1
|
Gandjour A. Evaluating the Usefulness of Population-Wide COVID-19 Testing in the Omicron Era: Insights from a German Model. DAS GESUNDHEITSWESEN 2024. [PMID: 39047785 DOI: 10.1055/a-2328-4165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND The Omicron variant of SARS-CoV-2, which has become dominant worldwide since late 2021, presents a unique challenge due to its high rate of asymptomatic transmission. This study evaluates the efficacy and value of population-wide testing, including self-testing, in the context of COVID-19, particularly under the Omicron variant, using data from Germany. METHODS A decision-analytical model and secondary data was used for assessing the impact of systematic screening and testing for COVID-19. Various scenarios were taken into consideration including seasonal patterns of COVID-19 transmission and the potential for annual waves. The model assessed the clinical benefits of testing against the backdrop of vaccine effectiveness, transmission rates, and the potential to prevent severe clinical events, including death, ICU admission, and long COVID syndrome. RESULTS The study found that the value of mass testing and self-testing for private use was highly contingent on the transmission rate and the scenario of COVID-19 waves (seasonal vs. continuous). For winter waves, a very high incidence rate was required to justify testing, while for continuous waves, testing could be valuable for those in contact with individuals in their last decade of life. The analysis highlighted the limitations of mass testing when community transmission rates were low and the potential value of testing in high-risk contacts or amidst new outbreaks. DISCUSSION The findings suggest that the resumption of testing during winter waves is unlikely to provide significant clinical benefits given the current understanding of Omicron's transmission and immunity waning. This study underscores the need for a nuanced approach to COVID-19 testing policies, considering both the epidemiological context and the practical implications of testing strategies.
Collapse
Affiliation(s)
- Afschin Gandjour
- Frankfurt School of Finance & Management gGmbH Economics Department, Frankfurt, Germany
| |
Collapse
|
2
|
Lima HS, Tupinambás U, Guimarães FG. Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods. PLoS One 2024; 19:e0305522. [PMID: 38885221 PMCID: PMC11182538 DOI: 10.1371/journal.pone.0305522] [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: 08/10/2023] [Accepted: 06/01/2024] [Indexed: 06/20/2024] Open
Abstract
Our study conducts a comprehensive analysis of the Covid-19 pandemic in Brazil, spanning five waves over three years. We employed a novel Susceptible-Infected-Recovered-Dead-Susceptible (SIRDS) model with a fuzzy transition between epidemic periods to estimate time-varying parameters and evaluate case underreporting. The initial basic reproduction number (R0) is identified at 2.44 (95% Confidence Interval (CI): 2.42-2.46), decreasing to 1.00 (95% CI: 0.99-1.01) during the first wave. The model estimates an underreporting factor of 12.9 (95% CI: 12.5-13.2) more infections than officially reported by Brazilian health authorities, with an increasing factor of 5.8 (95% CI: 5.2-6.4), 12.9 (95% CI: 12.5-13.3), and 16.8 (95% CI: 15.8-17.5) in 2020, 2021, and 2022 respectively. Additionally, the Infection Fatality Rate (IFR) is initially 0.88% (95% CI: 0.81%-0.94%) during the initial phase but consistently reduces across subsequent outbreaks, reaching its lowest value of 0.018% (95% CI: 0.011-0.033) in the last outbreak. Regarding the immunity period, the observed uncertainty and low sensitivity indicate that inferring this parameter is particularly challenging. Brazil successfully reduced R0 during the first wave, coinciding with decreased human mobility. Ineffective public health measures during the second wave resulted in the highest mortality rates within the studied period. We attribute lower mortality rates in 2022 to increased vaccination coverage and the lower lethality of the Omicron variant. We demonstrate the model generalization by its application to other countries. Comparative analyses with serological research further validate the accuracy of the model. In forecasting analysis, our model provides reasonable outbreak predictions. In conclusion, our study provides a nuanced understanding of the Covid-19 pandemic in Brazil, employing a novel epidemiological model. The findings contribute to the broader discourse on pandemic dynamics, underreporting, and the effectiveness of health interventions.
Collapse
Affiliation(s)
- Hélder Seixas Lima
- Instituto Federal do Norte de Minas Gerais, Januária, MG, Brazil
- Graduate Program in Electrical Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Unaí Tupinambás
- Department of Medical Clinic, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | |
Collapse
|
3
|
Ofori SK, Dankwa EA, Estrada EH, Hua X, Kimani TN, Wade CG, Buckee CO, Murray MB, Hedt-Gauthier BL. COVID-19 vaccination strategies in Africa: A scoping review of the use of mathematical models to inform policy. Trop Med Int Health 2024; 29:466-476. [PMID: 38740040 DOI: 10.1111/tmi.13994] [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] [Indexed: 05/16/2024]
Abstract
OBJECTIVE Mathematical models are vital tools to understand transmission dynamics and assess the impact of interventions to mitigate COVID-19. However, historically, their use in Africa has been limited. In this scoping review, we assess how mathematical models were used to study COVID-19 vaccination to potentially inform pandemic planning and response in Africa. METHODS We searched six electronic databases: MEDLINE, Embase, Web of Science, Global Health, MathSciNet and Africa-Wide NiPAD, using keywords to identify articles focused on the use of mathematical modelling studies of COVID-19 vaccination in Africa that were published as of October 2022. We extracted the details on the country, author affiliation, characteristics of models, policy intent and heterogeneity factors. We assessed quality using 21-point scale criteria on model characteristics and content of the studies. RESULTS The literature search yielded 462 articles, of which 32 were included based on the eligibility criteria. Nineteen (59%) studies had a first author affiliated with an African country. Of the 32 included studies, 30 (94%) were compartmental models. By country, most studies were about or included South Africa (n = 12, 37%), followed by Morocco (n = 6, 19%) and Ethiopia (n = 5, 16%). Most studies (n = 19, 59%) assessed the impact of increasing vaccination coverage on COVID-19 burden. Half (n = 16, 50%) had policy intent: prioritising or selecting interventions, pandemic planning and response, vaccine distribution and optimisation strategies and understanding transmission dynamics of COVID-19. Fourteen studies (44%) were of medium quality and eight (25%) were of high quality. CONCLUSIONS While decision-makers could draw vital insights from the evidence generated from mathematical modelling to inform policy, we found that there was limited use of such models exploring vaccination impacts for COVID-19 in Africa. The disparity can be addressed by scaling up mathematical modelling training, increasing collaborative opportunities between modellers and policymakers, and increasing access to funding.
Collapse
Affiliation(s)
- Sylvia K Ofori
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Emmanuelle A Dankwa
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eve Hiyori Estrada
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Xinyi Hua
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Teresia N Kimani
- KAVI-Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
- Department of Health Services, Kiambu County, Ministry of Health Kenya, Kiambu County, Kenya
| | - Carrie G Wade
- Countway Library, Harvard School of Medicine, Boston, Massachusetts, USA
| | - Caroline O Buckee
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Megan B Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Bethany L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Zhong J, Zhong Q, Xiong H, Wu D, Zheng C, Liu S, Zhong Q, Chen Y, Zhang D. Public acceptance of COVID-19 control measures and associated factors during Omicron-dominant period in China: a cross-sectional survey. BMC Public Health 2024; 24:543. [PMID: 38383375 PMCID: PMC10882874 DOI: 10.1186/s12889-024-17646-3] [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: 10/08/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES This study aims to evaluate the public acceptance of coronavirus disease 2019 (COVID-19) control measures during the Omicron-dominant period and its associated factors. METHODS A cross-sectional design was conducted and 1391 study participants were openly recruited to participate in the questionnaire survey. Logistic regression model was performed to assess the association between the public acceptance and potential factors more specifically. RESULTS By August 26, 2022, 58.9% of the study participants were less acceptive of the control measures while 41.1% expressed higher acceptance. Factors associated with lower acceptance included young age, such as < 18 (OR = 8.251, 95% CI: 2.009 to 33.889) and 18-29 (OR = 2.349, 95% CI: 1.564 to 3.529), and household per capita monthly income lower than 5000 yuan (OR = 1.512, 95% CI: 1.085 to 2.105). Furthermore, individuals who perceived that the case fatality rate (CFR) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was very low (OR = 6.010, 95% CI: 2.475 to 14.595) and that the restrictions could be eased once the CFR dropped to 2-3 times of the influenza (OR = 2.792, 95% CI: 1.939 to 4.023) showed greater oppositional attitudes. Likewise, respondents who were dissatisfied with control measures (OR = 9.639, 95% CI: 4.425 to 20.998) or preferred fully relaxation as soon as possible (OR = 13.571, 95% CI: 7.751 to 23.758) had even lower acceptability. By contrast, rural residents (OR = 0.683, 95% CI: 0.473 to 0.987), students (OR = 0.510, 95% CI: 0.276 to 0.941), public (OR = 0.417, 95% CI: 0.240 to 0.727) and private (OR = 0.562, 95% CI: 0.320 to 0.986) employees, and vaccinated participants (OR = 0.393, 95% CI: 0.204 to 0.756) were more compliant with control measures. CONCLUSION More than half of the Chinese public were less supportive of COVID-19 control measures during Omicron-dominant period, which varied based on their different demographic characteristics, cognition and overall attitude towards SARS-CoV-2 infection. Control measures that struck a balance between public safety and individual freedom would be more acceptable during the pandemic.
