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Asplin P, Keeling MJ, Mancy R, Hill EM. Epidemiological and health economic implications of symptom propagation in respiratory pathogens: A mathematical modelling investigation. PLoS Comput Biol 2024; 20:e1012096. [PMID: 38701066 PMCID: PMC11095726 DOI: 10.1371/journal.pcbi.1012096] [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: 08/08/2023] [Revised: 05/15/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Respiratory pathogens inflict a substantial burden on public health and the economy. Although the severity of symptoms caused by these pathogens can vary from asymptomatic to fatal, the factors that determine symptom severity are not fully understood. Correlations in symptoms between infector-infectee pairs, for which evidence is accumulating, can generate large-scale clusters of severe infections that could be devastating to those most at risk, whilst also conceivably leading to chains of mild or asymptomatic infections that generate widespread immunity with minimal cost to public health. Although this effect could be harnessed to amplify the impact of interventions that reduce symptom severity, the mechanistic representation of symptom propagation within mathematical and health economic modelling of respiratory diseases is understudied. METHODS AND FINDINGS We propose a novel framework for incorporating different levels of symptom propagation into models of infectious disease transmission via a single parameter, α. Varying α tunes the model from having no symptom propagation (α = 0, as typically assumed) to one where symptoms always propagate (α = 1). For parameters corresponding to three respiratory pathogens-seasonal influenza, pandemic influenza and SARS-CoV-2-we explored how symptom propagation impacted the relative epidemiological and health-economic performance of three interventions, conceptualised as vaccines with different actions: symptom-attenuating (labelled SA), infection-blocking (IB) and infection-blocking admitting only mild breakthrough infections (IB_MB). In the absence of interventions, with fixed underlying epidemiological parameters, stronger symptom propagation increased the proportion of cases that were severe. For SA and IB_MB, interventions were more effective at reducing prevalence (all infections and severe cases) for higher strengths of symptom propagation. For IB, symptom propagation had no impact on effectiveness, and for seasonal influenza this intervention type was more effective than SA at reducing severe infections for all strengths of symptom propagation. For pandemic influenza and SARS-CoV-2, at low intervention uptake, SA was more effective than IB for all levels of symptom propagation; for high uptake, SA only became more effective under strong symptom propagation. Health economic assessments found that, for SA-type interventions, the amount one could spend on control whilst maintaining a cost-effective intervention (termed threshold unit intervention cost) was very sensitive to the strength of symptom propagation. CONCLUSIONS Overall, the preferred intervention type depended on the combination of the strength of symptom propagation and uptake. Given the importance of determining robust public health responses, we highlight the need to gather further data on symptom propagation, with our modelling framework acting as a template for future analysis.
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Affiliation(s)
- Phoebe Asplin
- EPSRC & MRC Centre for Doctoral Training in Mathematics for Real-World Systems, University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
| | - Matt J. Keeling
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Rebecca Mancy
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Edward M. Hill
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
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2
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Lecona OA, Arroyo-Valerio AG, Bueno-Hernández N, Carrillo-Ruíz JD, Ruelas L, Márquez-Franco R, Aguado-García A, Barrón EV, Escobedo G, Ibarra-Coronado E, Olguín-Rodríguez PV, Barajas-Martínez A, Rivera AL, Fossion R. Risk factors contributing to infection with SARS-CoV-2 are modulated by sex. PLoS One 2024; 19:e0297901. [PMID: 38416704 PMCID: PMC10901358 DOI: 10.1371/journal.pone.0297901] [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: 09/07/2023] [Accepted: 01/15/2024] [Indexed: 03/01/2024] Open
Abstract
Throughout the early stages of the COVID-19 pandemic in Mexico (August-December 2020), we closely followed a cohort of n = 100 healthcare workers. These workers were initially seronegative for Immunoglobulin G (IgG) antibodies against SARS-CoV-2, the virus that causes COVID-19, and maintained close contact with patients afflicted by the disease. We explored the database of demographic, physiological and laboratory parameters of the cohort recorded at baseline to identify potential risk factors for infection with SARS-CoV-2 at a follow-up evaluation six months later. Given that susceptibility to infection may be a systemic rather than a local property, we hypothesized that a multivariate statistical analysis, such as MANOVA, may be an appropriate statistical approach. Our results indicate that susceptibility to infection with SARS-CoV-2 is modulated by sex. For men, different physiological states appear to exist that predispose to or protect against infection, whereas for women, we did not find evidence for divergent physiological states. Intriguingly, male participants who remained uninfected throughout the six-month observation period, had values for mean arterial pressure and waist-to-hip ratio that exceeded the normative reference range. We hypothesize that certain risk factors that worsen the outcome of COVID-19 disease, such as being overweight or having high blood pressure, may instead offer some protection against infection with SARS-CoV-2.
