vincenzo Puro
- UOC Emerging Infections and Centro di Riferimento AIDS (CRAIDS), National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Emanuele Nicastri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| | - Claudio Gasperini
- Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00149 Rome, Italy
| |
Collapse
|
10
|
Richter WR, Sunderman MM, Schaeufele DJ, Willenberg Z, Ratliff K, Calfee MW, Oudejans L. Evaluation of steam heat as a decontamination approach for SARS-CoV-2 when applied to common transit-related materials. J Appl Microbiol 2023; 134:lxad053. [PMID: 36906281 PMCID: PMC10257936 DOI: 10.1093/jambio/lxad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/31/2023] [Accepted: 03/10/2023] [Indexed: 03/13/2023]
Abstract
AIMS The purpose of this study was to evaluate the efficacy of steam heat for inactivation of SARS-CoV-2 when applied to materials common in mass transit installations. METHODS AND RESULTS SARS CoV-2 (USA-WA1/2020) was resuspended in either cell culture media or synthetic saliva, inoculated (∼1 × 106 TCID50) onto porous and nonporous materials and subjected to steam inactivation efficacy tests as either wet or dried droplets. The inoculated test materials were exposed to steam heat ranging from 70°C to 90°C. The amount of infectious SARS-CoV-2 remaining after various exposure durations ranging from 1 to 60 s was assessed. Higher steam heat application resulted in higher inactivation rates at short contact times. Steam applied at 1-inch distance (∼90°C at the surface) resulted in complete inactivation for dry inoculum within 2 s of exposure (excluding two outliers of 19 test samples at the 5-s duration) and within 2-30 s of exposure for wet droplets. Increasing the distance to 2 inches (∼70°C) also increased the exposure time required to achieve complete inactivation to 15 or 30 s for materials inoculated with saliva or cell culture media, respectively. CONCLUSIONS Steam heat can provide high levels of decontamination (>3 log reduction) for transit-related materials contaminated with SARS-CoV-2 using a commercially available steam generator with a manageable exposure time of 2-5 s.
Collapse
Affiliation(s)
| | | | | | | | - Katherine Ratliff
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, United States
| | - M. Worth Calfee
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, United States
| | - Lukas Oudejans
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, United States
| |
Collapse
|
11
|
Ling TC, Chen PL, Li NY, Ko WC, Sun CY, Chao JY, Shieh CC, Shen CF, Wu JL, Huang TC, Chao CH, Wang JR, Chang YT. Trajectory of Humoral Responses to Two Doses of ChAdOx1 nCoV-19 Vaccination in Patients Receiving Maintenance Hemodialysis. Microbiol Spectr 2023; 11:e0344522. [PMID: 36809164 PMCID: PMC10100369 DOI: 10.1128/spectrum.03445-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/27/2023] [Indexed: 02/23/2023] Open
Abstract
The ChAdOx1 nCoV-19 (AZD1222) vaccine is one of the most commonly delivered SARS-CoV-2 vaccines worldwide; however, few clinical studies have investigated its immunogenicity in dialysis patients. We prospectively enrolled 123 patients on maintenance hemodialysis at a medical center in Taiwan. All patients were infection-naive, had received two doses of the AZD1222 vaccine, and were monitored for 7 months. The primary outcomes were anti-SARS-CoV-2 receptor-binding domain (RBD) antibody concentrations before and after each dose and 5 months after the second dose and neutralization capacity against ancestral SARS-CoV-2, delta, and omicron variants. The anti-SARS-CoV-2 RBD antibody titers significantly increased with time following vaccination, with a peak at 1 month after the second dose (median titer, 498.8 U/mL; interquartile range, 162.5 to 1,050 U/mL), and a 4.7-fold decrease at 5 months. At 1 month after the second dose, 84.6, 83.7, and 1.6% of the participants had neutralizing antibodies against the ancestral virus, delta variant, and omicron variant, respectively, measured by a commercial surrogate neutralization assay. The geometric mean 50% pseudovirus neutralization titers for the ancestral virus, delta variant, and omicron variant were 639.1, 264.2, and 24.7, respectively. The anti-RBD antibody titers correlated well with neutralization capacity against the ancestral virus and delta variant. Transferrin saturation and C-reactive protein were associated with neutralization against the ancestral virus and delta variant. Although two doses of the AZD1222 vaccine initially elicited high anti-RBD antibody titers and neutralization against the ancestral virus and delta variant in hemodialysis patients, neutralizing antibodies against omicron variant were rarely detected, and the anti-RBD and neutralization antibodies waned over time. Additional/booster vaccinations are warranted in this population. IMPORTANCE Patients with kidney failure have worse immune response following vaccination compared to general population, but few clinical studies have investigated immunogenicity of ChAdOx1 nCoV-19 (AZD1222) vaccination in hemodialysis patients. Here, we showed two doses of AZD1222 vaccines lead to high seroconversion rate of anti-SARS-CoV-2 receptor-binding domain (RBD) antibodies, and more than 80% patients acquired neutralizing antibodies against ancestral virus and delta variant. However, seldom did they obtain neutralizing antibodies against the omicron variant. The geometric mean 50% pseudovirus neutralization titer against the ancestral virus was 25.9-fold higher than that against the omicron variant. Also, there was a substantial decay in anti-RBD titers with time. Our findings provided evidence supporting that more protective measures, including additional/booster vaccinations, is warranted in these patients during the current COVID-19 pandemic.
Collapse
Affiliation(s)
- Tsai-Chieh Ling
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Lin Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Infection Control Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Yao Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Yao Sun
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jo-Yen Chao
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Chang Shieh
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jia-Ling Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Teng-Ching Huang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chiao-Hsuan Chao
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jen-Ren Wang
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
| | - Yu-Tzu Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
12
|
Offersgaard A, Duarte Hernandez CR, Feng S, Marichal-Gallardo P, Holmbeck K, Pihl AF, Fernandez-Antunez C, Alzua GP, Hartmann KT, Pham LV, Zhou Y, Gammeltoft KA, Fahnøe U, Schneider UV, Pedersen GK, Jensen HE, Christensen JP, Ramirez S, Bukh J, Gottwein JM. An inactivated SARS-CoV-2 vaccine induced cross-neutralizing persisting antibodies and protected against challenge in small animals. iScience 2023; 26:105949. [PMID: 36644321 PMCID: PMC9829433 DOI: 10.1016/j.isci.2023.105949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/07/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Vaccines have relieved the public health burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and globally inactivated vaccines are most widely used. However, poor vaccination accessibility and waning immunity maintain the pandemic, driving emergence of variants. We developed an inactivated SARS-CoV-2 (I-SARS-CoV-2) vaccine based on a viral isolate with the Spike mutation D614G, produced in Vero cells in a scalable bioreactor, inactivated with β-propiolactone, purified by membrane-based steric exclusion chromatography, and adjuvanted with MF59-like adjuvant AddaVax. I-SARS-CoV-2 and a derived split vaccine induced persisting neutralizing antibodies in mice; moreover, lyophilized antigen was immunogenic. Following homologous challenge, I-SARS-CoV-2 immunized hamsters were protected against disease and lung pathology. In contrast with reports for widely used vaccines, hamster plasma similarly neutralized the homologous and the Delta (B.1.617.2) variant viruses, whereas the Omicron (B.1.1.529) variant was neutralized less efficiently. Applied bioprocessing approaches offer advantages regarding scalability and production, potentially benefitting worldwide vaccine coverage.
Collapse
Affiliation(s)
- Anna Offersgaard
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Carlos Rene Duarte Hernandez
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Shan Feng
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Pavel Marichal-Gallardo
- Bioprocess Engineering, Max Planck Institute for Dynamics of Complex Technical Systems, 39106 Magdeburg, Germany
| | - Kenn Holmbeck
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Anne Finne Pihl
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Carlota Fernandez-Antunez
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Garazi Peña Alzua
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Katrine Top Hartmann
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Long V. Pham
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Yuyong Zhou
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Karen Anbro Gammeltoft
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Ulrik Fahnøe
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Uffe Vest Schneider
- Department of Clinical Microbiology, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark
| | | | - Henrik Elvang Jensen
- Department of Veterinary and Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Jan Pravsgaard Christensen
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Santseharay Ramirez
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Jens Bukh
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Judith Margarete Gottwein
- Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases, Copenhagen University Hospital–Hvidovre, 2650 Hvidovre, Denmark,CO-HEP, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark,Corresponding author
| |
Collapse
|
13
|
Sheng WH, Ieong SM, Lin PH, Hsieh MJ, Yang HC, Pan CF, Chao TL, Chang SY, Chang SC. Immunogenicity and safety of third-dose mRNA COVID-19 vaccines in healthy adults previously vaccinated with two doses of the ChAdOx1 vaccine. J Formos Med Assoc 2023; 122:121-131. [PMID: 36127206 PMCID: PMC9452412 DOI: 10.1016/j.jfma.2022.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND/PURPOSE The efficacy and safety of coronavirus disease 2019 (COVID-19) booster vaccines remain limited. We investigated the immunogenicity and adverse events of the third dose of mRNA vaccines in healthy adults. METHODS Volunteers vaccinated with two doses of the adenoviral vaccine (ChAdOx1) 12 weeks before were administered with an mRNA COVID-19 vaccine. These were divided into three groups, full-dose mRNA-1273 (group 1); half-dose mRNA-1273 (group 2); and full-dose BNT-162b2 (group 3). Primary outcomes included serum anti-SARS-CoV-2 spike immunoglobulin G (IgG) titers and neutralizing antibody titers against B.1.1.7 (alpha), B.1.617.2 (delta), and B.1.1.529 (omicron) variants. Secondary outcomes included the evaluation of humoral and cellular immunity and vaccine-associated adverse events after the boost. RESULTS Totally 300 participants were recruited, and 298 participants were enrolled. For all three groups, an increase in anti-SARS-CoV-2 spike IgG geometric mean titers (30.12- to 71.80-fold) and neutralizing antibody titers against the alpha variant (69.80- to 173.23-folds), delta variant (132.69- to 324.63-folds), and omicron variant (135.36- to 222.37-folds) were observed on day 28. All groups showed robust T- and B-cell responses after boosting. Adverse events were overall mild and transient but with higher prevalence and severity in group 1 participants than in other groups. CONCLUSION Third dose mRNA COVID-19 vaccines markedly enhanced cellular and humoral responses and were safe. Immunological responses and adverse events were higher in individuals receiving the full-dose mRNA-1273 vaccine, followed by a half-dose mRNA-1273 vaccine and BNT-162b2 vaccine.
Collapse
Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Si-Man Ieong
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pin-Hung Lin
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Chih Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Fu Pan
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tai-Ling Chao
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.
| |
Collapse
|
14
|
Chau NVV, Nguyet LA, Dung NT, Quang VM, Truong NT, Toan LM, Hung LM, Man DNH, Khoa DB, Phong NT, Ngoc NM, Thao HP, Ty DTB, Thanh PB, Ny NTH, Thanh LK, Thuy CT, Anh NT, Hong NTT, Nhu LNT, Yen LM, Thwaites G, Thanh TT, Tan LV. Kinetics of Neutralizing Antibodies against Omicron Variant in Vietnamese Healthcare Workers after Primary Immunization with ChAdOx1-S and Booster Immunization with BNT162b2. Am J Trop Med Hyg 2023; 108:137-144. [PMID: 36450229 PMCID: PMC9833090 DOI: 10.4269/ajtmh.22-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
We studied the development and persistence of neutralizing antibodies against SARS-CoV-2 ancestral strain, and Delta and Omicron (BA.1 and BA.2) variants in Vietnamese healthcare workers (HCWs) up to 15 weeks after booster vaccination. We included 47 HCWs, including group 1 (G1, N = 21) and group 2 (G2; N = 26) without and with breakthrough Delta variant infection before booster immunization, respectively). The study participants had completed primary immunization with ChAdOx1-S and booster vaccination with BNT162b2. Neutralizing antibodies were measured using a surrogate virus neutralization assay. Of the 21 study participants in G1, neutralizing antibodies against ancestral strain, Delta variant, BA.1, and BA.2 were (almost) abolished at month 8 after the second dose, but all had detectable neutralizing antibodies to the study viruses at week 2 post booster dose. Of the 26 study participants in G2, neutralizing antibody levels to BA.1 and BA.2 were significantly higher than those to the corresponding viruses measured at week 2 post breakthrough infection and before the booster dose. At week 15 post booster vaccination, neutralizing antibodies to BA.1 and BA.2 dropped significantly, with more profound changes observed in those without breakthrough Delta variant infection. Booster vaccination enhanced neutralizing activities against ancestral strain and Delta variant compared with those induced by primary vaccination. These responses were maintained at high levels for at least 15 weeks. Our findings emphasize the importance of the first booster dose in producing cross-neutralizing antibodies against Omicron variant. A second booster to maintain long-term vaccine effectiveness against the currently circulating variants merits further research.