Collapse
Affiliation(s)
- Jiayi Zhong
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Qianhong Zhong
- Department of Tuberculosis Control, The Fourth People's Hospital of Foshan city, 528000, Foshan, Guangdong, China
| | - Husheng Xiong
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Dawei Wu
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Caiyun Zheng
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Shuang Liu
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Qinyi Zhong
- School of Law, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China
| | - Yan Chen
- Medical College of Shaoguan University, 512026, Shaoguan, Guangdong, China.
| | - Dingmei Zhang
- School of Public Health, Sun Yat-Sen University, 510080, Guangzhou, Guangdong, China.
| |
Collapse
|
5
|
Coimbra MT, Francisco JATS, Freitas JC, Carvalho RV, Vilela SRB, Ribeiro CICD, Silvano JLCSL, Pedroso S, Almeida M, Martins LS, Malheiro J. Excess Mortality in Kidney and Kidney-Pancreas Transplant Recipients in the COVID-19 Pandemic in Portugal-A Cohort Study. Transpl Int 2023; 36:11655. [PMID: 37850156 PMCID: PMC10577594 DOI: 10.3389/ti.2023.11655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
The COVID-19 pandemic increased morbidity and mortality worldwide, particularly in the Kidney and Kidney-Pancreas Transplant Recipient (KTR/KPTR) population. Aiming at assessing the absolute and relative excess mortality (EM) in a Portuguese KTR/KPTR cohort, we conducted a retrospective observational study of two KTR/KPTRs cohorts: cohort 1 (P1; n = 2,179) between September/2012 and March/2020; cohort 2 (P2; n = 2067) between March/2020, and August/2022. A correlation between relative and absolute EM and age, sex, time from transplantation and cause of death was explored. A total of 145 and 84 deaths by all causes were observed in P1 and P2, respectively. The absolute EM in P2 versus P1 was 19.2 deaths (observed/expected mortality ratio 1.30, p = 0.006), and the relative EM was 1.47/1,000 person-months (95% CI 1.11-1.93, p = 0.006). Compared to the same period in the general population, the standardized mortality rate by age in P2 was 3.86 (95% CI 2.40-5.31), with a peak at 9.00 (95% CI 4.84-13.16) in P2C. The higher EM identified in this population was associated, mainly, with COVID-19 infection, with much higher values during the second seasonal COVID-19 peak when compared to the general population, despite generalized vaccination. These highlight the need for further preventive measures and improved therapies in these patients.
Collapse
Affiliation(s)
- Miguel T. Coimbra
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Nephrology, Hospital Espírito Santo de Évora, Évora, Portugal
| | - José A. T. S. Francisco
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Joana C. Freitas
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Renata V. Carvalho
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - Sara R. B. Vilela
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Department of Nephrology, Hospital Garcia de Orta, Almada, Portugal
| | | | | | - Sofia Pedroso
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Manuela Almeida
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - La Salete Martins
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Jorge Malheiro
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| |
Collapse
|
6
|
Andre M, Lau LS, Pokharel MD, Ramelow J, Owens F, Souchak J, Akkaoui J, Ales E, Brown H, Shil R, Nazaire V, Manevski M, Paul NP, Esteban-Lopez M, Ceyhan Y, El-Hage N. From Alpha to Omicron: How Different Variants of Concern of the SARS-Coronavirus-2 Impacted the World. BIOLOGY 2023; 12:1267. [PMID: 37759666 PMCID: PMC10525159 DOI: 10.3390/biology12091267] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/07/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
SARS-CoV-2, the virus that causes COVID-19, is prone to mutations and the generation of genetic variants. Since its first outbreak in 2019, SARS-CoV-2 has continually evolved, resulting in the emergence of several lineages and variants of concern (VOC) that have gained more efficient transmission, severity, and immune evasion properties. The World Health Organization has given these variants names according to the letters of the Greek Alphabet, starting with the Alpha (B.1.1.7) variant, which emerged in 2020, followed by the Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2), and Omicron (B.1.1.529) variants. This review explores the genetic variation among different VOCs of SARS-CoV-2 and how the emergence of variants made a global impact on the pandemic.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nazira El-Hage
- Herbert Wertheim College of Medicine, Biomedical Sciences Program Florida International University, Miami, FL 33199, USA; (M.A.); (L.-S.L.); (M.D.P.); (J.R.); (F.O.); (J.S.); (J.A.); (E.A.); (H.B.); (R.S.); (V.N.); (M.M.); (N.P.P.); (M.E.-L.); (Y.C.)
| |
Collapse
|
7
|
Zwetsloot PP, Smit WL, Van der Kaaij NP, Szymanski MK, Van der Meer MG, Van Laake LW, Troelstra A, Wegdam-Blans MCA, Oerlemans MIFJ. Pre-Operative SARS-CoV-2 Testing in Asymptomatic Heart Transplantation Recipients. Biomedicines 2023; 11:2103. [PMID: 37626599 PMCID: PMC10452735 DOI: 10.3390/biomedicines11082103] [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: 06/15/2023] [Revised: 07/16/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION From the start of the coronavirus disease 2019 (COVID-19) pandemic, international guidelines have recommended pre-operative screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) before heart transplantation (HTx). Due to the changing prevalence of COVID-19, the chances of false positive results have increased. Because of increased immunity in the population and evolution of SARS-CoV-2 to current Omicron variants, associated mortality and morbidity have decreased. We set out to investigate the yield and side effects of SARS-CoV-2 screening in our center. METHODS We performed a retrospective cohort study in the University Medical Center Utrecht. The study period was from March 2019 to January 2023. All data from patients who underwent HTx were collected, including all pre-operative and post-operative SARS-CoV-2 tests. Furthermore, all clinical SARS-CoV-2 tests for the indication of potential HTx were screened. RESULTS In the period under study, 51 patients underwent HTx. None of the recipients reported any symptoms of a viral infection. Fifty HTx recipients were screened for SARS-CoV-2. Forty-nine out of fifty patients tested negative. One patient had a false positive result, potentially delaying the HTx procedure. There were no cancelled HTx procedures due to a true positive SARS-CoV-2 test result. CONCLUSION Pre-operative SARS-CoV-2 screening in asymptomatic HTx recipients did not lead to any true positive cases. In 2% of the cases, screening resulted in a false positive test result. With the current Omicron variants, in combination with a low-prevalence situation, we propose to abandon pre-operative SARS-CoV-2 screening and initiate a symptom-driven approach for the general viral testing of patients who are called in for a potential HTx.
Collapse
Affiliation(s)
- Peter-Paul Zwetsloot
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (P.-P.Z.); (M.K.S.); (M.G.V.d.M.)
| | - Wouter L. Smit
- Department of Medical Microbiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (W.L.S.); (A.T.); (M.C.A.W.-B.)
| | - Niels P. Van der Kaaij
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Mariusz K. Szymanski
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (P.-P.Z.); (M.K.S.); (M.G.V.d.M.)
| | - Manon G. Van der Meer
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (P.-P.Z.); (M.K.S.); (M.G.V.d.M.)
| | - Linda W. Van Laake
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (P.-P.Z.); (M.K.S.); (M.G.V.d.M.)
| | - Annet Troelstra
- Department of Medical Microbiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (W.L.S.); (A.T.); (M.C.A.W.-B.)
| | - Marjolijn C. A. Wegdam-Blans
- Department of Medical Microbiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (W.L.S.); (A.T.); (M.C.A.W.-B.)
| | - Marish I. F. J. Oerlemans
- Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands; (P.-P.Z.); (M.K.S.); (M.G.V.d.M.)
| |
Collapse
|
8
|
Hogan AB, Doohan P, Wu SL, Mesa DO, Toor J, Watson OJ, Winskill P, Charles G, Barnsley G, Riley EM, Khoury DS, Ferguson NM, Ghani AC. Estimating long-term vaccine effectiveness against SARS-CoV-2 variants: a model-based approach. Nat Commun 2023; 14:4325. [PMID: 37468463 DOI: 10.1038/s41467-023-39736-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
With the ongoing evolution of the SARS-CoV-2 virus updated vaccines may be needed. We fitted a model linking immunity levels and protection to vaccine effectiveness data from England for three vaccines (Oxford/AstraZeneca AZD1222, Pfizer-BioNTech BNT162b2, Moderna mRNA-1273) and two variants (Delta, Omicron). Our model reproduces the observed sustained protection against hospitalisation and death from the Omicron variant over the first six months following dose 3 with the ancestral vaccines but projects a gradual waning to moderate protection after 1 year. Switching the fourth dose to a variant-matched vaccine against Omicron BA.1/2 is projected to prevent nearly twice as many hospitalisations and deaths over a 1-year period compared to administering the ancestral vaccine. This result is sensitive to the degree to which immunogenicity data can be used to predict vaccine effectiveness and uncertainty regarding the impact that infection-induced immunity (not captured here) may play in modifying future vaccine effectiveness.