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Affiliation(s)
- Octavio A. Lecona
- Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | - Nallely Bueno-Hernández
- Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - José Damian Carrillo-Ruíz
- Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
- Coordinación de Neurociencias, Facultad de Psicología, Universidad Anahuac México, Mexico City, Mexico
| | - Luis Ruelas
- Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - René Márquez-Franco
- Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Alejandro Aguado-García
- Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
- Centro de Investigación en Ciencias (CInC), Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, Mexico
| | - Eira Valeria Barrón
- Servicio de Medicina Genómica “Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Galileo Escobedo
- Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Elizabeth Ibarra-Coronado
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Paola V. Olguín-Rodríguez
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Centro de Investigación en Ciencias (CInC), Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, Mexico
| | - Antonio Barajas-Martínez
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ana Leonor Rivera
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ruben Fossion
- Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
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3
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Xu Z, Peng Q, Song J, Zhang H, Wei D, Demongeot J, Zeng Q. Bioinformatic analysis of defective viral genomes in SARS-CoV-2 and its impact on population infection characteristics. Front Immunol 2024; 15:1341906. [PMID: 38348041 PMCID: PMC10859446 DOI: 10.3389/fimmu.2024.1341906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
DVGs (Defective Viral Genomes) are prevalent in RNA virus infections. In this investigation, we conducted an analysis of high-throughput sequencing data and observed widespread presence of DVGs in SARS-CoV-2. Comparative analysis between SARS-CoV-2 and diverse DNA viruses revealed heightened susceptibility to damage and increased sequencing sample heterogeneity within the SARS-CoV-2 genome. Whole-genome sequencing depth variability analysis exhibited a higher coefficient of variation for SARS-CoV-2, while DVG analysis indicated a significant proportion of recombination sites, signifying notable genome heterogeneity and suggesting that a large proportion of assembled virus particles contain incomplete RNA sequences. Moreover, our investigation explored the sequencing depth and DVG content differences among various strains. Our findings revealed that as the virus evolves, there is a notable increase in the proportion of intact genomes within virus particles, as evidenced by third-generation sequencing data. Specifically, the proportion of intact genome in the Omicron strain surpassed that of the Delta and Alpha strains. This observation effectively elucidates the heightened infectiousness of the Omicron strain compared to the Delta and Alpha strains. We also postulate that this improvement in completeness stems from enhanced virus assembly capacity, as the Omicron strain can promptly facilitate the binding of RNA and capsid protein, thereby reducing the exposure time of vulnerable virus RNA in the host environment and significantly mitigating its degradation. Finally, employing mathematical modeling, we simulated the impact of DVG effects under varying environmental factors on infection characteristics and population evolution. Our findings provide an explanation for the close association between symptom severity and the extent of virus invasion, as well as the substantial disparity in population infection characteristics caused by the same strain under distinct environmental conditions. This study presents a novel approach for future virus research and vaccine development.