Collapse
Affiliation(s)
- Nguyen Van Vinh Chau
- Department of Health, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Lam Anh Nguyet
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Vo Minh Quang
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Le Mau Toan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Manh Hung
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Dao Bach Khoa
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nghiem My Ngoc
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | - Pham Ba Thanh
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Le Kim Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Cao Thu Thuy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen To Anh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Lam Minh Yen
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Tan Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Le Van Tan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
15
|
Disanto G, Galante A, Cantu' M, Sacco R, Mele F, Eisler JJ, Keller F, Bernasconi E, Sallusto F, Zecca C, Gobbi C. Longitudinal Postvaccine SARS-CoV-2 Immunoglobulin G Titers, Memory B-Cell Responses, and Risk of COVID-19 in Multiple Sclerosis Over 1 Year. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:e200043. [PMID: 36396447 PMCID: PMC9747147 DOI: 10.1212/nxi.0000000000200043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Some disease-modifying treatments impair response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in multiple sclerosis (MS), potentially increasing the risk of breakthrough infections. We aimed to investigate longitudinal SARS-CoV-2 antibody dynamics and memory B cells after 2 and 3 messenger RNA (mRNA) vaccine doses and their association with the risk of COVID-19 in patients with MS on different treatments over 1 year. METHODS Prospective observational cohort study in patients with MS undergoing SARS-CoV-2 mRNA vaccinations. Antispike (anti-S) immunoglobulin G (IgG) titers were measured by chemiluminescence microparticle immunoassay. Frequencies of spike-specific memory B cells were measured on polyclonal stimulation of peripheral blood mononuclear cells and screening of secreted antibodies by ELISA. RESULTS We recruited 120 patients with MS (58 on anti-CD20 antibodies, 9 on sphingosine 1-phosphate (S1P) receptor modulators, 15 on cladribine, 24 on teriflunomide (TFL), and 14 untreated) and collected 392 samples up to 10.8 months after 2 vaccine doses. When compared with untreated patients, anti-CD20 antibodies (β = -2.07, p < 0.001) and S1P modulators (β = -2.02, p < 0.001) were associated with lower anti-S IgG, while TFL and cladribine were not. Anti-S IgG decreased with months since vaccine (β = -0.14, p < 0.001), independently of treatments. Within anti-CD20 patients, anti-S IgG remained higher in those with greater baseline B-cell counts and were not influenced by postvaccine anti-CD20 infusions. Anti-S IgG increase after a 3rd vaccine was mild on anti-CD20 and S1P modulators. Spike-specific memory B-cell responses were weaker on S1P modulators and anti-CD20 than on TFL and influenced by postvaccine anti-CD20 infusions. The frequency of breakthrough infections was comparable between DMTs, but the risk of COVID-19 was predicted by the last measured anti-S IgG titer before infection (OR = 0.56, 95% CI = 0.37-0.86, p = 0.008). DISCUSSION Postvaccine anti-S IgG titers decrease over time regardless of MS treatment and are associated with breakthrough COVID-19. Both humoral and specific memory B-cell responses are diminished on S1P modulators. Within anti-CD20-treated patients, B-cell count at first vaccine determines anti-S IgG production, whereas postvaccine anti-CD20 infusions negatively affect spike-specific memory B cells.
Collapse
Affiliation(s)
- Giulio Disanto
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Alice Galante
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Marco Cantu'
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Rosaria Sacco
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Federico Mele
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Jennifer Jessica Eisler
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Franco Keller
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Enos Bernasconi
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Federica Sallusto
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Chiara Zecca
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland
| | - Claudio Gobbi
- From the Multiple Sclerosis Center (G.D., R.S., J.J.E., C.Z., C.G.), Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano; Institute for Research in Biomedicine (A.G., F.M., F.S.), Università Della Svizzera Italiana, Bellinzona; Institute of Laboratory Medicine (M.C., F.K.), Ente Ospedaliero Cantonale, Bellinzona; Department of Medicine (E.B.), Ente Ospedaliero Cantonale, Lugano; Faculty of Biomedical Sciences (E.B., F.S., C.Z., C.G.), Università Della Svizzera Italiana, Lugano; and Institute of Microbiology (F.S.), ETH Zurich, Switzerland.
| |
Collapse
|
16
|
Heinzl MW, Kolenchery L, Resl M, Klammer C, Black A, Obendorf F, Schinagl L, Feldbauer R, Pohlhammer J, Wagner T, Berger T, Dieplinger B, Clodi M. High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15581. [PMID: 36497655 PMCID: PMC9740194 DOI: 10.3390/ijerph192315581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although vaccination against COVID-19 is highly effective, breakthrough infections occur, often leading to severe courses and death. The extent of protection provided by individual antibody levels in breakthrough infections is still unknown and cut-off levels have yet to be determined. METHODS In 80 consecutive fully vaccinated patients hospitalized between August and December 2021 with COVID-19 breakthrough infection (Delta variant), anti-CoV2S antibody levels were analyzed for the endpoint of death. RESULTS Ten out of the 12 patients who died (83.3%) had antibody levels < 600 U/mL; 5 (41.7%) of these had antibody levels < 200 U/mL. Only 2 patients with a level of >600 U/mL died from vaccine breakthrough infection. Correction for the number of comorbidities and age revealed that anti-CoV2S antibody levels at the time of hospitalization were a significant predictor for reduced risk of death (OR = 0.402 for every 1000 U/mL, p = 0.018). CONCLUSIONS In this retrospective data analysis, we show that almost all patients who died from COVID-19 vaccine breakthrough infection had antibody levels < 600 U/mL, most of them below 200 U/mL. In logistic regression corrected for the number of comorbidities and age, anti-CoV2S antibody levels at the time of hospitalization proved to be a significantly protective predictor against death.
Collapse
Affiliation(s)
- Matthias Wolfgang Heinzl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Lisa Kolenchery
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Michael Resl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Carmen Klammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Anne Black
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Florian Obendorf
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Lukas Schinagl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Roland Feldbauer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Johannes Pohlhammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Wagner
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Berger
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Martin Clodi
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| |
Collapse
|
17
|
Goupil de Bouillé J, Luong Nguyen LB, Crépey P, Garlantezec R, Doré V, Dumas A, Ben Mechlia M, Tattevin P, Gaudart J, Spire B, Lert F, Yazdanpanah Y, Delaugerre C, Noret M, Zeggagh J. Transmission of SARS-CoV-2 during indoor clubbing events: A clustered randomized, controlled, multicentre trial protocol. Front Public Health 2022; 10:981213. [PMID: 36438274 PMCID: PMC9687087 DOI: 10.3389/fpubh.2022.981213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The SARS-CoV-2 pandemic led to the implementation of several non-pharmaceutical interventions (NPIs), from closings of bars and restaurants to curfews and lockdowns. Vaccination campaigns started hoping it could efficiently alleviate NPI. The primary objective of the "Indoor Transmission of COVID-19" (ITOC) study is to determine among a fully vaccinated population the relative risk of SARS-CoV-2 transmission during one indoor clubbing event. Secondary objectives are to assess the transmission of other respiratory viruses, risk exposure, and attitudes toward COVID-19 vaccination, health pass, and psychological impact of indoor club closing. Methods and analysis Four thousand four hundred healthy volunteers aged 18-49 years and fully vaccinated will be included in Paris region. The intervention is an 8-hour indoor clubbing event with no masks, no social distance, maximum room capacity, and ventilation. A reservation group of up to 10 people will recruit participants, who will be randomized 1:1 to either the experimental group (2,200 volunteers in two venues with capacities of 1,000 people each) or the control group (2,200 volunteers asked not to go to the club). All participants will provide a salivary sample on the day of the experiment and 7 days later. They also will answer several questionnaires. Virological analyses include polymerase chain reaction (PCR) of salivary samples and air of the venue, investigating SARS-CoV-2 and 18 respiratory viruses. Ethics and dissemination Ethical clearance was first obtained in France from the institutional review board (Comité de Protection des Personnes Ile de France VII - CPP), and the trial received clearance from the French National Agency for Medicines and Health Products (Agence National de Sécurité du Médicament - ANSM). The trial is supported and approved by The Agence Nationale Recherche sur le SIDA, les hépatites et maladies émergences (ANRS-MIE). Positive, negative, and inconclusive results will be published in peer-reviewed scientific journals. Trial registration number IDR-CB 2021-A01473-38. Clinicaltrial.gov, identifier: NCT05311865.
Collapse
Affiliation(s)
- Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France,LEPS Laboratoire Éducations et Pratiques de Santé, Université Paris 13, Bobigny, France,*Correspondence: Jeanne Goupil de Bouillé
| | | | - Pascal Crépey
- Univ Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | | | - Audrey Dumas
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Jean Gaudart
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Hop Timone, BioSTIC, Biostatistic and ICT, Marseille, France
| | - Bruno Spire
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Marseille, France
| | - France Lert
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | - Yazdan Yazdanpanah
- ANRS, Agence Nationale Recherche Sida, Paris, France,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, INSERM U944, Université de Paris, Paris, France
| | | | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| |
Collapse
|
18
|
Deruelle F. The pharmaceutical industry is dangerous to health. Further proof with COVID-19. Surg Neurol Int 2022; 13:475. [PMID: 36324959 PMCID: PMC9610448 DOI: 10.25259/sni_377_2022] [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: 04/23/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The COVID-19 period highlights a huge problem that has been developing for decades, the control of science by industry. In the 1950s, the tobacco industry set the example, which the pharmaceutical industry followed. Since then, the latter has been regularly condemned for illegal marketing, misrepresentation of experimental results, dissimulation of information about the dangers of drugs, and considered as criminal. Therefore, this study was conducted to show that knowledge is powerfully manipulated by harmful corporations, whose goals are: 1/financial; 2/to suppress our ability to make choices to acquire global control of public health. Methods: Pharmaceutical industry techniques for manipulating science and COVID-19 reporting were reviewed. Several sources of official documents were used: PubMed; National Institutes of Health resources; pharmaceutical companies; policy documents; national newspapers and news agencies; and books by prominent professionals (scientific and legal). A few studies have not been published in peer-reviewed journals; however, they have been conducted by reputable scientists in their respective fields. Results: Since the beginning of COVID-19, we can list the following methods of information manipulation which have been used: falsified clinical trials and inaccessible data; fake or conflict-of-interest studies; concealment of vaccines’ short-term side effects and total lack of knowledge of the long-term effects of COVID-19 vaccination; doubtful composition of vaccines; inadequate testing methods; governments and international organizations under conflicts of interest; bribed physicians; the denigration of renowned scientists; the banning of all alternative effective treatments; unscientific and liberticidal social methods; government use of behavior modification and social engineering techniques to impose confinements, masks, and vaccine acceptance; scientific censorship by the media. Conclusion: By supporting and selecting only the one side of science information while suppressing alternative viewpoints, and with obvious conflicts of interest revealed by this study, governments and the media constantly disinform the public. Consequently, the unscientifically validated vaccination laws, originating from industry-controlled medical science, led to the adoption of social measures for the supposed protection of the public but which became serious threats to the health and freedoms of the population.
Collapse
|
19
|
Barberá-Riera M, Porru S, Barneo-Muñoz M, Villasante Ferrer A, Carrasco P, de Llanos R, Llueca A, Delgado-Saborit JM. Genetic Load of SARS-CoV-2 in Aerosols Collected in Operating Theaters. Appl Environ Microbiol 2022; 88:e0129722. [PMID: 36102660 PMCID: PMC9552596 DOI: 10.1128/aem.01297-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022] Open
Abstract
After the outbreak of COVID-19, additional protocols have been established to prevent the transmission of the SARS-CoV-2 from the patient to the health personnel and vice versa in health care settings. However, in the case of emergency surgeries, it is not always possible to ensure that the patient is not infected with SARS-CoV-2, assuming a potential source of transmission of the virus to health personnel. This work aimed to evaluate the presence of the SARS-CoV-2 and quantify the viral load in indoor air samples collected inside operating rooms, where emergency and scheduled operations take place. Samples were collected for 3 weeks inside two operating rooms for 24 h at 38 L/min in quartz filters. RNA was extracted from the filters and analyzed using RT-qPCR targeting SARS-CoV-2 genes E, N1 and N2 regions. SARS-CoV-2 RNA was detected in 11.3% of aerosol samples collected in operating rooms, despite with low concentrations (not detected at 13.5 cg/m3 and 10.5 cg/m3 in the scheduled and emergency operating rooms, respectively). Potential sources of airborne SARS-CoV-2 could be aerosolization of the virus during aerosol-generating procedures and in open surgery from patients that might have been recently infected with the virus, despite presenting a negative COVID-19 test. Another source could be related to health care workers unknowingly infected with the virus and exhaling SARS-CoV-2 virions into the air. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers, and information campaigns. IMPORTANCE Operating rooms are critical environments in which asepsis must be ensured. The COVID-19 pandemic entailed the implementation of additional preventative measures in health care settings, including operating theaters. Although one of the measures is to operate only COVID-19 free patients, this measure cannot be always implemented, especially in emergency interventions. Therefore, a surveillance campaign was conducted during 3 weeks in two operating rooms to assess the level of SARS-CoV-2 genetic material detected in operating theaters with the aim to assess the risk of COVID-19 transmission during operating procedures. SARS-CoV-2 genetic material was detected in 11% of aerosol samples collected in operating rooms, despite with low concentrations. Plausible SARS-CoV-2 sources have been discussed, including patients and health care personnel infected with the virus. These results highlight the importance of reinforcing preventive measures against COVID-19 in operating rooms, such as the correct use of protective equipment, screening programs for health care workers and information campaigns.