Collapse
Affiliation(s)
- Alexandra B Hogan
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Patrick Doohan
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Sean L Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Daniela Olivera Mesa
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Jaspreet Toor
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Oliver J Watson
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Giovanni Charles
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Gregory Barnsley
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Neil M Ferguson
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Azra C Ghani
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
| |
Collapse
|
9
|
Lee T, Cheng MP, Vinh DC, Lee TC, Tran KC, Winston BW, Sweet D, Boyd JH, Walley KR, Haljan G, McGeer A, Lamontagne F, Fowler R, Maslove DM, Singer J, Patrick DM, Marshall JC, Burns KD, Murthy S, Mann PK, Hernandez G, Donohoe K, Russell JA. Outcomes and characteristics of patients hospitalized for COVID-19 in British Columbia, Ontario and Quebec during the Omicron wave. CMAJ Open 2023; 11:E672-E683. [PMID: 37527902 PMCID: PMC10400083 DOI: 10.9778/cmajo.20220194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Omicron is the current predominant variant of concern of SARS-CoV-2. We hypothesized that vaccination alters outcomes of patients hospitalized with COVID-19 during the Omicron wave and that these patients have different characteristics and outcomes than in previous waves. METHODS This is a substudy of the Host Response Mediators in Coronavirus (COVID-19) Infection (ARBs CORONA I) trial, which included adults admitted to hospital with acute COVID-19 up to July 2022 from 9 hospitals in British Columbia, Ontario and Quebec. We excluded emergency department visits without hospital admission, readmissions and admissions for another reason. Using adjusted regression analysis, we compared mortality and organ dysfunction between vaccinated (≥ 2 doses) and unvaccinated patients during the Omicron wave, as well as between all patients in the Omicron and first 3 waves of the COVID-19 pandemic. RESULTS During the Omicron wave, 28-day mortality was significantly lower in vaccinated (n = 19/237) than unvaccinated hospitalized patients (n = 12/127) (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.15-0.89); vaccinated patients had lower risk of admission to the intensive care unit, invasive ventilation and acute respiratory distress syndrome and shorter hospital length of stay. Patients hospitalized during the Omicron wave had more comorbidities than in previous waves, and lower 28-day mortality than in waves 1 and 2 (adjusted OR 0.38, 95% CI 0.24-0.59; and 0.42, 95% CI 0.26-0.65) but not wave 3 (adjusted OR 0.81, 95% CI 0.43-1.51) and had less organ dysfunction than in the first 2 waves. INTERPRETATION Patients who were at least double vaccinated had lower mortality than unvaccinated patients hospitalized during the Omicron wave. Patients hospitalized during the Omicron wave had more chronic disease and lower mortality than in the first 2 waves, but not wave 3. Changes in vaccination, treatments and predominant SARS-CoV-2 variant may have decreased mortality in patients hospitalized during the Omicron wave.
Collapse
Affiliation(s)
- Terry Lee
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Matthew P Cheng
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Donald C Vinh
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Todd C Lee
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Karen C Tran
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Brent W Winston
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - David Sweet
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - John H Boyd
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Keith R Walley
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Greg Haljan
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Allison McGeer
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Francois Lamontagne
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Robert Fowler
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - David M Maslove
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Joel Singer
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - David M Patrick
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - John C Marshall
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Kevin D Burns
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Srinivas Murthy
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Puneet K Mann
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Geraldine Hernandez
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - Kathryn Donohoe
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| | - James A Russell
- Centre for Health Evaluation and Outcome Science, St. Paul's Hospital, University of British Columbia (Lee, Singer), Vancouver, BC; Division of Infectious Diseases, Department of Medicine (Cheng, Vinh, Lee), McGill University Health Centre, Montréal, Que.; Division of General Internal Medicine, Vancouver General Hospital; University of British Columbia (Tran), Vancouver, BC; Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology (Winston), Foothills Medical Centre; University of Calgary, Calgary, Alta.; Division of Critical Care Medicine (Sweet), Vancouver General Hospital; University of British Columbia; Centre for Heart Lung Innovation (Boyd, Walley, Russell), St. Paul's Hospital, University of British Columbia, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia (Boyd, Walley, Russell), Vancouver, BC; Department of Medicine (Haljan), Surrey Memorial Hospital, Surrey, BC; Mt. Sinai Hospital and University of Toronto (McGeer), Toronto, Ont.; University of Sherbrooke (Lamontagne), Sherbrooke, Que.; Sunnybrook Health Sciences Centre (Fowler), Toronto, Ont.; Department of Critical Care, Kingston General Hospital and Queen's University (Maslove), Kingston, Ont.; British Columbia Centre for Disease Control and University of British Columbia (Patrick), Vancouver, BC; Department of Surgery (Marshall), St. Michael's Hospital, Toronto, Ont.; Division of Nephrology, Department of Medicine (Burns), Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ont.; BC Children's Hospital and University of British Columbia (Murthy), Vancouver, BC; Black Tusk Research Group (Mann, Hernandez, Donohoe), Vancouver, BC
| |
Collapse
|
10
|
Zhang L, Wang Z, Lyu F, Liu C, Li C, Liu W, Ma X, Zhou J, Qian X, Qian Z, Lu Y. Characterizing distinct profiles of immune and inflammatory response with age to Omicron infection. Front Immunol 2023; 14:1189482. [PMID: 37457688 PMCID: PMC10348361 DOI: 10.3389/fimmu.2023.1189482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Understanding inflammatory and immune responses to Omicron infection based on age is crucial when addressing this global health threat. However, the lacking of comprehensive elucidation hinders the development of distinct treatments tailored to different age populations. Methods 1299 cases of Omicron infection in Shanghai were enrolled between April 10, 2022 and June 3, 2022, dividing into three groups by ages: Adult group (18-59 years), Old group (60-79 years), and Elder group (≥ 80 years). Laboratory data including inflammatory cytokines, cellular, and humoral immunity were collected and analyzed. Results The mean age of Adult, Old, and Elder groups were 44.14, 69.98, and 89.35 years, respectively, with 40.9% being men. The Elder group patients exhibited higher white blood cell (WBC) counts and elevated levels of inflammatory cytokines, but their lymphocyte counts were relatively lower. In comparison to the Old group patients, the Elder group patients demonstrated significantly lower CD3+ T-cell counts, CD3+ T-cell proportion, CD4+ T-cell counts, CD8+ T-cell counts, and CD19+ B-cell counts, while the NK-cell counts were higher. Omicron negative patients displayed a higher proportion of CD19+ B-cells and higher levels of Complement-3 and IL-17 compared to the positive patients in the Old group. Omicron negative patients had lower WBC counts, CD3+CD8+ T-cells proportion, and the levels of serum amyloid A and IgA in the Elder group, but the CD4+/CD8+ ratio was higher. Conclusions Our study identified the distinct profiles of inflammatory and immune responses to Omicron infection varying with age and highlighted the diverse correlations between the levels of various biomarkers and Omicron infected/convalescent patients.