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Affiliation(s)
- Zhaobin Xu
- Department of Life Science, Dezhou University, Dezhou, China
| | - Qingzhi Peng
- Department of Life Science, Dezhou University, Dezhou, China
| | - Jian Song
- Department of Life Science, Dezhou University, Dezhou, China
| | - Hongmei Zhang
- Department of Life Science, Dezhou University, Dezhou, China
| | - Dongqing Wei
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Shanghai Jiao Tong University, Shanghai, China
- Joint International Research Laboratory of Metabolic & Developmental Sciences and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Zhongjing Research and Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Meixi, Nanyang, Henan, China
- Peng Cheng National Laboratory, Shenzhen, Guangdong, China
| | - Jacques Demongeot
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), F-38700 La Tronche, France
| | - Qiangcheng Zeng
- Department of Life Science, Dezhou University, Dezhou, China
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4
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Gao ZX, Wang Y, Yan LY, Liu T, Peng LW. Epidemiological characteristics of respiratory viruses in children during the COVID-19 epidemic in Chengdu, China. Microbiol Spectr 2024; 12:e0261423. [PMID: 38051057 PMCID: PMC10783071 DOI: 10.1128/spectrum.02614-23] [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: 06/22/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
IMPORTANCE During the coronavirus disease 2019 epidemic, the Chinese government launched and used a series of nonpharmaceutical interventions (NPIs), including banning social gatherings, wearing face masks, home isolation, and maintaining hand hygiene, to control the disease spread. Whether and how NPIs influence other respiratory viruses in children remain unclear. In this article, we analyzed relative data and found that the number of samples and positive proportion of respiratory viruses decreased significantly compared with that before the epidemic. Clinicians and public health policymakers should pay attention to changes in the epidemic trends and types of respiratory viruses and maintain monitoring of respiratory-related viruses to avoid possible abnormal rebounds and epidemic outbreaks of these viruses.
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Affiliation(s)
- Zheng-Xiang Gao
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ya Wang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ling-Yi Yan
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ting Liu
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Lei-Wen Peng
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
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5
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Holdenrieder S, Dos Santos Ferreira CE, Izopet J, Theel ES, Wieser A. Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19. Front Public Health 2023; 11:1290402. [PMID: 38222091 PMCID: PMC10788057 DOI: 10.3389/fpubh.2023.1290402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.
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Affiliation(s)
- Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | | | - Jacques Izopet
- Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France
| | - Elitza S. Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany
- Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany
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6
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Styles CT, Zhou J, Flight KE, Brown JC, Lewis C, Wang X, Vanden Oever M, Peacock TP, Wang Z, Millns R, O'Neill JS, Borodavka A, Grove J, Barclay WS, Tregoning JS, Edgar RS. Propylene glycol inactivates respiratory viruses and prevents airborne transmission. EMBO Mol Med 2023; 15:e17932. [PMID: 37970627 PMCID: PMC10701621 DOI: 10.15252/emmm.202317932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023] Open
Abstract
Viruses are vulnerable as they transmit between hosts, and we aimed to exploit this critical window. We found that the ubiquitous, safe, inexpensive and biodegradable small molecule propylene glycol (PG) has robust virucidal activity. Propylene glycol rapidly inactivates a broad range of viruses including influenza A, SARS-CoV-2 and rotavirus and reduces disease burden in mice when administered intranasally at concentrations commonly found in nasal sprays. Most critically, vaporised PG efficiently abolishes influenza A virus and SARS-CoV-2 infectivity within airborne droplets, potently preventing infection at levels well below those tolerated by mammals. We present PG vapour as a first-in-class non-toxic airborne virucide that can prevent transmission of existing and emergent viral pathogens, with clear and immediate implications for public health.
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Affiliation(s)
| | - Jie Zhou
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Katie E Flight
- Department of Infectious DiseaseImperial College LondonLondonUK
- Present address:
University College LondonLondonUK
| | | | - Charlotte Lewis
- MRC‐University of Glasgow Centre for Virus ResearchGlasgowUK
| | - Xinyu Wang
- Department of BiochemistryUniversity of CambridgeCambridgeUK
| | - Michael Vanden Oever
- Department of Infectious DiseaseImperial College LondonLondonUK
- Present address:
Life Edit TherapeuticsMorrisvilleNCUSA
| | | | - Ziyin Wang
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Rosie Millns
- Department of Infectious DiseaseImperial College LondonLondonUK
| | | | | | - Joe Grove
- MRC‐University of Glasgow Centre for Virus ResearchGlasgowUK
| | - Wendy S Barclay
- Department of Infectious DiseaseImperial College LondonLondonUK
| | | | - Rachel S Edgar
- Department of Infectious DiseaseImperial College LondonLondonUK
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7
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Torres Ortiz A, Kendall M, Storey N, Hatcher J, Dunn H, Roy S, Williams R, Williams C, Goldstein RA, Didelot X, Harris K, Breuer J, Grandjean L. Within-host diversity improves phylogenetic and transmission reconstruction of SARS-CoV-2 outbreaks. eLife 2023; 12:e84384. [PMID: 37732733 PMCID: PMC10602588 DOI: 10.7554/elife.84384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 09/20/2023] [Indexed: 09/22/2023] Open
Abstract
Accurate inference of who infected whom in an infectious disease outbreak is critical for the delivery of effective infection prevention and control. The increased resolution of pathogen whole-genome sequencing has significantly improved our ability to infer transmission events. Despite this, transmission inference often remains limited by the lack of genomic variation between the source case and infected contacts. Although within-host genetic diversity is common among a wide variety of pathogens, conventional whole-genome sequencing phylogenetic approaches exclusively use consensus sequences, which consider only the most prevalent nucleotide at each position and therefore fail to capture low-frequency variation within samples. We hypothesized that including within-sample variation in a phylogenetic model would help to identify who infected whom in instances in which this was previously impossible. Using whole-genome sequences from SARS-CoV-2 multi-institutional outbreaks as an example, we show how within-sample diversity is partially maintained among repeated serial samples from the same host, it can transmitted between those cases with known epidemiological links, and how this improves phylogenetic inference and our understanding of who infected whom. Our technique is applicable to other infectious diseases and has immediate clinical utility in infection prevention and control.