Collapse
Affiliation(s)
- María Barberá-Riera
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Simona Porru
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Manuela Barneo-Muñoz
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Andrea Villasante Ferrer
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Paula Carrasco
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO–Universitat Jaume I–Universitat de València, Valencia, Spain
| | - Rosa de Llanos
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Antoni Llueca
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellon, Castellón, Spain
| | - Juana María Delgado-Saborit
- Department of Medicine, School of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO–Universitat Jaume I–Universitat de València, Valencia, Spain
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, United Kingdom
| |
Collapse
|
20
|
Yan L, Talic S, Wild H, Gasevic D, Gasević D, Ilic D, Deppeler J, Corrigan D, Martinez-Maldonado R, Trauer J. Transmission of SARS-CoV-2 in a primary school setting with and without public health measures using real-world contact data: A modelling study. J Glob Health 2022; 12:05034. [PMID: 36181503 PMCID: PMC9526455 DOI: 10.7189/jogh.12.05034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Stringent public health measures have been shown to influence the transmission of SARS-CoV-2 within school environments. We investigated the potential transmission of SARS-CoV-2 in a primary school setting with and without public health measures, using fine-grained physical positioning traces captured before the COVID-19 pandemic. Methods Approximately 172.63 million position data from 98 students and six teachers from an open-plan primary school were used to predict a potential transmission of SARS-CoV-2 in primary school settings. We first estimated the daily average number of contacts of students and teachers with an infected individual during the incubation period. We then used the Reed-Frost model to estimate the probability of transmission per contact for the SARS-CoV-2 Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron variant (B.1.1.529). Finally, we built a binomial distribution model to estimate the probability of onward transmission in schools with and without public health measures, including face masks and physical distancing. Results An infectious student would have 49.1 (95% confidence interval (CI) = 46.1-52.1) contacts with their peers and 2.00 (95% CI = 1.82-2.18) contacts with teachers per day. An infectious teacher would have 47.6 (95% CI = 45.1-50.0) contacts with students and 1.70 (95% CI = 1.48-1.92) contacts with their colleague teachers per day. While the probability of onward SARS-CoV-2 transmission was relatively low for the Alpha and Delta variants, the risk increased for the Omicron variant, especially in the absence of public health measures. Onward teacher-to-student transmission (88.9%, 95% CI = 88.6%-89.1%) and teacher-to-teacher SARS-CoV-2 transmission (98.4%, 95% CI = 98.5%-98.6%) were significantly higher for the Omicron variant without public health measures in place. Conclusions Our findings illustrate that, despite a lower frequency of close contacts, teacher-to-teacher close contacts demonstrated a higher risk of transmission per contact of SARS-CoV-2 compared to student-to-student close contacts. This was especially significant with the Omicron variant, with onward transmission more likely occurring from teacher index cases than student index cases. Public health measures (eg, face masks and physical distance) seem essential in reducing the risk of onward transmission within school environments.
Collapse
Affiliation(s)
- Lixiang Yan
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia.,Centre for Learning Analytics at Monash, Monash University, Clayton, Victoria, Australia
| | - Stella Talic
- School of Public Health and Preventive Medicine, Monash University Clayton, Victoria, Australia
| | - Holly Wild
- Public Health & Health Sciences, Torrens University Australia, Melbourne, Victoria, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University Clayton, Victoria, Australia.,Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Dragan Gasević
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia.,Centre for Learning Analytics at Monash, Monash University, Clayton, Victoria, Australia
| | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University Clayton, Victoria, Australia
| | - Joanne Deppeler
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Deborah Corrigan
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Roberto Martinez-Maldonado
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia.,Centre for Learning Analytics at Monash, Monash University, Clayton, Victoria, Australia
| | - James Trauer
- School of Public Health and Preventive Medicine, Monash University Clayton, Victoria, Australia
| |
Collapse
|
21
|
Keshishian E, Kuge E, Memmott J, Hasenbalg P, Belford N, Matlock A, Schritter S, Agbayani G, Dietrich T, Santarelli A, Ashurst J. Casirivimab/imdevimab treatment for outpatient COVID-19 during a SARS-CoV-2 B1.617.2 (Delta) surge at a community hospital. J Osteopath Med 2022; 122:635-640. [PMID: 36123325 DOI: 10.1515/jom-2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Vaccination status has been shown to be linked to patient-centered outcomes in those with COVID-19. However, minimal data have explored the relationship between vaccination status and representation rates after receiving monoclonal antibodies (MABs) the Delta strain of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in a community setting. OBJECTIVES The authors sought to determine if there was a difference in patient-centered outcomes between those who were vaccinated and unvaccinated after the administration of casirivimab/imdevimab for mild-to-moderate COVID-19 during the time when the Delta strain was most prevalent. METHODS A convenience sample of consecutive adults given casirivimab/imdevimab at either an outpatient infusion center or within the emergency department (ED) were included in analysis. Patient demographics, authorized-use qualifiers from the emergency use authorization (EUA), baseline vital signs at the time of infusion, representation rates to a healthcare provider within the hospital's network, and any admissions to the hospital following infusion were all collected from the patient's electronic medical record. Vaccination status was confirmed in both the patient's electronic medical record and the Arizona State Immunization Information System (ASIIS). Analysis was conducted utilizing descriptive statistics, the Mann-Whitney U test for continuous data, and the chi-squared analysis for nominal data. RESULTS In total, 743 patients were included in the study, with 585 being unvaccinated and 158 being vaccinated at the time of administration. Those in the vaccinated group were more likely to be older (60.0 vs. 55.0 years; p<0.001) and to have a history of diabetes (18.4% vs. 11.3%; p=0.02), hypertension (39.9% vs. 28.5%; p=0.006), immunosuppression (7.0% vs. 1.4%; p<0.001), and chronic kidney disease (7.0% vs. 3.4%; p=0.05). In the entire sample, 105 (14.1%) patients had an unexpected return visit to either the ED or urgent care at 28 days, with 17 (2.3%) requiring hospitalization. Patients who were vaccinated were more likely to represent for care after casirivimab/imdevimab infusion (20.3% vs. 12.5%; p=0.01), but no difference was noted in hospitalization rates between the two groups (18.8% vs. 15.1%; p=0.15). CONCLUSIONS MAB therapy with casirivimab/imdevimab for the outpatient treatment of mild-to-moderate COVID-19 was associated with a low rate of hospitalization. However, those who were vaccinated were more likely to present for unexpected return care at either the ED or urgent care within 28 days of the initial infusion.
Collapse
Affiliation(s)
- Erika Keshishian
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, WA, USA
| | - Elizabeth Kuge
- Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA
| | - Jordan Memmott
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, WA, USA
| | - Phillip Hasenbalg
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, WA, USA
| | - Nakiya Belford
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, WA, USA
| | - Alexander Matlock
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, WA, USA
| | - Sarah Schritter
- Department of Nursing, Kingman Regional Medical Center, Kingman, AZ, USA
| | - Geovar Agbayani
- Department of Graduate Medical Education, Kingman Regional Medical Center, Kingman, AZ, USA
| | - Tyson Dietrich
- Department of Pharmacology, Kingman Regional Medical Center, Kingman, AZ, USA
| | - Anthony Santarelli
- Department of Graduate Medical Education, Kingman Regional Medical Center, Kingman, AZ, USA
| | - John Ashurst
- Department of Graduate Medical Education, Kingman Regional Medical Center, Kingman, AZ, USA
| |
Collapse
|
22
|
A machine learning COVID-19 mass screening based on symptoms and a simple olfactory test. Sci Rep 2022; 12:15622. [PMID: 36114256 PMCID: PMC9481525 DOI: 10.1038/s41598-022-19817-x] [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: 11/22/2021] [Accepted: 09/05/2022] [Indexed: 11/09/2022] Open
Abstract
The early detection of symptoms and rapid testing are the basis of an efficient screening strategy to control COVID-19 transmission. The olfactory dysfunction is one of the most prevalent symptom and in many cases is the first symptom. This study aims to develop a machine learning COVID-19 predictive tool based on symptoms and a simple olfactory test, which consists of identifying the smell of an aromatized hydroalcoholic gel. A multi-centre population-based prospective study was carried out in the city of Reus (Catalonia, Spain). The study included consecutive patients undergoing a reverse transcriptase polymerase chain reaction test for presenting symptoms suggestive of COVID-19 or for being close contacts of a confirmed COVID-19 case. A total of 519 patients were included, 386 (74.4%) had at least one symptom and 133 (25.6%) were asymptomatic. A classification tree model including sex, age, relevant symptoms and the olfactory test results obtained a sensitivity of 0.97 (95% CI 0.91–0.99), a specificity of 0.39 (95% CI 0.34–0.44) and an AUC of 0.87 (95% CI 0.83–0.92). This shows that this machine learning predictive model is a promising mass screening for COVID-19.
Collapse
|
23
|
Vass WB, Lednicky JA, Shankar SN, Fan ZH, Eiguren-Fernandez A, Wu CY. Viable SARS-CoV-2 Delta variant detected in aerosols in a residential setting with a self-isolating college student with COVID-19. JOURNAL OF AEROSOL SCIENCE 2022; 165:106038. [PMID: 35774447 PMCID: PMC9217630 DOI: 10.1016/j.jaerosci.2022.106038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 05/08/2023]
Abstract
The B.1.617.2 (Delta) variant of SARS-CoV-2 emerged in India in October of 2020 and spread widely to over 145 countries, comprising over 99% of genome sequence-confirmed virus in COVID-19 cases of the United States (US) by September 2021. The rise in COVID-19 cases due to the Delta variant coincided with a return to in-person school attendance, straining COVID-19 mitigation plans implemented by educational institutions. Some plans required sick students to self-isolate off-campus, resulting in an unintended consequence: exposure of co-inhabitants of dwellings used by the sick person during isolation. We assessed air and surface samples collected from the bedroom of a self-isolating university student with mild COVID-19 for the presence of SARS-CoV-2. That virus' RNA was detected by real-time reverse-transcription quantitative polymerase chain reaction (rRT-qPCR) in air samples from both an isolation bedroom and a distal, non-isolation room of the same dwelling. SARS-CoV-2 was detected and viable virus was isolated in cell cultures from aerosol samples as well as from the surface of a mobile phone. Genomic sequencing revealed that the virus was a Delta variant SARS-CoV-2 strain. Taken together, the results of this work confirm the presence of viable SARS-CoV-2 within a residential living space of a person with COVID-19 and show potential for transportation of virus-laden aerosols beyond a designated isolation suite to other areas of a single-family home.
Collapse
Affiliation(s)
- William B Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, 32611, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| |
Collapse
|
24
|
Neutralizing-antibody response to SARS-CoV-2 for 12 months after the COVID-19 workplace outbreaks in Japan. PLoS One 2022; 17:e0273712. [PMID: 36040882 PMCID: PMC9426944 DOI: 10.1371/journal.pone.0273712] [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: 12/21/2021] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to elucidate the 12-month durability of neutralizing antibodies (NAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients infected during the 2020 workplace outbreaks of coronavirus disease 2019 (COVID-19) in Japan. We followed 33 Japanese patients infected with SARS-CoV-2 in April 2020 for 12 months (12M). Patients were tested for NAbs and for antibodies against the SARS-CoV-2 nucleocapsid (anti-NC-Ab) and antibodies against the spike receptor-binding domain (anti-RBD-Ab). Tests were performed at 2M, 6M, and 12M after the primary infection (api) with commercially available test kits. In 90.9% (30/33) of patients, NAbs persisted for 12M api, though the median titers significantly declined from 78.7% (interquartile range [IQR]: 73.0–85.0%) at 2M, to 59.8% (IQR: 51.2–77.9) at 6M (P = 0.008), and to 56.2% (IQR: 39.6–74.4) at 12M (P<0.001). An exponential decay model showed that the NAb level reached undetectable concentrations at 35.5 months api (95% confidence interval: 26.5–48.0 months). Additionally, NAb titers were significantly related to anti-RBD-Ab titers (rho = 0.736, P<0.001), but not to anti-NC-Ab titers. In most patients convalescing from COVID-19, NAbs persisted for 12M api. This result suggested that patients need a booster vaccination within one year api, even though NAbs could be detected for over two years api. Anti-RBD-Ab titers could be used as a surrogate marker for predicting residual NAb levels.