Collapse
Affiliation(s)
- Lina Zhang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhanwen Wang
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Lyu
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Chun Liu
- Respiratory and Critical Care Medicine Department, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chunhui Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Liu
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinhua Ma
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jieyu Zhou
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Xinyu Qian
- School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Zhaoxin Qian
- Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yong Lu
- Department of Radiology, Ruijin Hospital Luwan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| |
Collapse
|
11
|
Lyu S, Qian C, McIntyre A, Lee CH. One Pandemic, Two Solutions: Comparing the U.S.-China Response and Health Priorities to COVID-19 from the Perspective of "Two Types of Control". Healthcare (Basel) 2023; 11:1848. [PMID: 37444682 DOI: 10.3390/healthcare11131848] [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: 05/11/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
After three years of global rampage, the COVID-19 epidemic, the most serious infectious disease to occur worldwide since the 1918 influenza pandemic, is nearing its end. From the global experience, medical control and social control are the two main dimensions in the prevention and control of COVID-19. From the perspective of "two types of control", namely medical control and social control, this paper finds that the political system, economic structure, and cultural values of the United States greatly limit the government's ability to impose social control, forcing it to adopt medical control to fight the virus in a single dimension. In contrast, China's political system, economic structure, and cultural values allow its government to adopt stringent, extensive, and frequent social control, as well as medical control to fight the virus. This approach departs from the traditional pathway of fighting the epidemic, i.e., "infection-treatment-immunization", thereby outpacing the evolution of the virus and controlling its spread more rapidly. This finding helps explain why the Chinese government adopted a strict "zeroing" and "dynamic zeroing" policy during the first three years, at the cost of enormous economic, social, and even political legitimacy. It was not until late 2022, when the Omicron variant with the waning virulence became prevalent, that China chose to "coexist" with the virus, thus avoiding a massive epidemic-related death. While the United States adopted a pulsed-style strategy at the beginning of the epidemic, i.e., "relaxation-suppression-relaxation-suppression", and began to "coexist" with the virus in just one year, resulting in a large number of excess deaths associated with the epidemic. The study contributes to explaining the difference in the interplay between public health priorities and COVID-19 response strategies in China and the United States, based on the specific public health context and the perspective of "medical control" and "social control".
Collapse
Affiliation(s)
- Shupeng Lyu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| | - Chen Qian
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| | - Aaron McIntyre
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| | - Ching-Hung Lee
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| |
Collapse
|
12
|
Moyers SA, Hartwell M, Chiaf A, Greiner B, Oliver JA, Croff JM. Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey. Tob Use Insights 2023; 16:1179173X231179675. [PMID: 37324057 PMCID: PMC10262671 DOI: 10.1177/1179173x231179675] [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: 01/30/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).
Collapse
Affiliation(s)
- Susette A Moyers
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Ashleigh Chiaf
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie M Croff
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| |
Collapse
|
13
|
Yang Y, You Y, Liu Y, Geng L, Huang L, Zhou H, Piao X, Liu X, Wu M, Wang Y, Zhou L, Wang P, Shen S, Hu M, Han Z, Xue Z. Factors associated with negative conversion of viral RNA in hospitalized children infected with SARS-CoV-2 Omicron variant in Shanghai, China: a retrospective analysis. BMC Infect Dis 2023; 23:264. [PMID: 37101288 PMCID: PMC10132404 DOI: 10.1186/s12879-023-08223-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
OBJECTIVES This study aimed to identify the related risk factors and potential predictors of SARS-CoV-2 RNA negative conversion by describing the dynamics of viral shedding in infected children admitted to two hospitals from Shanghai during the Omicron variant outbreak. METHODS This retrospective cohort included laboratory-confirmed cases of SARS-CoV-2 infection from Shanghai between March 28 and May 31, 2022. Clinical characteristics, personal vaccination, and household vaccination rates were collected through electronic health records and telephone interviews. RESULTS A total of 603 paediatric patients confirmed to have COVID-19 were included in this study. Both univariate and multivariate analyses were performed to filter independent factors for the duration to viral RNA negative conversion. Data on the redetection of SARS-CoV-2 in the patients after they showed negative results on the RT‒PCR test (intermittent negative status) were also analysed. The median duration of virus shedding was 12 (interquartile range, IQR: 10-14) days. The severity of clinical outcome, personal vaccination-2doses, household vaccination rates, and abnormal defecation were factors indecently affecting negative conversion of SARS-CoV-2 RNA, suggesting that patients who had abnormal defecation or with more severe conditions would have delayed virological clearance, while patients who previously had 2 doses of vaccination or had higher household vaccination rates would have accelerated virological clearance. Loss of appetite (odds ratio (OR): 5.343; 95% CI: 3.307-8.632) and abnormal defecation (OR: 2.840; 95% CI: 1.736-4.645) were significantly associated with intermittent negative status. CONCLUSION These findings could provide clues for the early identification of paediatric patients with prolonged viral shedding and could enrich the evidence for the development of prevention and control strategies, especially vaccination policies for children and adolescents.
Collapse
Affiliation(s)
- Yan Yang
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Yannan You
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Yazun Liu
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Lina Geng
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Lirong Huang
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Huan Zhou
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Xiang Piao
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Xiao Liu
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Mingyun Wu
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Yajuan Wang
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Lili Zhou
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Peng Wang
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Shiping Shen
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Mingge Hu
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Zhaopeng Han
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China
| | - Zheng Xue
- Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, 200040, China.
| |
Collapse
|
14
|
Rahman MS, Hoque MN, Chowdhury SR, Siddique MM, Islam OK, Galib SM, Islam MT, Hossain MA. Temporal dynamics and fatality of SARS-CoV-2 variants in Bangladesh. Health Sci Rep 2023; 6:e1209. [PMID: 37077184 PMCID: PMC10108430 DOI: 10.1002/hsr2.1209] [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: 01/11/2023] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/21/2023] Open
Abstract
Background and Aims Since the beginning of the SARS-CoV-2 pandemic, multiple new variants have emerged posing an increased risk to global public health. This study aimed to investigate SARS-CoV-2 variants, their temporal dynamics, infection rate (IFR) and case fatality rate (CFR) in Bangladesh by analyzing the published genomes. Methods We retrieved 6610 complete whole genome sequences of the SARS-CoV-2 from the GISAID (Global Initiative on Sharing all Influenza Data) platform from March 2020 to October 2022, and performed different in-silico bioinformatics analyses. The clade and Pango lineages were assigned by using Nextclade v2.8.1. SARS-CoV-2 infections and fatality data were collected from the Institute of Epidemiology Disease Control and Research (IEDCR), Bangladesh. The average IFR was calculated from the monthly COVID-19 cases and population size while average CFR was calculated from the number of monthly deaths and number of confirmed COVID-19 cases. Results SARS-CoV-2 first emerged in Bangladesh on March 3, 2020 and created three pandemic waves so far. The phylogenetic analysis revealed multiple introductions of SARS-CoV-2 variant(s) into Bangladesh with at least 22 Nextstrain clades and 107 Pangolin lineages with respect to the SARS-CoV-2 reference genome of Wuhan/Hu-1/2019. The Delta variant was detected as the most predominant (48.06%) variant followed by Omicron (27.88%), Beta (7.65%), Alpha (1.56%), Eta (0.33%) and Gamma (0.03%) variant. The overall IFR and CFR from circulating variants were 13.59% and 1.45%, respectively. A time-dependent monthly analysis showed significant variations in the IFR (p = 0.012, Kruskal-Wallis test) and CFR (p = 0.032, Kruskal-Wallis test) throughout the study period. We found the highest IFR (14.35%) in 2020 while Delta (20A) and Beta (20H) variants were circulating in Bangladesh. Remarkably, the highest CFR (1.91%) from SARS-CoV-2 variants was recorded in 2021. Conclusion Our findings highlight the importance of genomic surveillance for careful monitoring of variants of concern emergence to interpret correctly their relative IFR and CFR, and thus, for implementation of strengthened public health and social measures to control the spread of the virus. Furthermore, the results of the present study may provide important context for sequence-based inference in SARS-CoV-2 variant(s) evolution and clinical epidemiology beyond Bangladesh.
Collapse
Affiliation(s)
- M. Shaminur Rahman
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - M. Nazmul Hoque
- Department of Gynecology, Obstetrics and Reproductive HealthBangabandhu Sheikh Mujibur Rahman Agricultural UniversityGazipurBangladesh
| | - Susmita Roy Chowdhury
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Md. Moradul Siddique
- Department of Computer Science and EngineeringJashore University of Science and TechnologyJashoreBangladesh
| | - Ovinu Kibria Islam
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - Syed Md. Galib
- Department of Computer Science and EngineeringJashore University of Science and TechnologyJashoreBangladesh
| | - Md. Tanvir Islam
- Department of MicrobiologyJashore University of Science and TechnologyJashoreBangladesh
| | - M. Anwar Hossain
- Department of MicrobiologyUniversity of DhakaDhakaBangladesh
- Jashore University of Science and TechnologyJashoreBangladesh
| |
Collapse
|
15
|
Goetz RL, Nellore A, Geer JT, Rusanov V, Wille K, Scullin D, Orozco-Hernandez E, Gongora E, Hoopes CW, Kaleekal TS. Bilateral Lung Transplantation With Donor Positive for COVID-19 Infection on Bronchoalveolar Lavage: A Case Report. Transplant Proc 2023; 55:540-542. [PMID: 36740511 PMCID: PMC9701633 DOI: 10.1016/j.transproceed.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/31/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022]
Abstract
Initial experience with lung transplant of COVID-19-positive donors was marked by disappointing results, including a reported case of mortality through donor to recipient transmission of infection. However, since that time a number of improvements in preventative and therapeutic measures against COVID-19 have been developed. We present the case of a 51-year-old woman with scleroderma-associated interstitial lung disease who was awaiting lung transplant. A potential donor with excellent lung physiology was located; however, initial testing on bronchoalveolar lavage (BAL) was positive for COVID-19. The donor had tested positive 2 weeks prior and had symptomatically recovered. Our patient had been fully vaccinated but not seroconverted. Given the history of a donor with recovering COVID infection and a fully immunized recipient, our multidisciplinary team elected to proceed with the transplant. The patient successfully underwent bilateral lung transplant with standard induction immunosuppression. Bebtelovimab was given post-transplant day 1 because the recipient remained seronegative to COVID-19. Serial bronchoalveolar lavages post transplant have been negative for COVID-19. The patient has done well after transplant. She was seen in the clinic 2 months post transplant and is ambulatory without supplemental oxygen requirements. To our knowledge, this represents the first reported successful case of lung transplant with a donor positive for COVID-19 on lower respiratory tract sampling.