Collapse
|
25
|
Huai Luo C, Paul Morris C, Sachithanandham J, Amadi A, Gaston DC, Li M, Swanson NJ, Schwartz M, Klein EY, Pekosz A, Mostafa HH. Infection With the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Delta Variant Is Associated With Higher Recovery of Infectious Virus Compared to the Alpha Variant in Both Unvaccinated and Vaccinated Individuals. Clin Infect Dis 2022; 75:e715-e725. [PMID: 34922338 PMCID: PMC8903351 DOI: 10.1093/cid/ciab986] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant of concern (VOC) B.1.617.2 (Delta) displaced B.1.1.7 (Alpha) and is associated with increases in coronavirus disease 2019 (COVID-19) cases, greater transmissibility, and higher viral RNA loads, but data are lacking regarding the infectious virus load and antiviral antibody levels in the nasal tract. METHODS Whole genome sequencing, cycle threshold (Ct) values, infectious virus, anti-SARS-CoV-2 immunoglobulin G (IgG) levels, and clinical chart reviews were combined to characterize SARS-CoV-2 lineages circulating in the National Capital Region between January and September 2021 and differentiate infections in vaccinated and unvaccinated individuals by the Delta, Alpha, and B.1.2 (the predominant lineage prior to Alpha) variants. RESULTS The Delta variant displaced the Alpha variant to constitute 99% of the circulating lineages in the National Capital Region by August 2021. In Delta infections, 28.5% were breakthrough cases in fully vaccinated individuals compared to 4% in the Alpha infected cohort. Breakthrough infections in both cohorts were associated with comorbidities, but only Delta infections were associated with a significant increase in the median days after vaccination. More than 74% of Delta samples had infectious virus compared to <30% from the Alpha cohort. The recovery of infectious virus with both variants was associated with low levels of local SARS-CoV-2 IgG. CONCLUSIONS Infection with the Delta variant was associated with more frequent recovery of infectious virus in vaccinated and unvaccinated individuals compared to the Alpha variant but was not associated with an increase in disease severity in fully vaccinated individuals. Infectious virus was correlated with the presence of low amounts of antiviral IgG in the nasal specimens.
Collapse
Affiliation(s)
- Chun Huai Luo
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - C Paul Morris
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Washington D.C., USA
| | - Jaiprasath Sachithanandham
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adannaya Amadi
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - David C Gaston
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Maggie Li
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas J Swanson
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Matthew Schwartz
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Eili Y Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USAand
- Center for Disease Dynamics, Economics, and Policy, Washington D.C., USA
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USAand
| | - Heba H Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Division of Medical Microbiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
26
|
Torres I, Bellido‐Blasco JB, Gimeno C, Burgos JS, Albert E, Moya‐Malo R, Gascó‐Laborda JC, Tornero A, Soriano J, Meseguer‐Ferrer N, Martínez‐Serrano M, Ortíz‐Rambla J, Buj H, Hernández N, Peiró S, Salas D, Limón R, Vanaclocha H, Sánchez‐Payá J, Díez‐Domingo J, Comas I, González‐Candelas F, Navarro D. SARS-CoV-2 Delta-variant breakthrough infections in nursing home residents at midterm after Comirnaty® COVID-19 vaccination. J Med Virol 2022; 94:3776-3782. [PMID: 35445415 PMCID: PMC9088586 DOI: 10.1002/jmv.27799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant breakthrough infections in nursing home residents following vaccination with Comirnaty® COVID-19 vaccine were characterized. In total, 201 participants (median age, 87 years; range, 64-100; 133 female) from two nursing homes in the Valencian community (Spain) were included. SARS-CoV-2-Spike (S) antibody responses were determined by a lateral flow immunocromatography (LFIC) assay and by quantitative electrochemiluminescent assay in LFIC-negative participants. SARS-CoV-2-S-IFNγ T cells were enumerated by flow cytometry in 10 participants. Nasopharyngeal SARS-CoV-2 RNA loads were quantified by real-time polymerase chain reaction assays. Vaccine breakthrough COVID-19 due to the Delta variant occurred in 39 residents (median age, 87 years; range, 69-96; 31 female) at a median of 6.5 months after vaccination (nine requiring hospitalization). Breakthrough infections occurred at a higher rate (p < 0.0001) in residents who had not been previously infected with SARS-CoV-2 (naïve) (33/108; 18%) than in those with prior diagnosis of SARS-CoV-2 infection (experienced) (6/93; 6.4%), and were more likely (p < 0.0001) to develop in residents who tested negative by LFIC (20/49) at 3 months after vaccination as compared to their LFIC-positive counterparts (19/142). Among LFIC-negative residents, a trend towards lower plasma anti-RBD antibody levels was noticed in those developing breakthrough infection (p = 0.16). SARS-CoV-2 RNA loads in nasopharyngeal specimens were lower in SARS-CoV-2-experienced residents (p < 0.001) and in those testing positive by LFIC (p = 0.13). The frequency of SARS-CoV-2-S-reactive T cells at 3 months was similar in LFIC-negative residents with (n = 7) or without (n = 3) breakthrough infection. Prior history of SARS-CoV-2 infection and detection of S-reactive antibodies by LFIC at 3 months is associated with a lower risk of Delta-variant breakthrough infection in nursing home residents at midterm after Comirnaty® COVID-19 vaccination.
Collapse
Affiliation(s)
- Ignacio Torres
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research InstituteValenciaSpain
| | - Juan B. Bellido‐Blasco
- Sección de Epidemiología, Centro de Salud Pública de CastellónValenciaSpain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)ValenciaSpain
- Universitat Jaume I (UJI)CastellóSpain
| | - Concepción Gimeno
- Microbiology Service, Consorcio Hospital General Universitario de ValenciaValenciaSpain
- Department of Microbiology, School of MedicineUniversity of ValenciaValenciaSpain
| | - Javier S. Burgos
- General Directorate of Research and Healthcare Supervision, Department of HealthValencia GovernmentValenciaSpain
| | - Eliseo Albert
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research InstituteValenciaSpain
| | | | | | - Ana Tornero
- Primary Health DirectoryConsorcio Hospital General Universitario de ValenciaValenciaSpain
| | - Josefa Soriano
- Primary Health DirectoryConsorcio Hospital General Universitario de ValenciaValenciaSpain
| | | | | | - Javier Ortíz‐Rambla
- Unidad de Hospitalización Domiciliaria del Departamento de Salud de la PlanaCastellónSpain
| | - Helena Buj
- Laboratory Service, Hospital de la PlanaVila‐RealCastellónSpain
| | | | - Salvador Peiró
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO)ValenciaSpain
| | - Dolores Salas
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO)ValenciaSpain
- Department of HealthGeneral Directorate of Public Health, Valencia GovernmentValenciaSpain
| | - Ramón Limón
- Department of HealthGeneral Directorate of Healthcare, Valencian GovernmentValenciaSpain
| | - Hermelinda Vanaclocha
- Department of HealthGeneral Directorate of Public Health, Valencia GovernmentValenciaSpain
| | - José Sánchez‐Payá
- Preventive Medicine ServiceAlicante General and University HospitalAlicanteSpain
- Alicante Institute of Health and Biomedical Research (ISABIAL)AlicanteSpain
| | - Javier Díez‐Domingo
- Foundation for the promotion of Health and Biomedical Research of the Valencian Community (FISABIO)ValenciaSpain
| | - Iñaki Comas
- Biomedicine Institute of Valencia, Spanish Research Council (CSIC)ValenciaSpain
- CIBER in Epidemiology and Public HealthSpain
| | - Fernando González‐Candelas
- CIBER in Epidemiology and Public HealthSpain
- Joint Research Unit “Infection and Public Health” FISABIO‐University of ValenciaValenciaSpain
- Institute for Integrative Systems Biology (I2SysBio)CSIC‐University of ValenciaValenciaSpain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research InstituteValenciaSpain
- Department of Microbiology, School of MedicineUniversity of ValenciaValenciaSpain
| | | |
Collapse
|
27
|
Nguyen DC, Lamothe PA, Woodruff MC, Saini AS, Faliti CE, Sanz I, Lee FE. COVID-19 and plasma cells: Is there long-lived protection? Immunol Rev 2022; 309:40-63. [PMID: 35801537 PMCID: PMC9350162 DOI: 10.1111/imr.13115] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Infection with SARS-CoV-2, the etiology of the ongoing COVID-19 pandemic, has resulted in over 450 million cases with more than 6 million deaths worldwide, causing global disruptions since early 2020. Memory B cells and durable antibody protection from long-lived plasma cells (LLPC) are the mainstay of most effective vaccines. However, ending the pandemic has been hampered by the lack of long-lived immunity after infection or vaccination. Although immunizations offer protection from severe disease and hospitalization, breakthrough infections still occur, most likely due to new mutant viruses and the overall decline of neutralizing antibodies after 6 months. Here, we review the current knowledge of B cells, from extrafollicular to memory populations, with a focus on distinct plasma cell subsets, such as early-minted blood antibody-secreting cells and the bone marrow LLPC, and how these humoral compartments contribute to protection after SARS-CoV-2 infection and immunization.
Collapse
Affiliation(s)
- Doan C. Nguyen
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Pedro A. Lamothe
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Matthew C. Woodruff
- Division of Rheumatology, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
- Emory Autoimmunity Center of ExcellenceEmory UniversityAtlantaGeorgiaUSA
- Lowance Center for Human ImmunologyEmory UniversityAtlantaGeorgiaUSA
| | - Ankur S. Saini
- Division of Rheumatology, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
- Emory Autoimmunity Center of ExcellenceEmory UniversityAtlantaGeorgiaUSA
- Lowance Center for Human ImmunologyEmory UniversityAtlantaGeorgiaUSA
| | - Caterina E. Faliti
- Division of Rheumatology, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
- Lowance Center for Human ImmunologyEmory UniversityAtlantaGeorgiaUSA
| | - Ignacio Sanz
- Division of Rheumatology, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
- Emory Autoimmunity Center of ExcellenceEmory UniversityAtlantaGeorgiaUSA
- Lowance Center for Human ImmunologyEmory UniversityAtlantaGeorgiaUSA
| | - Frances Eun‐Hyung Lee
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of MedicineEmory UniversityAtlantaGeorgiaUSA
- Lowance Center for Human ImmunologyEmory UniversityAtlantaGeorgiaUSA
| |
Collapse
|
28
|
Hussein NR, Rasheed BN, Naqid IA, Dirbaz AM, Saleem ZSM, Ibrahim N, Musa DH, Mohammed SM. A study of SARS-CoV-2 delta variant breakthrough infections and side effects of the Oxford-AstraZeneca vaccine. PUBLIC HEALTH IN PRACTICE 2022; 4:100303. [PMID: 35936975 PMCID: PMC9339090 DOI: 10.1016/j.puhip.2022.100303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 01/03/2023] Open
Abstract
Objective This study aimed to investigate the breakthrough infection rate and safety profile of the AstraZeneca vaccine. Methods The breakthrough COVID-19 infection rate was defined as a positive polymerase chain reaction test 14 days after the vaccine dose. Safety was assessed as local reactions and systemic events that occurred within 14 days of receiving vaccine doses. Results The average age of the 265 participants was 43.85 years and 169 (63.77%) were male. . After the second dose, 18 (6.71%) participants contracted the infection. The SARS-CoV-2 delta variant was responsible for all infections but no participants required hospitalisation. We found significant correlations between post-vaccination IgG levels and post-vaccination infection (P = 0.001; odds ratio [OR] = 0.959; 95% Confidence interval [CI]: 0.944-0.974), and between a history of previous infection and post-vaccination infection rates (P = 0.005; OR = 0.1; 95%CI:0.009-0.6). IgG levels were significantly higher in women than in men (P = 0.006) and in patients who developed side effects after vaccination than in those without side effects (P = 0.04). A significant association was found between a history of COVID-19 infection prior to vaccination and IgG levels (P = 0.001). Conclusions The vaccine is effective in preventing severe disease, with few side effects.
Collapse
Affiliation(s)
- Nawfal R. Hussein
- Department of Biomedical Sciences, College of Medicine, University of Zakho, Kurdistan Region, Iraq
| | - Bizav Naji Rasheed
- Department of Medical Laboratory Technology, College of Health and Medical Techniques, Shikhan, Duhok Polytechnique University, Duhok, Kurdistan Region, Iraq
| | - Ibrahim A. Naqid
- Department of Biomedical Sciences, College of Medicine, University of Zakho, Kurdistan Region, Iraq,Corresponding author. Microbiology and immunology (UK) Head of Biomedical Science Department College of Medicine, University of Zakho, Kurdistan Region, Iraq.
| | | | - Zana Sidiq M. Saleem
- Department of Internal Medicine and Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Nashwan Ibrahim
- Department of Internal Medicine and Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | - Dildar H. Musa
- Department of Internal Medicine and Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
| | | |
Collapse
|
29
|
Corrêa IA, Faffe DS, Galliez RM, Gonçalves CCA, Maia RA, da Silva GP, Moreira FRR, Mariani D, Campos MF, Leitão IDC, de Souza MR, Cunha MS, Nascimento ÉRDS, Ribeiro LDJ, da Cruz TFC, Policarpo C, Gonzales L, Rodgers MA, Berg M, Vijesurier R, Cloherty GA, Hackett J, Ferreira ODC, Castiñeiras TMPP, Tanuri A, da Costa LJ. A SARS-CoV-2 Negative Antigen Rapid Diagnostic in RT-qPCR Positive Samples Correlates With a Low Likelihood of Infectious Viruses in the Nasopharynx. Front Microbiol 2022; 13:912138. [PMID: 35966714 PMCID: PMC9364907 DOI: 10.3389/fmicb.2022.912138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) transmission occurs even among fully vaccinated individuals; thus, prompt identification of infected patients is central to control viral circulation. Antigen rapid diagnostic tests (Ag-RDTs) are highly specific, but sensitivity is variable. Discordant RT-qPCR vs. Ag-RDT results are reported, raising the question of whether negative Ag-RDT in positive RT-qPCR samples could imply the absence of infectious viruses. To study the relationship between negative Ag-RDT results with virological, molecular, and serological parameters, we selected a cross-sectional and a follow-up dataset and analyzed virus culture, subgenomic RNA quantification, and sequencing to determine infectious viruses and mutations. We demonstrated that RT-qPCR positive while SARS-CoV-2 Ag-RDT negative discordant results correlate with the absence of infectious virus in nasopharyngeal samples. A decrease in sgRNA detection together with an expected increase in detectable anti-S and anti-N IgGs was also verified in these samples. The data clearly demonstrate that a negative Ag-RDT sample is less likely to harbor infectious SARS-CoV-2 and, consequently, has a lower transmissible potential.
Collapse
Affiliation(s)
- Isadora Alonso Corrêa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Débora Souza Faffe
- Departamento de Doenças Infecciosas e Parasitárias, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Mello Galliez
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Richard Araújo Maia
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo Peixoto da Silva
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Filipe Romero Rebello Moreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diana Mariani
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Freire Campos
- Departamento de Doenças Infecciosas e Parasitárias, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela de Carvalho Leitão
- Departamento de Doenças Infecciosas e Parasitárias, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos Romário de Souza
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcela Sabino Cunha
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Liane de Jesus Ribeiro
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thais Felix Cordeiro da Cruz
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia Policarpo
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis Gonzales
- Abbott Laboratories Inc., Chicago, IL, United States
| | | | - Michael Berg
- Abbott Laboratories Inc., Chicago, IL, United States
| | | | | | - John Hackett
- Abbott Laboratories Inc., Chicago, IL, United States
| | - Orlando da Costa Ferreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Jesus da Costa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
30
|
Torres R, Toro L, Sanhueza ME, Lorca E, Ortiz M, Pefaur J, Clavero R, Machuca E, Gonzalez F, Herrera P, Mocarquer A, Frias A, Roessler E, Muñoz C, Nuñez M, Aravena C, Quintana E, Lemus J, Lillo M, Reynolds E, Morales A, Pais E, Fiabane A, Parra-Lucares A, Garrido C, Mendez G, Villa E, Mansilla R, Sotomayor G, Gonzalez M, Miranda C, Briones E, Gomez E, Mezzano S, Bernales W, Rocca X, Espinoza O, Zuñiga E, Aragon H, Badilla M, Valenzuela M, Escobar L, Zamora D, Flores I, Tapia B, Borquez T, Herrera P. Clinical efficacy of SARS-CoV-2 vaccination in hemodialysis patients. Kidney Int Rep 2022; 7:2176-2185. [PMID: 35874643 PMCID: PMC9287586 DOI: 10.1016/j.ekir.2022.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population. Methods A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined. Results A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8–23.8%), and prevention of death was 66.0% (95% CI:60.6–70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac. Conclusion The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.
Collapse
Affiliation(s)
- Rubén Torres
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Luis Toro
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.,Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - María E Sanhueza
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Eduardo Lorca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Mireya Ortiz
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Department of Nephrology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jacqueline Pefaur
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Rene Clavero
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Dr. Gustavo Fricke, Valparaiso, Chile
| | - Eduardo Machuca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Fresenius Medical Care Chile, Chile
| | | | - Patricia Herrera
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Alfredo Mocarquer
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Gran Avenida, Santiago, Chile
| | - Alondra Frias
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Regional de Talca, Talca, Chile
| | - Eric Roessler
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Department of Nephrology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Muñoz
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Puerto Montt, Puerto Montt, Chile
| | - Miguel Nuñez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Puerto Montt, Puerto Montt, Chile
| | - Cesar Aravena
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Municipal La Granja, Santiago, Chile
| | - Enrique Quintana
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Padre Hurtado, Santiago, Chile
| | - Juan Lemus
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Dialisis Antares, Santiago, Chile
| | - Mario Lillo
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Centro Médico y de Diálisis Ltda, Santiago, Chile
| | - Enrique Reynolds
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Alvaro Morales
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Edgard Pais
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Complejo Asistencial Sótero del Río, Santiago, Chile
| | - Andrea Fiabane
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Alfredo Parra-Lucares
- Centro de Investigación Clínica Avanzada, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Cristian Garrido
- Department of Radiology, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Gabriel Mendez
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Eduardo Villa
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Rodrigo Mansilla
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Critical Care Medicine, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Germana Sotomayor
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Marcela Gonzalez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clínico de Magallanes, Punta Arenas, Chile
| | - Cecilia Miranda
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Militar de Santiago, Santiago, Chile
| | - Eduardo Briones
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,CID Servicio Integral de Salud S.A, Santiago, Chile
| | - Esteban Gomez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Indisa, Santiago, Chile
| | - Sergio Mezzano
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clinico San Borja Arriaran, Santiago, Chile
| | - Waldo Bernales
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Faculty of Medicine, Universidad Austral de Chile, Valdivia, Santiago
| | - Ximena Rocca
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Oscar Espinoza
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Eric Zuñiga
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Regional de Coyhaique, Coyhaique, Chile
| | - Henry Aragon
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Bupa Antofagasta, Antofagasta, Chile
| | - Marta Badilla
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital San José, Santiago, Chile
| | - Marcela Valenzuela
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Complejo Asistencial Sótero del Río, Santiago, Chile
| | - Luis Escobar
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Clinica Bupa Antofagasta, Antofagasta, Chile
| | - Daniela Zamora
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Ivan Flores
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital de Puerto Natales, Puerto Natales, Chile
| | - Beatriz Tapia
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Dr. Gustavo Fricke, Valparaiso, Chile
| | - Tamara Borquez
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital San Juan de Dios de Curicó, Curicó, Chile
| | - Patricio Herrera
- Fuerza de Trabajo anti-COVID-19 (FUTAC Team), Sociedad Chilena de Nefrología, Chile.,Division of Nephrology, Hospital Clínico del Sur, Concepción, Chile
| |
Collapse
|
31
|
Jelley L, Douglas J, Ren X, Winter D, McNeill A, Huang S, French N, Welch D, Hadfield J, de Ligt J, Geoghegan JL. Genomic epidemiology of Delta SARS-CoV-2 during transition from elimination to suppression in Aotearoa New Zealand. Nat Commun 2022; 13:4035. [PMID: 35821124 PMCID: PMC9274967 DOI: 10.1038/s41467-022-31784-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
New Zealand's COVID-19 elimination strategy heavily relied on the use of genomics to inform contact tracing, linking cases to the border and to clusters during community outbreaks. In August 2021, New Zealand entered its second nationwide lockdown after the detection of a single community case with no immediately apparent epidemiological link to the border. This incursion resulted in the largest outbreak seen in New Zealand caused by the Delta Variant of Concern. Here we generated 3806 high quality SARS-CoV-2 genomes from cases reported in New Zealand between 17 August and 1 December 2021, representing 43% of reported cases. We detected wide geographical spread coupled with undetected community transmission, characterised by the apparent extinction and reappearance of genomically linked clusters. We also identified the emergence, and near replacement, of genomes possessing a 10-nucleotide frameshift deletion that caused the likely truncation of accessory protein ORF7a. By early October, New Zealand moved from an elimination strategy to a suppression strategy and the role of genomics changed markedly from being used to track and trace, towards population-level surveillance.
Collapse
Affiliation(s)
- Lauren Jelley
- Institute of Environmental Science and Research, Wellington, New Zealand
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Jordan Douglas
- Centre for Computational Evolution, School of Computer Science, University of Auckland, Auckland, New Zealand
| | - Xiaoyun Ren
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - David Winter
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Andrea McNeill
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Sue Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Nigel French
- Tāwharau Ora/School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - David Welch
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - James Hadfield
- Fred Hutchinson Cancer Research Centre, Seattle, Washington, USA
| | - Joep de Ligt
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Jemma L Geoghegan
- Institute of Environmental Science and Research, Wellington, New Zealand.
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand.
| |
Collapse
|
32
|
Hajjaji N, Lepoutre K, Lakhdar S, Bécourt S, Bellier C, Kaczmarek E, Broyelle A, Giscard S, Lartigau E. 16 Months Follow Up of Patients’ Behavior and Mild COVID-19 Patterns in a Large Cohort of Cancer Patients During the Pandemic. Front Oncol 2022; 12:901426. [PMID: 35747798 PMCID: PMC9209649 DOI: 10.3389/fonc.2022.901426] [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: 03/21/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Acute severe forms of COVID-19 infection are more likely in cancer patients and growing attention has been given to the persistent symptoms of the disease after severe COVID-19. However, mild illness is the dominant clinical presentation of COVID-19 infection. To investigate patients’ behavior and the short- and longer-term pattern of the disease in cancer patients with mild COVID infection, a longitudinal online survey was conducted for 16 months during the pandemic in a large cohort of cancer patients from a French COVID-19 hot spot. An online questionnaire was administered at three time points between the first wave of the pandemic in France and the fourth wave. The questionnaire was completed by 1415 to 2224 patients, which queried patients’ demographics, their behavior, and COVID infection patterns. Seventy percent of the patients were female, and 40% had a comorbid condition. More than one-third of the participants had breast cancer, and half were survivors. The rate of infection was 30% during wave 1 and 10% in wave 4; most patients had a mild COVID-19 infection. Twenty-five percent of infected patients during wave 4 did not seek medical advice. At wave 4, 87% of the patients received at least one dose of vaccine. Systematic compliance to shielding measures decreased over time. The short-term pattern of mild COVID changed between wave 1 and wave 4. Twenty-two percent of infected patients experienced persistent signs for more than 6 months with a negative impact on sleep, social behavior, and increased consumption of stress-relieving drugs. Our results showed a high prevalence of long-lasting symptoms in cancer patients with mild COVID-19 infection and inadequate behavior toward the disease and prevention measures among patients.