Collapse
Affiliation(s)
- Ryan L Goetz
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama.
| | - Anoma Nellore
- Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Jack T Geer
- Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Victoria Rusanov
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Keith Wille
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Daniel Scullin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| | - Erik Orozco-Hernandez
- Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama Birmingham, Birmingham, Alabama
| | - Enrique Gongora
- Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama Birmingham, Birmingham, Alabama
| | - Charles W Hoopes
- Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama Birmingham, Birmingham, Alabama
| | - Thomas S Kaleekal
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama
| |
Collapse
|
16
|
Tartof SY, Slezak JM, Puzniak L, Hong V, Frankland TB, Xie F, Ackerson BK, Valluri SR, Jodar L, McLaughlin JM. Effectiveness and durability of BNT162b2 vaccine against hospital and emergency department admissions due to SARS-CoV-2 omicron sub-lineages BA.1 and BA.2 in a large health system in the USA: a test-negative, case-control study. THE LANCET. RESPIRATORY MEDICINE 2023; 11:176-187. [PMID: 36216013 PMCID: PMC9765328 DOI: 10.1016/s2213-2600(22)00354-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The SARS-CoV-2 omicron (B.1.1.529 BA.1) lineage was first detected in November, 2021, and is associated with reduced vaccine effectiveness. By March, 2022, BA.1 had been replaced by sub-lineage BA.2 in the USA. As new variants evolve, vaccine performance must be continually assessed. We aimed to evaluate the effectiveness and durability of BNT162b2 (Pfizer-BioNTech) against hospital and emergency department admissions for BA.1 and BA.2. METHODS In this test-negative, case-control study, we sourced data from the electronic health records of adult (aged ≥18 years) members of Kaiser Permanente Southern California (KPSC), which is a health-care system in the USA, who were admitted to one of 15 KPSC hospitals or emergency departments (without subsequent hospitalisation) between Dec 27, 2021, and June 4, 2022, with an acute respiratory infection and were tested for SARS-CoV-2 by RT-PCR. Omicron sub-lineage was determined by use of sequencing, spike gene target failure, and the predominance of variants in certain time periods. Our main outcome was the effectiveness of two or three doses of BNT162b2 in preventing emergency department or hospital admission. Variant-specific vaccine effectiveness was evaluated by comparing the odds ratios from logistic regression models of vaccination between test-positive cases and test-negative controls, adjusting for the month of admission, age, sex, race and ethnicity, body-mass index, Charlson Comorbidity Index, previous influenza or pneumococcal vaccines, and previous SARS-CoV-2 infection. We also assessed effectiveness by the time since vaccination. This study is registered at ClinicalTrials.gov, NCT04848584, and is ongoing. FINDINGS Of 65 813 total admissions during the study period, we included 16 994 in our analyses, of which 7435 were due to BA.1, 1056 were due to BA.2, and 8503 were not due to SARS-CoV-2. In adjusted analyses, two-dose vaccine effectiveness was 40% (95% CI 27 to 50) for hospitalisation and 29% (18 to 38) for emergency department admission against BA.1 and 56% (31 to 72) for hospitalisation and 16% (-5 to 33) for emergency department admission against BA.2. Three-dose vaccine effectiveness was 79% (74 to 83) for hospitalisation and 72% (67 to 77) for emergency department admission against BA.1 and 71% (55 to 81) for hospitalisation and 21% (1 to 37) for emergency department admission against BA.2. Less than 3 months after the third dose, vaccine effectiveness was 80% (74 to 84) for hospitalisation and 74% (69 to 78) for emergency department admission against BA.1. Vaccine effectiveness 3 months or more after the third dose was 76% (69 to 82) against BA.1-related hospitalisation and 65% (56 to 73) against BA.1-related emergency department admission. Against BA.2, vaccine effectiveness was 74% (47 to 87) for hospitalisation and 59% (40 to 72) for emergency department admission at less than 3 months after the third dose and 70% (53 to 81) for hospitalisation and 5% (-21 to 25) for emergency department admission at 3 months or more after the third dose. INTERPRETATION Two doses of BNT162b2 provided only partial protection against BA.1-related and BA.2-related hospital and emergency department admission, which underscores the need for booster doses against omicron. Although three doses offered high levels of protection (≥70%) against hospitalisation, variant-adapted vaccines are probably needed to improve protection against less severe endpoints, like emergency department admission, especially for BA.2. FUNDING Pfizer.
Collapse
Affiliation(s)
- Sara Y Tartof
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
| | - Jeff M Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | - Vennis Hong
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Timothy B Frankland
- Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | - Fagen Xie
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | | | | | | |
Collapse
|
17
|
Zárate S, Taboada B, Rosales-Rivera M, García-López R, Muñoz-Medina JE, Sanchez-Flores A, Herrera-Estrella A, Gómez-Gil B, Selem Mojica N, Salas-Lais AG, Vazquez-Perez JA, Cabrera-Gaytán DA, Fernandes-Matano L, Uribe-Noguez LA, Chale-Dzul JB, Maldonado Meza BI, Mejía-Nepomuceno F, Pérez-Padilla R, Gutiérrez-Ríos RM, Loza A, Roche B, López S, Arias CF. Omicron-BA.1 Dispersion Rates in Mexico Varied According to the Regional Epidemic Patterns and the Diversity of Local Delta Subvariants. Viruses 2023; 15:243. [PMID: 36680283 PMCID: PMC9863047 DOI: 10.3390/v15010243] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The Omicron subvariant BA.1 of SARS-CoV-2 was first detected in November 2021 and quickly spread worldwide, displacing the Delta variant. In this work, a characterization of the spread of this variant in Mexico is presented. METHODS The time to fixation of BA.1, the diversity of Delta sublineages, the population density, and the level of virus circulation during the inter-wave interval were determined to analyze differences in BA.1 spread. RESULTS BA.1 began spreading during the first week of December 2021 and became dominant in the next three weeks, causing the fourth COVID-19 epidemiological surge in Mexico. Unlike previous variants, BA.1 did not exhibit a geographically distinct circulation pattern. However, a regional difference in the speed of the replacement of the Delta variant was observed. CONCLUSIONS Viral diversity and the relative abundance of the virus in a particular area around the time of the introduction of a new lineage seem to have influenced the spread dynamics, in addition to population density. Nonetheless, if there is a significant difference in the fitness of the variants, or if the time allowed for the competition is sufficiently long, it seems the fitter virus will eventually become dominant, as observed in the eventual dominance of the BA.1.x variant in Mexico.