Collapse
Affiliation(s)
- Nawale Hajjaji
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
- Inserm, U1192, Laboratoire Protéomique, Réponse Inflammatoire et Spectrométrie de Masse (PRISM), Univ. Lille, Lille, France
- *Correspondence: Nawale Hajjaji,
| | | | - Sarra Lakhdar
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
| | - Stéphanie Bécourt
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
| | - Charlotte Bellier
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
| | - Emilie Kaczmarek
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
| | - Antonin Broyelle
- Medical Oncology department, Oscar Lambret Cancer Center, Lille, France
| | | | - Eric Lartigau
- Radiotherapy department, Oscar Lambret Cancer Center, Lille, France
| |
Collapse
|
33
|
Aggarwal A, Stella AO, Walker G, Akerman A, Esneau C, Milogiannakis V, Burnett DL, McAllery S, Silva MR, Lu Y, Foster CSP, Brilot F, Pillay A, Van Hal S, Mathivanan V, Fichter C, Kindinger A, Hoppe AC, Munier ML, Amatayakul-Chantler S, Roth N, Coppola G, Symonds GP, Schofield P, Jackson J, Lenthall H, Henry JY, Mazigi O, Jäck HM, Davenport MP, Darley DR, Matthews GV, Khoury DS, Cromer D, Goodnow CC, Christ D, Robosa R, Starck DJ, Bartlett NW, Rawlinson WD, Kelleher AD, Turville SG. Platform for isolation and characterization of SARS-CoV-2 variants enables rapid characterization of Omicron in Australia. Nat Microbiol 2022; 7:896-908. [PMID: 35637329 PMCID: PMC9159941 DOI: 10.1038/s41564-022-01135-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/26/2022] [Indexed: 01/31/2023]
Abstract
Genetically distinct variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged since the start of the COVID-19 pandemic. Over this period, we developed a rapid platform (R-20) for viral isolation and characterization using primary remnant diagnostic swabs. This, combined with quarantine testing and genomics surveillance, enabled the rapid isolation and characterization of all major SARS-CoV-2 variants circulating in Australia in 2021. Our platform facilitated viral variant isolation, rapid resolution of variant fitness using nasopharyngeal swabs and ranking of evasion of neutralizing antibodies. In late 2021, variant of concern Omicron (B1.1.529) emerged. Using our platform, we detected and characterized SARS-CoV-2 VOC Omicron. We show that Omicron effectively evades neutralization antibodies and has a different entry route that is TMPRSS2-independent. Our low-cost platform is available to all and can detect all variants of SARS-CoV-2 studied so far, with the main limitation being that our platform still requires appropriate biocontainment.
Collapse
Affiliation(s)
- Anupriya Aggarwal
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Alberto Ospina Stella
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Gregory Walker
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Anouschka Akerman
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Camille Esneau
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Vanessa Milogiannakis
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Deborah L Burnett
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Samantha McAllery
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mariana Ruiz Silva
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Yonghui Lu
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Charles S P Foster
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Fabienne Brilot
- Brain Autoimmunity Group, Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, School of Medical Sciences, Sydney University of Sydney, Sydney Institute for Infectious Diseases, Sydney, New South Wales, Australia
| | - Aleha Pillay
- Brain Autoimmunity Group, Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, School of Medical Sciences, Sydney University of Sydney, Sydney Institute for Infectious Diseases, Sydney, New South Wales, Australia
| | | | - Vennila Mathivanan
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Christina Fichter
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrea Kindinger
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Carey Hoppe
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Mee Ling Munier
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Supavadee Amatayakul-Chantler
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring, Broadmeadows, Melbourne, Victoria, Australia
| | - Nathan Roth
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring AG, Bern, Switzerland
| | - Germano Coppola
- Department of Bioanalytical Sciences, Plasma Product Development, Research and Development, CSL Behring, Broadmeadows, Melbourne, Victoria, Australia
| | | | - Peter Schofield
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jennifer Jackson
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Helen Lenthall
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jake Y Henry
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Ohan Mazigi
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | | | - Miles P Davenport
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - David R Darley
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - David S Khoury
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Deborah Cromer
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Daniel Christ
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Roselle Robosa
- Molecular Diagnostic Medicine Laboratory, Sydpath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Damien J Starck
- Molecular Diagnostic Medicine Laboratory, Sydpath, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Nathan W Bartlett
- Serology and Virology Division (SAViD), NSW Health Pathology, Sydney, New South Wales, Australia
| | - William D Rawlinson
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Anthony D Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Stuart G Turville
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
| |
Collapse
|
34
|
Correlation Analysis of Anti-SARS-CoV-2 RBD IgG and Neutralizing Antibody against SARS-CoV-2 Omicron Variants after Vaccination. Diagnostics (Basel) 2022; 12:diagnostics12061315. [PMID: 35741126 PMCID: PMC9221553 DOI: 10.3390/diagnostics12061315] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 01/14/2023] Open
Abstract
Various vaccines have been developed to control the COVID-19 pandemic, but the available vaccines were developed using ancestral SARS-CoV-2 wild-type (WT) strains. Commercial anti-SARS-CoV-2 receptor binding domain (RBD) antibody assays have been established and employed for validation of vaccine efficacy. However, these assays were developed before the SARS-CoV-2 variants of concern (VOCs) emerged. It is unclear whether anti-RBD IgG levels can predict immunity against VOCs. In this study, we determined the correlations between the levels of anti-RBD IgG and neutralizing antibodies (NAbs) against SARS-CoV-2 variants in vaccinated subjects. After vaccination, 100% of subjects showed an anti-RBD IgG response, whereas 82, 79, 30, 75, and 2% showed NAb responses against WT, Alpha, Beta, Delta, and Omicron variants, respectively. A high correlation was observed between anti-RBD IgG and NAbs against WT, Alpha, Beta, and Delta, but not so for the Omicron NAbs. Among subjects with high levels of anti-RBD IgG, 93, 93, 71, 93, and 0% of them had NAbs against WT, Alpha, Beta, Delta, and Omicron variants, respectively. These results indicate that anti-RBD IgG levels cannot be used as a predictor for the presence of NAbs against the globally dominant SARS-CoV-2 Omicron variant.
Collapse
|
35
|
Liwsrisakun C, Pata S, Laopajon W, Takheaw N, Chaiwong W, Inchai J, Pothirat C, Bumroongkit C, Deesomchok A, Theerakittikul T, Limsukon A, Tajarernmuang P, Niyatiwatchanchai N, Trongtrakul K, Chuensirikulchai K, Kasinrerk W. Neutralizing antibody and T cell responses against SARS-CoV-2 variants of concern following ChAdOx-1 or BNT162b2 boosting in the elderly previously immunized with CoronaVac vaccine. Immun Ageing 2022; 19:24. [PMID: 35610643 PMCID: PMC9126751 DOI: 10.1186/s12979-022-00279-8] [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: 02/06/2022] [Accepted: 05/07/2022] [Indexed: 12/16/2022]
Abstract
Background The existence of SARS-CoV-2 variants of concern (VOCs) in association with evidence of breakthrough infections despite vaccination resulted in the need for vaccine boosting. In elderly individuals, information on the immunogenicity of booster vaccinations is limited. In countries where the CoronaVac inactivated vaccine is the primary vaccine, the appropriate boosting regimen is not clear. Immunologic studies of the effects of booster vaccination against VOCs, particularly Delta and Omicron, following CoronaVac in elderly individuals are helpful for policy makers. In this study, we determined the immune responses against VOCs following ChAdOx-1 or BNT162b2 boosting in elderly individuals previously immunized with CoronaVac. Results Before boosting, the median % inhibition of neutralizing antibodies (NAbs) against the wild-type (WT), Alpha, Beta, Delta and Omicron variants in the ChAdOx-1 and BNT162b2 groups was 52.8% vs. 53.4, 36.6% vs. 39.9, 5.2% vs. 13.7, 34.3% vs. 44.9, and 20.8% vs. 18.8%, respectively. After boosting with ChAdOx-1 or BNT162b2, the % inhibition of NAbs were increased to 97.3% vs. 97.4, 94.3% vs. 97.3%, 79.9 vs. 93.7, 95.5% vs. 97.5, and 26.9% vs. 31.9% for WT, Alpha, Beta, Delta and Omicron variants, respectively. Boosting with BNT162b2 induced significantly higher NAb levels than boosting with ChAdOx-1 against the Alpha, Beta and Delta variants but not the WT and Omicron variants. NAb levels against Omicron variant were not significantly different before and after boosting with ChAdOx-1 or BNT162b2. To evaluate T-cell responses, S peptides of the WT, Alpha, Beta and Delta variants were used to stimulate T cells. Upon stimulation, the expression of IL-17A in CD8 T cells was higher in the BNT162b2 group than in the ChAdOx-1 boosting group. However, IFN-γ production in CD4 and CD8 T cells did not significantly differ under all vaccination regimens. The expression of FasL in CD4 T cells, but not CD8 T cells, was higher in the BNT162b2-boosted group. Conclusion Boosting with either ChAdOx-1 or BNT162b2 in CoronaVac-primed healthy elderly individuals induced high NAb production against all examined VOCs except Omicron. BNT162b2 stimulated higher NAb and some T-cell responses than ChAdOx-1. Vaccine boosting is, therefore, recommended for elderly individuals previously immunized with CoronaVac. Supplementary Information The online version contains supplementary material available at 10.1186/s12979-022-00279-8.
Collapse
Affiliation(s)
- Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supansa Pata
- Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Technology Research Center, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency at the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Witida Laopajon
- Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Technology Research Center, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency at the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Nuchjira Takheaw
- Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Technology Research Center, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency at the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juthamas Inchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kantinan Chuensirikulchai
- Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Technology Research Center, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency at the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Watchara Kasinrerk
- Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. .,Biomedical Technology Research Center, National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency at the Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
| |
Collapse
|
36
|
Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review. Trop Med Infect Dis 2022; 7:tropicalmed7050081. [PMID: 35622708 PMCID: PMC9144541 DOI: 10.3390/tropicalmed7050081] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough infections (BTIs) in individuals who had completed a primary COVID-19 vaccination series. Thirty-three papers were included in the review. BTIs were more common among variants of concern (VOC) of which Delta accounted for the largest number of BTIs (96%), followed by Alpha (0.94%). In addition, 90% of patients with BTIs recovered, 11.6% were hospitalized with mechanical ventilation, and 0.6% resulted in mortality. BTIs were more common in healthcare workers (HCWs) and immunodeficient individuals with a small percentage found in fully vaccinated healthy individuals. VOC mutations were the primary cause of BTIs. Continued mitigation approaches (e.g., wearing masks and social distancing) are warranted even in fully vaccinated individuals to prevent transmission. Further studies utilizing genomic surveillance and heterologous vaccine regimens to boost the immune response are needed to better understand and control BTIs.
Collapse
|
37
|
A SARS-CoV-2 outbreak associated with vaccine breakthrough in an acute care hospital. Am J Infect Control 2022; 50:1006-1012. [PMID: 35605754 PMCID: PMC9121639 DOI: 10.1016/j.ajic.2022.05.010] [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: 01/12/2022] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND We aimed to analyze an outbreak caused by a vaccine breakthrough infection in a hospital with an active infection control program where 91.9% of health care workers were vaccinated. METHODS We investigated a SARS-CoV-2 outbreak between September 9 and October 2, 2021, in a referral teaching hospital in Korea. We retrospectively collected data on demographics, vaccination history, transmission, and clinical features of confirmed coronavirus disease 2019 (COVID-19) in patients, health care workers, and caregivers. RESULTS During the outbreak, 94 individuals tested positive for SARS-CoV-2 using reverse transcription-polymerase chain reaction testing. There were infections in 61 health care workers, 18 patients, and 15 caregivers; 74.5% (70/94) were vaccine breakthrough infections. Most transmissions appeared to be caused by three index cases, which accounted for 86.2% (81/94) of transmissions. Forty-seven (58.0%, 47/81) cases were associated with the hospital staff cafeteria and offices located in the basement. Among health care workers and caregivers, only one required oxygen supplementation. In contrast, among patients, there were four fatal cases (22.2%, 4/18), 3 of which were unvaccinated. CONCLUSIONS Superspreading infection among fully vaccinated individuals occurred in an acute care hospital while the delta variant was dominant. Given the potential for severe complications, as this outbreak demonstrated, preventive measures including adequate ventilation should be emphasized to minimize transmission in hospitals.
Collapse
|
38
|
Jamil M, Bhattacharya PK, Barman B, Lynrah KG, Lyngdoh M, Tiewsoh I, Gupta A, Mandal A, Sahoo DP, Sathees V. COVID-19 Vaccination Status Among Healthcare Workers and Its Effect on Disease Manifestations: A Study From Northeast India. Cureus 2022; 14:e25159. [PMID: 35747003 PMCID: PMC9206765 DOI: 10.7759/cureus.25159] [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] [Accepted: 05/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background and objective Since being declared a global pandemic, coronavirus disease 2019 (COVID-19) has led to millions of cases and deaths worldwide. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to wreak havoc on individuals, healthcare systems, and economies, the intensive vaccination strategies adopted by several countries have significantly slowed the progress and the severity of the disease. In this study, we aimed to determine the COVID-19 vaccination status among healthcare workers (HCWs) and examine the effects of vaccination on disease manifestations. Materials and methods This cross-sectional study was conducted at a teaching hospital in Northeast India from April 2021 to September 2021, during the second phase of the COVID-19 pandemic. HCWs employed in the hospital who were laboratory-confirmed cases of COVID-19 based on semiquantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) or cartridge-based nucleic acid amplification test (CBNAAT) on oropharyngeal samples were included in the study. Data analysis was performed using Microsoft Excel (Microsoft Office Professional Plus 2019, Microsoft Corp., Redmond, WA) Results A total of 178 HCWs reported positive for COVID-19 infection during the study period. Of these, 42 (23.59%) were males and 136 were females (76.40%). Among them, 86 (48.32%) HCWs were fully vaccinated, 58 (32.58%) were partially vaccinated, and 34 (19.10%) were not vaccinated. Most of the HCWs experienced mild disease (145, 81.46%), and only four (2.24%) reported moderate to severe disease. Compared with unvaccinated HCWs, individuals who have had either one or two doses of vaccines were less likely to have moderate to severe disease or seek treatment at the hospital. On symptoms analysis, shortness of breath was found to be more common in unvaccinated individuals than in vaccinated patients, and anosmia and loss of taste were more common in vaccinated than in unvaccinated individuals. No deaths were reported among the participants included in this study. Conclusions Following the first and second waves of the COVID-19 pandemic, a substantial proportion of HCWs were infected with SARS-CoV-2, likely as a result of the acquisition of the virus in the community during the early phase of local spread. Fully vaccinated individuals with COVID-19 were more likely to be completely asymptomatic or only mildly symptomatic compared to unvaccinated HCWs.
Collapse
|
39
|
Polechová J, Johnson KD, Payne P, Crozier A, Beiglböck M, Plevka P, Schernhammer E. SARS-CoV-2 rapid antigen tests provide benefits for epidemic control - observations from Austrian schools. J Clin Epidemiol 2022; 145:14-19. [PMID: 35041972 PMCID: PMC8760838 DOI: 10.1016/j.jclinepi.2022.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This paper motivates and justifies the use of antigen tests for epidemic control as distinct from a diagnostic test. STUDY DESIGN AND SETTING We discuss the relative advantages of antigen and PCR tests, summarizing evidence from both the literature as well as Austrian schools, which conducted frequent, mass rapid antigen testing during the spring of 2021. While our report on testing predates Delta, we have updated the review with recent data on viral loads in breakthrough infections and more information about testing efficacy, especially in children. RESULTS Rapid antigen tests detect proteins at the surface of virus particles, identifying the disease during its infectious phase. In contrast, PCR tests detect viral genomes: they can thus diagnose COVID-19 before the infectious phase but also react to remnants of the virus genome, even weeks after live virus ceases to be detectable in the respiratory tract. Furthermore, the logistics for administering the tests are different. Large-scale rapid antigen testing in Austrian schools showed low false-positive rates along with an approximately 10% lower effective reproduction number in the tested cohort. CONCLUSION Using antigen tests at least 2-3 times per week could become a powerful tool to suppress the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Kory D Johnson
- Institute of Statistics and Mathematical Methods in Economics, TU Wien, Austria.
| | - Pavel Payne
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Alex Crozier
- Division of Biosciences, University College London, London, UK
| | | | - Pavel Plevka
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria
| |
Collapse
|
40
|
Favresse J, Dogné JM, Douxfils J. Assessment of the humoral response in Omicron breakthrough cases in healthcare workers who received the BNT162b2 booster. Clin Chem Lab Med 2022; 60:e153-e156. [PMID: 35452575 DOI: 10.1515/cclm-2022-0323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/09/2022] [Indexed: 12/20/2022]
Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique Saint-Luc Bouge, Namur, Bouge, Belgium.,Department of Pharmacy, University of Namur, Namur Research Institute for Life Sciences, Namur, Belgium
| | - Jean-Michel Dogné
- Department of Pharmacy, University of Namur, Namur Research Institute for Life Sciences, Namur, Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, University of Namur, Namur Research Institute for Life Sciences, Namur, Belgium.,Qualiblood s.a., Namur, Belgium
| |
Collapse
|
41
|
Dewhurst RE, Heinrich T, Watt P, Ostergaard P, Marimon JM, Moreira M, Houldsworth PE, Rudrum JD, Wood D, Kõks S. Validation of a rapid, saliva-based, and ultra-sensitive SARS-CoV-2 screening system for pandemic-scale infection surveillance. Sci Rep 2022; 12:5936. [PMID: 35395856 PMCID: PMC8990279 DOI: 10.1038/s41598-022-08263-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/02/2022] [Indexed: 12/23/2022] Open
Abstract
Without any realistic prospect of comprehensive global vaccine coverage and lasting immunity, control of pandemics such as COVID-19 will require implementation of large-scale, rapid identification and isolation of infectious individuals to limit further transmission. Here, we describe an automated, high-throughput integrated screening platform, incorporating saliva-based loop-mediated isothermal amplification (LAMP) technology, that is designed for population-scale sensitive detection of infectious carriers of SARS-CoV-2 RNA. Central to this surveillance system is the "Sentinel" testing instrument, which is capable of reporting results within 25 min of saliva sample collection with a throughput of up to 3840 results per hour. It incorporates continuous flow loading of samples at random intervals to cost-effectively adjust for fluctuations in testing demand. Independent validation of our saliva-based RT-LAMP technology on an automated LAMP instrument coined the "Sentinel", found 98.7% sensitivity, 97.6% specificity, and 98% accuracy against a RT-PCR comparator assay, confirming its suitability for surveillance screening. This Sentinel surveillance system offers a feasible and scalable approach to complement vaccination, to curb the spread of COVID-19 variants, and control future pandemics to save lives.
Collapse
Affiliation(s)
- Robert E Dewhurst
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - Tatjana Heinrich
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - Paul Watt
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, 6009, Australia
| | | | - Jose M Marimon
- Biodonostia Health Research Institute, Infectious Diseases Area, Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, San Sebastián, Spain
| | - Mariana Moreira
- Lancs Lamp Laboratory, Heatley House, Bowran Street, Preston, PR1 2UX, UK
| | | | - Jack D Rudrum
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Avicena Systems Ltd, West Perth, WA, 6005, Australia
| | - David Wood
- University of Western Australia, Perth, WA, 6009, Australia
| | - Sulev Kõks
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia.
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, 6150, Australia.
- Prion Ltd, 50410, Tartu, Estonia.
| |
Collapse
|
42
|
Richter WR, Sunderman MM, Mera TO, O'Brien KA, Morgan K, Streams S. Evaluation of environmental conditions as a decontamination approach for SARS-CoV-2 when applied to common library, archive and museum-related materials. J Appl Microbiol 2022; 132:3405-3415. [PMID: 35094472 PMCID: PMC9306959 DOI: 10.1111/jam.15468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/02/2022]
Abstract
AIMS The purpose of this study was to evaluate the effects of ambient or altered environmental conditions on the inactivation of SARS-CoV-2 applied to materials common in libraries, archives and museums. METHODS AND RESULTS Porous and non-porous materials (e.g. paper, plastic protective book cover) were inoculated with approximately 1 × 105 TCID50 SARS CoV-2 (USA-WA1/2020), dried, placed within test chamber in either a stacked or unstacked configuration, and exposed to environmental conditions ranging from 4 to 29°C at 40 ± 10% relative humidity. The amount of infectious SARS-CoV-2 was then assessed at various timepoints from 0 to 10 days. Ambient conditions resulted in varying inactivation rates per material type. Virus inactivation rate decreased when materials were stacked or at colder temperatures. Virus inactivation rate increased when materials were unstacked or at warmer temperatures. CONCLUSIONS SARS-CoV-2 at ambient conditions resulted in the inactivation of virus below limit of quantitation (LOQ) for all materials by Day 8. Warmer temperatures, for a subset of materials, increased SARS-CoV-2 inactivation, and all were SIGNIFICANCE AND IMPACT OF THE STUDY These results provide information for the library, archives and museum community regarding the inactivation of SARS-CoV-2, showing that inactivation is possible using prescribed environmental conditions and is a potential method of decontamination for items not compatible with common liquid disinfectants.
Collapse
|
43
|
Mok CKP, Chen C, Yiu K, Chan TO, Lai KC, Ling KC, Sun Y, Hui DS, Cheng SMS, Peiris M. A Randomized Clinical Trial Using CoronaVac or BNT162b2 Vaccine as a Third Dose in Adults Vaccinated with Two Doses of CoronaVac. Am J Respir Crit Care Med 2022; 205:844-847. [PMID: 35015969 PMCID: PMC9836218 DOI: 10.1164/rccm.202111-2655le] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Chris Ka Pun Mok
- Li Ka Shing Institute of Health SciencesHong Kong Special Administrative Region, People’s Republic of China,The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Chunke Chen
- Li Ka Shing Institute of Health SciencesHong Kong Special Administrative Region, People’s Republic of China,The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Karen Yiu
- The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Tat-On Chan
- The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Kiu Cheung Lai
- The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Kwun Cheung Ling
- The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Yuanxin Sun
- Li Ka Shing Institute of Health SciencesHong Kong Special Administrative Region, People’s Republic of China,The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - David S. Hui
- The Chinese University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Samuel M. S. Cheng
- The University of Hong KongHong Kong Special Administrative Region, People’s Republic of China
| | - Malik Peiris
- The University of Hong KongHong Kong Special Administrative Region, People’s Republic of China,Corresponding author (e-mail: )
| |
Collapse
|
44
|
Sendo F, Yoshitake H, Araki Y. Targeting of neutrophil activation in the early phase of the disease for prevention of Coronavirus disease-19 severity. Microbiol Immunol 2022; 66:264-276. [PMID: 35348252 PMCID: PMC9111295 DOI: 10.1111/1348-0421.12978] [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: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
Abstract
The prevention of the disease severity seems critical for reducing the mortality of Coronavirus (CoV) disease‐19. The neutrophils play a key role in the induction of severity. It is proposed here that inhibition of neutrophil activation and/or cascade reactions of complement, leading to this cell activation at the early phase of the disease, is a potential tool to inhibit aggravation of the disease. The need for appropriate timing in intervention is emphasized as follows. (1) Intervention at the very early stage of severe acute respiratory syndrome‐CoV‐2 infection may harm the defensive host response to the infection because of the critical function of neutrophils in this response, and (2) intervention at too late a stage will not stop the infiltration of fully activated neutrophils that produce large amounts of toxic substances.
Collapse
Affiliation(s)
| | - Hiroshi Yoshitake
- Institute for Environmental & Gender-specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan
| | - Yoshihiko Araki
- Institute for Environmental & Gender-specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan.,Division of Microbiology, Department of Pathology & Microbiology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| |
Collapse
|
45
|
SARS-CoV-2 IgG Seroprevalence Detected by Chemiluminescence Immunoassay Among Healthcare Personnel and Patients in a Province With a Low Incidence Rate of COVID-19 During the First Wave of COVID-19 in Thailand. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
46
|
Nguyen LT, Nguyen PM, Dinh DV, Pham HN, Bui LAT, Vo CV, Nguyen BH, Bui HD, Hoang CX, Ngo NMV, Dang TT, Do AN, Vu DD, Nguyen LT, Nguyen MN, Dinh THT, Ho SA, Hoang LV, Hoang SX, Do Q. Establishment of an in‐house real‐time RT‐PCR assay for the detection of severe acute respiratory syndrome coronavirus 2 using the first World Health Organization international standard in a resource‐limited country. J Clin Lab Anal 2022; 36:e24355. [PMID: 35312118 PMCID: PMC9102516 DOI: 10.1002/jcla.24355] [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] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 03/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID‐19 pandemic caused by SARS‐CoV‐2 remains public health burdens and many unresolved issues worldwide. Molecular assays based on real‐time RT‐PCR are critical for the detection of SARS‐CoV‐2 in clinical specimens from patients suspected of COVID‐19. Objective We aimed to establish and validate an in‐house real‐time RT‐PCR for the detection of SARS‐CoV‐2. Methodology Primers and probes sets in our in‐house real‐time RT‐PCR assay were designed in conserved regions of the N and E target genes. Optimized multiplex real‐time RT‐PCR assay was validated using the first WHO International Standard (NIBSC code: 20/146) and evaluated clinical performance. Results The limit of detection validated using the first WHO International Standard was 159 IU/ml for both E and N target genes. The evaluation of clinical performance on 170 clinical samples showed a positive percent agreement of 100% and the negative percent agreement of 99.08% for both target genes. The Kappa value of 0.99 was an excellent agreement, the strong correlation of Ct values observed between two tests with r2 = 0.84 for the E gene and 0.87 for the N gene. Notably, we assessed on 60 paired saliva and nasopharyngeal samples. The overall agreement was 91.66%, and Kappa value of 0.74 showed a high agreement between two types of samples. When using nasopharyngeal swabs as the reference standard, positive percent agreement, and negative percent agreement were 91.83% and 90.90%, respectively. Conclusion In the present study, we established and validated an in‐house real‐time RT‐PCR for molecular detection of SARS‐CoV‐2 in a resource‐limited country.