Collapse
Affiliation(s)
- Selene Zárate
- Posgrado en Ciencias Genómicas, Universidad Autónoma de la Ciudad de México, Mexico City 03100, Mexico
| | - Blanca Taboada
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Mauricio Rosales-Rivera
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Rodrigo García-López
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - José Esteban Muñoz-Medina
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Mexico City 07760, Mexico
| | - Alejandro Sanchez-Flores
- Unidad Universitaria de Secuenciación Masiva y Bioinformática, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Alfredo Herrera-Estrella
- Laboratorio Nacional de Genómica Para la Biodiversidad-Unidad de Genómica Avanzada, Centro de Investigación y de Estudios Avanzados del IPN, Irapuato 36821, Mexico
| | - Bruno Gómez-Gil
- Centro de Investigación en Alimentación y Desarrollo AC, Coordinación Regional Mazatlán, Acuicultura y Manejo Ambiental, Mazatlan 82100, Mexico
| | - Nelly Selem Mojica
- Centro de Ciencias Matemáticas, Universidad Nacional Autónoma de México, Morelia 58089, Mexico
| | - Angel Gustavo Salas-Lais
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Mexico City 07760, Mexico
| | - Joel Armando Vazquez-Perez
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México City 14080, Mexico
| | - David Alejandro Cabrera-Gaytán
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Mexico City 07760, Mexico
| | - Larissa Fernandes-Matano
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Mexico City 07760, Mexico
| | - Luis Antonio Uribe-Noguez
- Laboratorio Central de Epidemiología, Instituto Mexicano del Seguro Social, Mexico City, 02990, Mexico
| | - Juan Bautista Chale-Dzul
- Unidad de Investigación Médica Yucatán, Instituto Mexicano del Seguro Social, Merida 97150, Mexico
| | | | - Fidencio Mejía-Nepomuceno
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México City 14080, Mexico
| | - Rogelio Pérez-Padilla
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México City 14080, Mexico
| | - Rosa María Gutiérrez-Ríos
- Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Antonio Loza
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Benjamin Roche
- Infectious Diseases: Vector, Control, Genetic, Ecology and Evolution (MIVEGEC) Université de Montpellier, IRD, CNRS, 34090 Montpellier, France
| | - Susana López
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| | - Carlos F. Arias
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico
| |
Collapse
|
18
|
Liu L, Xie S, Li C, Su L, Zhu C. Effect of nasal irrigation in adults infected with Omicron variant of COVID-19: A quasi-experimental study. Front Public Health 2023; 10:1046112. [PMID: 36699894 PMCID: PMC9868717 DOI: 10.3389/fpubh.2022.1046112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To investigate the effect of nasal irrigation on the duration of symptoms and nucleic acid conversion in adults infected with the Omicron variant of COVID-19. Methods This quasi-experimental study enrolled patients diagnosed with asymptomatic, mild, or moderate Omicron infection at the Shandong Public Health Clinical Center between April 1, 2022 and May 1, 2022. Patients were divided into two groups to receive Lianhua Qingwen granules and traditional Chinese medicine (TCM) prescriptions (conventional group) and 3% hypertonic saline nasal irrigation based on conventional treatment (nasal irrigation groups), respectively. Primary outcomes were symptom disappearance time and nucleic acid negative conversion time. Secondary outcomes were peripheral blood white blood cell (WBC), lymphocyte (LYM) count, neutrophil (NEU) count, C-reactive protein (CRP) level, and chest CT examination findings. Results Eighty patients were included (40 patients/group). Multiple linear regression analysis showed that, after adjustment for comorbidities, smoking history, LYM count, and Ct values of N gene, the patients in the nasal irrigation group were more likely to get lower nucleic acid negative conversion time (β = -11.052, 95% CI: -8.277-13.827, P < 0.001) compared with the conventional group. The symptom disappearance time showed no significant improvement (P > 0.05). Subgroup analysis for treatment-naïve patients in the nasal irrigation group showed similar nucleic acid negative conversion time improvement (P = 0.038). Conclusion Early nasal irrigation shortens the nucleic acid negative conversion time in adults infected with the Omicron variant but without improvements in symptom disappearance time.
Collapse
Affiliation(s)
- Li Liu
- Department of Digestive Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Shuangshuang Xie
- Department of Digestive Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Cheng Li
- Department of Digestive Diseases, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Liang Su
- Department of Medical Service, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| | - Chengbao Zhu
- Department of Clinical Laboratory, Shandong Public Health Clinical Center, Shandong University, Jinan, China
| |
Collapse
|
19
|
Zhu J, Zhu GP, Weng YM, Zhang Y, Li BX. Clinical Practice and Effectiveness Analysis of the Management of Corona Virus Disease 2019 Infected at Shanghai Fangcang Shelter Hospital: A Descriptive Study. Risk Manag Healthc Policy 2023; 16:337-346. [PMID: 36883054 PMCID: PMC9985874 DOI: 10.2147/rmhp.s403414] [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: 01/02/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Background The Fangcang shelter hospital has gradually become the primary management mode in China's fight against this Corona Virus Disease 2019 (COVID-19) in 2020. In early 2022, the Fangcang shelter hospital management model was successfully applied to the new outbreak of COVID-19 in Shanghai also. Although Fangcang shelter hospitals are no longer the prevailing mode of prevention of COVID-19, the management experience of Shanghai makeshift hospitals is worthy of reference for public health. Methods The authors conducted a descriptive statistical analysis of Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. The whole hall of the Fangcang shelter hospital was managed by the one hospital, and the inclusion of third-party management personnel alleviated the shortage of medical personnel human resources. Through practice, a new procedure for treating batch infected people was introduced. Results By optimizing ward management, 72 on-duty doctors, 360 on-duty nurses, 3 sense-control administrators, and 15 administrators cured 18,574 infected people in 40 days, and created a record of a doctor managing 700 infected people without compromising the quality of treatment. There have been no deaths and no complaints from the infected people located in Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. Conclusion Compared with previous data, the new management mode of Fangcang shelter hospitals provides a reference for the management of the new infectious diseases for public health.
Collapse
Affiliation(s)
- Jian Zhu
- Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Guang-Ping Zhu
- Department of Endocrinology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Yan-Ming Weng
- Department of Stomatology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Yong Zhang
- Department of Integrative Medicine, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, People's Republic of China
| | - Bi-Xi Li
- Department of Anesthesiology, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, Hubei Province, People's Republic of China
| |
Collapse
|
20
|
Solante R, Alvarez-Moreno C, Burhan E, Chariyalertsak S, Chiu NC, Chuenkitmongkol S, Dung DV, Hwang KP, Ortiz Ibarra J, Kiertiburanakul S, Kulkarni PS, Lee C, Lee PI, Lobo RC, Macias A, Nghia CH, Ong-Lim AL, Rodriguez-Morales AJ, Richtmann R, Safadi MAP, Satari HI, Thwaites G. Expert review of global real-world data on COVID-19 vaccine booster effectiveness and safety during the omicron-dominant phase of the pandemic. Expert Rev Vaccines 2023; 22:1-16. [PMID: 36330971 DOI: 10.1080/14760584.2023.2143347] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, the emergence of the Omicron variant and subvariants as the globally dominant strains have raised doubts about the effectiveness of currently available vaccines and prompted debate about potential future vaccination strategies. AREAS COVERED Using the publicly available IVAC VIEW-hub platform, we reviewed 52 studies on vaccine effectiveness (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease and death and stratified by vaccine schedule and age. In addition, a non-systematic literature review of safety was performed to identify single or multi-country studies investigating adverse event rates for at least two of the currently available COVID-19 vaccines. EXPERT OPINION Booster shots of the current COVID-19 vaccines provide consistently high protection against Omicron-related severe disease and death. Additionally, this protection appears to be conserved for at least 3 months, with a small but significant waning after that. The positive risk-benefit ratio of these vaccines is well established, giving us confidence to administer additional doses as required. Future vaccination strategies will likely include a combination of schedules based on risk profile, as overly frequent boosting may be neither beneficial nor sustainable for the general population.
Collapse
Affiliation(s)
| | - Carlos Alvarez-Moreno
- Infectious Diseases Unit, Facultad de Medicina. Universidad Nacional de Colombia. Clinica Universitaria Colombia, Clínica Colsanitas, Colombia
| | - Erlina Burhan
- Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia
| | | | | | | | - D V Dung
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kao-Pin Hwang
- China Medical University Children's Hospital, Taichung, Taiwan
| | - Javier Ortiz Ibarra
- Médico Hospital Materno Perinatal Monica Pretelini Sáez, Toluca de Lerdo, México
| | | | | | | | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | - Anna Lisa Ong-Lim
- College of Medicine - Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Alfonso J Rodriguez-Morales
- Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Risaralda, Colombia & Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | - Rosana Richtmann
- Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Brazil
| | | | - Hindra Irawan Satari
- Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, Universitas Indonesia, Cipto Mangunkusumo Hospital, Indonesia
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, and The Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
21
|
Amodio E, Genovese D, Fallucca A, Ferro P, Sparacia B, D’Azzo L, Fertitta A, Maida CM, Vitale F. Clinical Severity in Different Waves of SARS-CoV-2 Infection in Sicily: A Model of Smith's "Law of Declining Virulence" from Real-World Data. Viruses 2022; 15:125. [PMID: 36680165 PMCID: PMC9867301 DOI: 10.3390/v15010125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The COVID-19 epidemic had a rapid spread worldwide with a continuous and fast mutation of the virus, resulting in the emergence of several variants of concern (VOC). The aim of this study was to evaluate the severity of each VOC among SARS-CoV-2 infected subjects by investigating deaths, ICU admissions, intubations, and severe critical symptoms. METHODS An ecological observational study was performed to evaluate mortality rates and clinical characteristics of 321,490 unvaccinated Sicilian SARS-CoV-2 cases observed from 2 March 2020 to 27 March 2022. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by multivariate logistic regression analysis evaluating factors determining a clinical worsening. RESULTS Delta (adj-OR 3.00, 95% Cls 2.70-3.33) and wild-type (adj-OR 2.41, 95% Cls 2.2-2.62) variants had a higher risk than the Omicron strain for developing critical COVID-19 necessitating intubation and eventually undergoing death. Moreover, males appeared to be significantly more susceptible to developing the worst clinical outcome considered, as did older subjects. CONCLUSIONS The present study provides evidence of factors implicated in the worsening of SARS-CoV-2-infection-related clinical outcomes. The study highlighted the different roles of VOC, in particular Delta and wild-type, and being male and elderly in the development of a worse clinical outcome.