Collapse
Affiliation(s)
- Linh Tung Nguyen
- Department of Occupational Medicine Vietnam Military Medical University Hanoi Vietnam
| | - Phuong Minh Nguyen
- Department of Occupational Medicine Vietnam Military Medical University Hanoi Vietnam
| | - Duc Viet Dinh
- Department of Epidemiology Vietnam Military Medical University Hanoi Vietnam
| | - Hung Ngoc Pham
- Department of Epidemiology Vietnam Military Medical University Hanoi Vietnam
| | - Lan Anh Thi Bui
- Institute of Biomedicine Vietnam‐Russia Tropical Center Hanoi Vietnam
| | - Cuong Viet Vo
- Institute of Biomedicine Vietnam‐Russia Tropical Center Hanoi Vietnam
| | - Ben Huu Nguyen
- Department of Occupational Medicine Vietnam Military Medical University Hanoi Vietnam
| | - Hoan Duy Bui
- Department of Occupational Medicine Vietnam Military Medical University Hanoi Vietnam
| | - Cuong Xuan Hoang
- Department of Occupational Medicine Vietnam Military Medical University Hanoi Vietnam
| | - Nhat Minh Van Ngo
- Department of Human Anatomy Vietnam Military Medical University Hanoi Vietnam
| | - Truong Tien Dang
- Department of Human Anatomy Vietnam Military Medical University Hanoi Vietnam
| | - Anh Ngoc Do
- Department of Parasitology Vietnam Military Medical University Hanoi Vietnam
| | - Dung Dinh Vu
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
- Hanoi University of Science and Technology Hanoi Vietnam
| | - Linh Thuy Nguyen
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
- Faculty of Biology National University of Hanoi Hanoi Vietnam
| | - Mai Ngoc Nguyen
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
- Faculty of Biology National University of Hanoi Hanoi Vietnam
| | - Thu Hang Thi Dinh
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
| | - Son Anh Ho
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
| | - Luong Van Hoang
- Department of Human Anatomy Vietnam Military Medical University Hanoi Vietnam
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
| | - Su Xuan Hoang
- Institute of Biomedicine and Pharmacy Vietnam Military Medical University Hanoi Vietnam
| | - Quyet Do
- Military Hospital 103 Vietnam Military Medical University Hanoi Vietnam
| |
Collapse
|
47
|
Aikawa NE, Kupa LDVK, Medeiros-Ribeiro AC, Saad CGS, Yuki EFN, Pasoto SG, Rojo PT, Pereira RMR, Shinjo SK, Sampaio-Barros PD, Andrade DCO, Halpern ASR, Fuller R, Souza FHC, Guedes LKN, Assad APL, Moraes JCBD, Lopes MRU, Martins VADO, Betancourt L, Ribeiro CT, Sales LP, Bertoglio IM, Bonoldi VLN, Mello RLP, Balbi GGM, Sartori AMC, Antonangelo L, Silva CA, Bonfa E. Increment of immunogenicity after third dose of a homologous inactivated SARS-CoV-2 vaccine in a large population of patients with autoimmune rheumatic diseases. Ann Rheum Dis 2022; 81:1036-1043. [DOI: 10.1136/annrheumdis-2021-222096] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 01/11/2023]
Abstract
ObjectiveTo determine the immunogenicity of the third dose of CoronaVac vaccine in a large population of patients with autoimmune rheumatic diseases (ARD) and the factors associated with impaired response.MethodsAdult patients with ARD and age-balanced/sex-balanced controls (control group, CG) previously vaccinated with two doses of CoronaVac received the third dose at D210 (6 months after the second dose). The presence of anti-SARS-CoV-2 S1/S2 IgG and neutralising antibodies (NAb) was evaluated previously to vaccination (D210) and 30 days later (D240). Patients with controlled disease suspended mycophenolate mofetil (MMF) for 7 days or methotrexate (MTX) for 2 weekly doses after vaccination.ResultsARD (n=597) and CG (n=199) had comparable age (p=0.943). Anti-S1/S2 IgG seropositivity rates significantly increased from D210 (60%) to D240 (93%) (p<0.0001) in patients with ARD. NAb positivity also increased: 38% (D210) vs 81.4% (D240) (p<0.0001). The same pattern was observed for CG, with significantly higher frequencies for both parameters at D240 (p<0.05). Multivariate logistic regression analyses in the ARD group revealed that older age (OR=0.98, 95% CI 0.96 to 1.0, p=0.024), vasculitis diagnosis (OR=0.24, 95% CI 0.11 to 0.53, p<0.001), prednisone ≥5 mg/day (OR=0.46, 95% CI 0.27 to 0.77, p=0.003), MMF (OR=0.30, 95% CI 0.15 to 0.61, p<0.001) and biologics (OR=0.27, 95% CI 0.16 to 0.46, p<0.001) were associated with reduced anti-S1/S2 IgG positivity. Similar analyses demonstrated that prednisone ≥5 mg/day (OR=0.63, 95% CI 0.44 to 0.90, p=0.011), abatacept (OR=0.39, 95% CI 0.20 to 0.74, p=0.004), belimumab (OR=0.29, 95% CI 0.13 to 0.67, p=0.004) and rituximab (OR=0.11, 95% CI 0.04 to 0.30, p<0.001) were negatively associated with NAb positivity. Further evaluation of COVID-19 seronegative ARD at D210 demonstrated prominent increases in positivity rates at D240 for anti-S1/S2 IgG (80.5%) and NAb (59.1%) (p<0.0001).ConclusionsWe provide novel data on a robust response to the third dose of CoronaVac in patients with ARD, even in those with prevaccination COVID-19 seronegative status. Drugs implicated in reducing immunogenicity after the regular two-dose regimen were associated with non-responsiveness after the third dose, except for MTX.Trial registration numberNCT04754698.
Collapse
|
48
|
Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, Derqui-Fernandez N, Barnett JL, Whitfield MG, Varro R, Charlett A, Kundu R, Fenn J, Cutajar J, Quinn V, Conibear E, Barclay W, Freemont PS, Taylor GP, Ahmad S, Zambon M, Ferguson NM, Lalvani A. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study. THE LANCET. INFECTIOUS DISEASES 2022; 22:183-195. [PMID: 34756186 PMCID: PMC8554486 DOI: 10.1016/s1473-3099(21)00648-4] [Citation(s) in RCA: 439] [Impact Index Per Article: 219.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The SARS-CoV-2 delta (B.1.617.2) variant is highly transmissible and spreading globally, including in populations with high vaccination rates. We aimed to investigate transmission and viral load kinetics in vaccinated and unvaccinated individuals with mild delta variant infection in the community. METHODS Between Sept 13, 2020, and Sept 15, 2021, 602 community contacts (identified via the UK contract-tracing system) of 471 UK COVID-19 index cases were recruited to the Assessment of Transmission and Contagiousness of COVID-19 in Contacts cohort study and contributed 8145 upper respiratory tract samples from daily sampling for up to 20 days. Household and non-household exposed contacts aged 5 years or older were eligible for recruitment if they could provide informed consent and agree to self-swabbing of the upper respiratory tract. We analysed transmission risk by vaccination status for 231 contacts exposed to 162 epidemiologically linked delta variant-infected index cases. We compared viral load trajectories from fully vaccinated individuals with delta infection (n=29) with unvaccinated individuals with delta (n=16), alpha (B.1.1.7; n=39), and pre-alpha (n=49) infections. Primary outcomes for the epidemiological analysis were to assess the secondary attack rate (SAR) in household contacts stratified by contact vaccination status and the index cases' vaccination status. Primary outcomes for the viral load kinetics analysis were to detect differences in the peak viral load, viral growth rate, and viral decline rate between participants according to SARS-CoV-2 variant and vaccination status. FINDINGS The SAR in household contacts exposed to the delta variant was 25% (95% CI 18-33) for fully vaccinated individuals compared with 38% (24-53) in unvaccinated individuals. The median time between second vaccine dose and study recruitment in fully vaccinated contacts was longer for infected individuals (median 101 days [IQR 74-120]) than for uninfected individuals (64 days [32-97], p=0·001). SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15-35] for vaccinated vs 23% [15-31] for unvaccinated). 12 (39%) of 31 infections in fully vaccinated household contacts arose from fully vaccinated epidemiologically linked index cases, further confirmed by genomic and virological analysis in three index case-contact pairs. Although peak viral load did not differ by vaccination status or variant type, it increased modestly with age (difference of 0·39 [95% credible interval -0·03 to 0·79] in peak log10 viral load per mL between those aged 10 years and 50 years). Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections. Within individuals, faster viral load growth was correlated with higher peak viral load (correlation 0·42 [95% credible interval 0·13 to 0·65]) and slower decline (-0·44 [-0·67 to -0·18]). INTERPRETATION Vaccination reduces the risk of delta variant infection and accelerates viral clearance. Nonetheless, fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts. Host-virus interactions early in infection may shape the entire viral trajectory. FUNDING National Institute for Health Research.
Collapse
Affiliation(s)
- Anika Singanayagam
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK; Department of Infectious Disease, Imperial College London, London, UK; National Infection Service, Public Health England, London, UK
| | - Seran Hakki
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jake Dunning
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Oxford, Oxford, UK; National Infection Service, Public Health England, London, UK
| | - Kieran J Madon
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael A Crone
- Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK
| | - Aleksandra Koycheva
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Nieves Derqui-Fernandez
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jack L Barnett
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael G Whitfield
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Robert Varro
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Andre Charlett
- Data and Analytical Services, Public Health England, London, UK
| | - Rhia Kundu
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Joe Fenn
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jessica Cutajar
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Valerie Quinn
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Emily Conibear
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Wendy Barclay
- Department of Infectious Disease, Imperial College London, London, UK
| | - Paul S Freemont
- Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, UK
| | - Shazaad Ahmad
- Department of Virology, Manchester Medical Microbiology Partnership, Manchester Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Maria Zambon
- National Infection Service, Public Health England, London, UK
| | - Neil M Ferguson
- NIHR Health Protection Research Unit in Modelling and Health Economics, MRC Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London, London, UK
| | - Ajit Lalvani
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
| |
Collapse
|
49
|
Zhu F, Althaus T, Tan CW, Costantini A, Chia WN, Van Vinh Chau N, Van Tan L, Mattiuzzo G, Rose NJ, Voiglio E, Wang LF. WHO international standard for SARS-CoV-2 antibodies to determine markers of protection. THE LANCET. MICROBE 2022; 3:e81-e82. [PMID: 34901897 PMCID: PMC8641955 DOI: 10.1016/s2666-5247(21)00307-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Feng Zhu
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169657
| | - Thomas Althaus
- Centre Scientifique de Monaco, Monaco
- Direction de l'Action Sanitaire in Monaco, Monaco
| | - Chee Wah Tan
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169657
| | | | - Wan Ni Chia
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169657
| | | | - Le Van Tan
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Giada Mattiuzzo
- National Institute for Biological Standards and Control, MHRA, South Mimms, UK
| | - Nicola J Rose
- National Institute for Biological Standards and Control, MHRA, South Mimms, UK
| | - Eric Voiglio
- Direction de l'Action Sanitaire in Monaco, Monaco
| | - Lin-Fa Wang
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore 169657
- SingHealth Duke-NUS Global Health Institute, Singapore
| |
Collapse
|
50
|
Wi YM, Kim SH, Peck KR. An Outbreak of Breakthrough Infections by the SARS-CoV-2 Delta Variant in a Psychiatric Closed Ward. J Korean Med Sci 2022; 37:e28. [PMID: 35075827 PMCID: PMC8787804 DOI: 10.3346/jkms.2022.37.e28] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/22/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A rapid decline in immunity and low neutralizing activity against the delta variant in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinees has been observed. This study describes an outbreak of coronavirus disease 2019 (COVID-19) breakthrough infections caused by the SARS-CoV-2 delta variant in a psychiatric closed ward. METHODS Data from epidemic intelligence service officers were utilized to obtain information regarding demographic, vaccination history, and clinical data along with SARS-CoV-2 PCR test results for a COVID-19 outbreak that occurred in a closed psychiatric ward. RESULTS Among the 164 residents, 144 (87.8%) received two doses of vaccines and 137 (95.1%) of them received ChAdOx1 nCoV-19 vaccine. The mean interval between the second vaccination and COVID-19 diagnosis was 132.77 ± 40.68 days. At the time of detection of the index case, SARS-CoV-2 had spread throughout the ward, infecting 162 of 164 residents. The case-fatality ratio was lower than that in the previously reported outbreak before the vaccination (1.2%, 2/162 vs. 6.9%, P = 0.030). Prolonged hospitalization occurred in 17 patients (11.1%) and was less prevalent in the vaccinated group than in the unvaccinated group (8.5% vs. 25.0%, P = 0.040). CONCLUSION The findings of this study highlight that while vaccination can reduce mortality and the duration of hospitalization, it is not sufficient to prevent an outbreak of the SARS-CoV-2 delta variant in the present psychiatric hospital setting.
Collapse
Affiliation(s)
- Yu Mi Wi
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Si-Ho Kim
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|