Collapse
Affiliation(s)
| | - Dario Genovese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Lei N, Li BX, Zhang KF, Bao H, Ding J, Wang Y. Analysis of the Protective Effect of Infection Controllers Supervising Third-Party Personnel Entering and Leaving Shanghai Fangcang Shelter Hospital. Infect Drug Resist 2022; 15:7519-7527. [PMID: 36570712 PMCID: PMC9788835 DOI: 10.2147/idr.s388707] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To analyze the impact of the new supervision and management methods of infection controllers on the protection of third-party personnel entering and leaving Shanghai Fangcang shelter hospital, to provide a reference for the management of third-party personnel in Fangcang shelter hospitals. Methods A total of 200 third-party personnel received with traditional supervision and management methods, and 156 received new supervision and management methods from the Fangcang shelter hospital of the Shanghai International Convention and Exhibition Center. The sociodemographic characteristics of third-party personnel, including gender, age, education level, work experience in fighting the epidemic with safety awareness, was analyzed. The effects of the two different management modes on the protection of third-party personnel were statistically analyzed by the Chi-square test or logistic regression analysis. Results There were statistically significant differences in the incidence of infection among third-party personnel in terms of age, education level, work experience in fighting the epidemic in traditional supervision and management group, and whether they accepted the new supervision and management model had statistically significant differences (p <0.05). The main causes of incorrect put on and take off protective clothing, such as wrong way to detach the face screen, wrong way to remove goggles, wrong way to undress protective clothing, wrong way to take off the shoe cover, hand washing steps omitted, are that causes infection of third-party personnel (p <0.05). Conclusion The new supervision and management model can reduce the infection rate of third-party personnel in Fangcang shelter hospitals through planned and purposeful training in terms of different age groups, education levels, work experience, and acceptance of protection knowledge.
Collapse
Affiliation(s)
- Na Lei
- Department of Disinfection and Supply, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Bi-Xi Li
- Department of Anesthesiology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Kai-Fen Zhang
- Department of Outpatient, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Hui Bao
- Department of Urology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| | - Jian Ding
- Department of Disinfection and Supply, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China,Correspondence: Jian Ding; Yan Wang, Department of Disinfection and Supply, General Hospital of Central Theater Command of the People’s Liberation Army, 627#, Wuluo Road, Wuchang District, Wuhan, 430070, People’s Republic of China, Tel +86-18971123442, Fax +86-27-50772953, Email ;
| | - Yan Wang
- Department of Disinfection and Supply, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, People’s Republic of China
| |
Collapse
|
23
|
Zhang P, Cai Z, He Z, Chen P, Wu W, Lin Y, Feng S, Peng L, Li J, Yuan J, Yang L, Wang F, Liu Y, Lu H. Analysis of 394 COVID-19 cases infected with Omicron variant in Shenzhen: impact of underlying diseases to patient's symptoms. Eur J Med Res 2022; 27:291. [PMID: 36522750 PMCID: PMC9751512 DOI: 10.1186/s40001-022-00927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The emergence of new variants of SARS-CoV-2 is continuously posing pressure to the epidemic prevention and control in China. The Omicron variant of SARS-CoV-2 having stronger infectivity, immune escape ability, and capability causing repetitive infection spread to many countries and regions all over the world including South Africa, United States and United Kingdom etc., in a short time. The outbreaks of Omicron variant also occurred in China. The aim of this study is to understand the epidemiological characteristics of Omicron variant infection in Shenzhen and to provide scientific basis for effective disease control and prevention. METHODS The clinical data of 394 imported COVID-19 cases infected with Omicron variant from 16 December 2021 to 24 March 2022 admitted to the Third People's hospital of Shenzhen were collected and analyzed retrospectively. Nucleic acid of SARS-CoV-2 of nasopharyngeal swabs and blood samples was detected using 2019-nCoV nucleic acid detection kit. Differences in Ct values of N gene were compared between mild group and moderate group. The specific IgG antibody was detected using 2019-nCoV IgG antibody detection kit. Statistical analysis was done using SPSS software and graphpad prism. RESULTS Patients were categorized into mild group and moderate group according to disease severity. The data on the general conditions, underlying diseases, COVID-19 vaccination and IgG antibody, viral load, laboratory examination results, and duration of hospitalization, etc., were compared among disease groups. Mild gorup had higher IgG level and shorter nucleic acid conversion time. Patients with underlying diseases have 4.6 times higher probability to progress to moderate infection. CONCLUSION In terms of epidemic prevention, immunization coverage should be strengthened in the population with underlying diseases. In medical institutions, more attention needs to be paid to such vulnerable population and prevent further deterioration of the disease.
Collapse
Affiliation(s)
- Peiyan Zhang
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Zhao Cai
- School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Zhiguang He
- Luohu Clinical Institute of Shantou University Medical College, Shantou, China
| | - Peifen Chen
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Weibo Wu
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Yuanlong Lin
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Shiyan Feng
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Ling Peng
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Jianming Li
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Jing Yuan
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Liang Yang
- School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China
- National Clinical Research Center for Infectious Disease, Shenzhen, 518112, China
- Shenzhen Key Laboratory for Gene Regulation and Systems Biology, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Fuxiang Wang
- Department of Infectious Diseases, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Yingxia Liu
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| |
Collapse
|
24
|
Canetti M, Barda N, Gilboa M, Indenbaum V, Mandelboim M, Gonen T, Asraf K, Weiss-Ottolenghi Y, Amit S, Doolman R, Mendelson E, Harats D, Freedman LS, Kreiss Y, Lustig Y, Regev-Yochay G. Immunogenicity and efficacy of fourth BNT162b2 and mRNA1273 COVID-19 vaccine doses; three months follow-up. Nat Commun 2022; 13:7711. [PMID: 36513665 PMCID: PMC9745767 DOI: 10.1038/s41467-022-35480-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Booster doses for the ongoing COVID-19 pandemic are under consideration in many countries. We report a three-month follow-up of 700 participants in a fourth vaccine dose study, comparing BNT162b2 and mRNA1273, administered four months after a third BNT162b2 dose. The primary outcomes are the levels of IgG, neutralizing antibodies, and microneutralization and the secondary outcomes are the levels of IgA and T cell activation, and clinical outcomes of SARS-CoV-2 infection and substantial symptomatic disease. Waning of the immune response is evident during follow-up, with an 11% (β = 0.89, 95% CI, 0.88-0.9) and 21% (β = 0.79, 95% CI, 0.76-0.82) multiplicative decay per week of IgG and neutralizing antibodies, respectively, in the mRNA1273 group, and of 14% (β = 0.86, 95% CI, 0.86-0.87) and 26% (β = 0.74, 95% CI, 0.72-0.76), respectively, in the BNT162b2 group. Direct neutralization of Omicron variants is low relative to ancestral strains. Cumulatively over the study period, both vaccines show little efficacy against infection but were highly efficacious against substantial symptomatic disease [89% [(IRR 0.11, 95% CI, 0.02-0.37) and 71% (IRR 0.29, 95% CI, 0.13-0.57) for mRNA1273 and BNT162b2, respectively]. These results are informative for further boosting policy-making. Trial registration numbers (clinicaltrials.gov): NCT05231005 and NCT05230953.
Collapse
Affiliation(s)
- Michal Canetti
- The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Noam Barda
- ARC Innovation Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Software and Information Systems Engineering, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Mayan Gilboa
- The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Victoria Indenbaum
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
| | - Michal Mandelboim
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
| | - Tal Gonen
- The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Keren Asraf
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Yael Weiss-Ottolenghi
- The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Sharon Amit
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Clinical Microbiology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ram Doolman
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Ella Mendelson
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
| | - Dror Harats
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Laurence S Freedman
- Biostatistics and Biomathematics Unit, Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Yitshak Kreiss
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Yaniv Lustig
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan, Israel
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Gili Regev-Yochay
- The Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| |
Collapse
|
25
|
Evolution and Control of COVID-19 Epidemic in Hong Kong. Viruses 2022; 14:v14112519. [PMID: 36423128 PMCID: PMC9698160 DOI: 10.3390/v14112519] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Hong Kong SAR has adopted universal masking, social distancing, testing of all symptomatic and high-risk groups for isolation of confirmed cases in healthcare facilities, and quarantine of contacts as epidemiological control measures without city lockdown or border closure. These measures successfully suppressed the community transmission of pre-Omicron SARS-CoV-2 variants or lineages during the first to the fourth wave. No nosocomial SARS-CoV-2 infection was documented among healthcare workers in the first 300 days. The strategy of COVID-19 containment was adopted to provide additional time to achieve population immunity by vaccination. The near-zero COVID-19 situation for about 8 months in 2021 did not enable adequate immunization of the eligible population. A combination of factors was identified, especially population complacency associated with the low local COVID-19 activity, together with vaccine hesitancy. The importation of the highly transmissible Omicron variant kickstarted the fifth wave of COVID-19, which could no longer be controlled by our initial measures. The explosive fifth wave, which was partially contributed by vertical airborne transmission in high-rise residential buildings, resulted in over one million cases of infection. In this review, we summarize the epidemiology of COVID-19 and the infection control and public health measures against the importation and dissemination of SARS-CoV-2 until day 1000.
Collapse
|
26
|
Chen X, Yan X, Sun K, Zheng N, Sun R, Zhou J, Deng X, Zhuang T, Cai J, Zhang J, Ajelli M, Yu H. Estimation of disease burden and clinical severity of COVID-19 caused by Omicron BA.2 in Shanghai, February-June 2022. Emerg Microbes Infect 2022; 11:2800-2807. [PMID: 36205530 DOI: 10.1080/22221751.2022.2128435] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
An outbreak of COVID-19 caused by the SARS-CoV-2 Omicron BA.2 sublineage occurred in Shanghai, China from February 26 to June 30, 2022. We use official reported data retrieved from Shanghai municipal Health Commissions to estimate the incidence of infections, severe/critical infections, and deaths to assess the disease burden. By adjusting for right censoring and RT PCR sensitivity, we provide estimates of clinical severity, including the infection fatality ratio, symptomatic case fatality ratio, and risk of developing severe/critical disease upon infection. The overall infection rate, severe/critical infection rate, and mortality rate were 2.74 (95% CI: 2.73-2.74) per 100 individuals, 6.34 (95% CI: 6.02-6.66) per 100,000 individuals and 2.42 (95% CI: 2.23-2.62) per 100,000 individuals, respectively. The severe/critical infection rate and mortality rate increased with age, noted in individuals aged 80 years or older. The overall fatality ratio and risk of developing severe/critical disease upon infection were 0.09% (95% CI: 0.09-0.10%) and 0.27% (95% CI: 0.24-0.29%), respectively. Having received at least one vaccine dose led to a 10-fold reduction in the risk of death for infected individuals aged 80 years or older. Under the repeated population-based screenings and strict intervention policies implemented in Shanghai, our results found a lower disease burden and mortality of the outbreak compared to other settings and countries, showing the impact of the successful outbreak containment in Shanghai. The estimated low clinical severity of this Omicron BA.2 epidemic in Shanghai highlight the key contribution of vaccination and availability of hospital beds to reduce the risk of death.
Collapse
Affiliation(s)
- Xinhua Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xuemei Yan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Kaiyuan Sun
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Nan Zheng
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ruijia Sun
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaxin Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xiaowei Deng
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Tingyu Zhuang
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jun Cai
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Juanjuan Zhang
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Hongjie Yu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China.,Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| |
Collapse
|
27
|
Wang C, Liu B, Zhang S, Huang N, Zhao T, Lu Q, Cui F. Differences in incidence and fatality of COVID-19 by SARS-CoV-2 Omicron variant versus Delta variant in relation to vaccine coverage: A world-wide review. J Med Virol 2022; 95:e28118. [PMID: 36056540 PMCID: PMC9537802 DOI: 10.1002/jmv.28118] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/13/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023]
Abstract
We aim to evaluate the evolution differences in the incidence and case fatality rate (CFR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants. The average incidence and CFRs were described between different countries. A gamma generalized linear mixed model (GLMM) was used to compare the CFRs of Delta and Omicron variants based on vaccination coverage. Totally, 50 countries were included for analyses. The incidence of coronavirus disease 2019 (COVID-19) ranged from 0.16/100,000 to 82.95/100,000 during the Delta period and 0.03/100,000 to 440.88/100,000 during the Omicron period. The median CFRs were 8.56 (interquartile range [IQR]: 4.76-18.39) during the Delta period and 3.04 (IQR: 1.87-7.48) during the Omicron period, respectively. A total of 47 out of 50 countries showed decreased CFRs of the Omicron variant with the rate ratio ranging from 0.02 (95% confidence interval [CI]: 0.01-0.03) (in Cambodia) to 0.97 (95% CI: 0.87-1.08) (in Ireland). Gamma GLMM analysis showed that the decreased CFR was largely a result of the decreased pathogenicity of Omicron besides the increased vaccination coverage. The Omicron variant shows a higher incidence but a lower CFR around the world as a whole, which is mainly a result of the decreased pathogenicity by SARS-CoV-2's mutation, while the vaccination against SARS-CoV-2 still acts as a valuable measure in preventing people from death.
Collapse
Affiliation(s)
- Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingPeople's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Ninghua Huang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Qing‐Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| |
Collapse
|
28
|
Richter J, Koptides D, Tryfonos C, Alexandrou D, Christodoulou C. Introduction, Spread and Impact of the SARS-CoV-2 Omicron Variants BA.1 and BA.2 in Cyprus. Microorganisms 2022; 10:1688. [PMID: 36144290 PMCID: PMC9503937 DOI: 10.3390/microorganisms10091688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/05/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to investigate and obtain insights into the appearance, spread and impact of the Omicron variants and their sub-lineages in Cyprus by analyzing 611 high-coverage full-genome sequences for the period from November 2021 until April 2022. All viruses sequenced were identified to belong to either Delta (B.1.617.2) or Omicron (lineage BA.1 and BA.2, respectively), with a variety of different sub-lineages. A detailed analysis of the mutational profile is presented and discussed. The Omicron variant BA.1 was shortly followed by BA.2; despite emerging against a background of high vaccination (81% of adult population) and pre-existing natural immunity, they gave rise to the largest waves of infection, with daily numbers rising dramatically, highlighting their increased ability for immune evasion. Within a period of only five months, the percentage of the Cypriot population with a confirmed infection increased from ~15% of the total population to >57%. Despite unprecedented case numbers, a significant reduction in hospital burden and mortality was observed. Our findings highlight the role of the importation of new variants through travel and demonstrate the importance of genomic surveillance in determining viral genetic diversity and the timely identification of new variants for guiding public health intervention measures.
Collapse
Affiliation(s)
- Jan Richter
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Dana Koptides
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Christina Tryfonos
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Denise Alexandrou
- Medical and Public Health Services, Ministry of Health, Nicosia 1148, Cyprus
| | - Christina Christodoulou
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| |
Collapse
|
29
|
McKenzie L, Shoukat A, Wong KO, Itahashi K, Yasuda E, Demarsh A, Khan K. Inferring the true number of SARS-CoV-2 infections in Japan. J Infect Chemother 2022; 28:1519-1522. [PMID: 35961504 PMCID: PMC9359925 DOI: 10.1016/j.jiac.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022]
Abstract
Introduction In Japan, as of December 31, 2021, more than 1.73 million laboratory-confirmed cases have been reported. However, the actual number of infections is likely to be under-ascertained due to the epidemiological characteristics such as mild and subclinical infections and limited testing availability in the early days of the pandemic. In this study, we infer the true number of infections in Japan between January 16, 2020, and December 31, 2021, using a statistical modelling framework that combines data on reported cases and fatalities. Methods We used reported COVID-19 deaths and age-specific infection fatality ratios (IFR) to impute the true number of infections. Estimates of IFR were informed from published studies and were adjusted to reflect the effects of pharmaceutical interventions, mass vaccination, and evolving variants. To account for the uncertainty in IFR, we sampled values from relevant distributions. Results We estimated that as of December 31, 2021, 3.07 million (CrI: 2.05–4.24 million) people had been infected in Japan, which is 1.77 times higher than the 1.73 million reported cases. Our meta-analysis confirmed that these findings were consistent with the intermittent seroprevalence studies conducted in Japan. Conclusions We have estimated that a substantial number of COVID-19 infections in Japan were unreported, particularly in adults. Our approach provides a more realistic assessment of the true underlying burden of COVID-19. The results of this study can be used as fundamental components to strengthen population health control and surveillance measures.
Collapse
Affiliation(s)
| | - Affan Shoukat
- BlueDot, Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada.
| | | | - Koju Itahashi
- Medical Affairs Department, Meiji Seika Pharma Co., Ltd., Chuo-ku, Tokyo, Japan
| | - Eiji Yasuda
- Digital Transformation Sect., Meiji Seika Pharma Co., Ltd., Chuo-ku, Tokyo, Japan
| | | | - Kamran Khan
- BlueDot, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| |
Collapse
|