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Affiliation(s)
- Arturo Torres Ortiz
- Department of Infectious Diseases, Imperial College LondonLondonUnited Kingdom
- Department of Infection, Immunity and Inflammation, University College LondonLondonUnited Kingdom
| | - Michelle Kendall
- Department of Statistics, University of WarwickCoventryUnited Kingdom
| | - Nathaniel Storey
- Department of Microbiology, Great Ormond Street HospitalLondonUnited Kingdom
| | - James Hatcher
- Department of Microbiology, Great Ormond Street HospitalLondonUnited Kingdom
| | - Helen Dunn
- Department of Microbiology, Great Ormond Street HospitalLondonUnited Kingdom
| | - Sunando Roy
- Department of Infection, Immunity and Inflammation, University College LondonLondonUnited Kingdom
| | | | | | | | - Xavier Didelot
- Department of Statistics, University of WarwickCoventryUnited Kingdom
| | - Kathryn Harris
- Department of Microbiology, Great Ormond Street HospitalLondonUnited Kingdom
- Department of Virology, East & South East London Pathology Partnership, Royal London Hospital, Barts Health NHS TrustLondonUnited Kingdom
| | - Judith Breuer
- Department of Infection, Immunity and Inflammation, University College LondonLondonUnited Kingdom
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, University College LondonLondonUnited Kingdom
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8
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Hung CY, Hsiao SH, Huang CG, Chang CS, Chen GY, Huang YL, Dutta A, Huang CT. Relatively preserved functional immune capacity with standard COVID-19 vaccine regimen in people living with HIV. Front Immunol 2023; 14:1204314. [PMID: 37731482 PMCID: PMC10507403 DOI: 10.3389/fimmu.2023.1204314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction People living with HIV (PLWH) are at a higher risk of severe disease with SARS-CoV-2 virus infection. COVID-19 vaccines are effective in most PLWH. However, suboptimal immune responses to the standard two-shot regimen are a concern, especially for those with moderate to severe immunodeficiency. An additional dose is recommended as part of the extended primary series in Taiwan. Herein, we study the efficacy of this additional shot in PLWH with mild immunodeficiency compared to that in healthy non-HIV people. Methods In total, 72 PLWH that were asymptomatic or with mild immunodeficiency (CD4 counts ≥200/mm3) and suppressed virology, and 362 healthcare workers of our hospital were enrolled. None of the participants had a history of SARS-CoV-2 infection. They received mRNA-1273 and ChAdOx1 vaccines. Anti-SARS-CoV-2 neutralizing and anti-Spike IgG antibodies, and SARS-CoV-2-specific T cell responses were evaluated. Results The standard two-shot regimen elicited lower responses in PLWH than the healthcare workers without HIV infection, although the difference was statistically insignificant. They had comparable levels of neutralizing and anti-Spike antibodies and comparable effector CD4+ and CD8+ T cell responses. The third shot boosted the SARS-CoV-2 immunity significantly more with better antibody responses and higher IFN-γ and IL-2 responses of the CD4+ and CD8+ T cells in PLWH compared to those without HIV. Upon in vitro stimulation with extracted Wuhan strain SARS-CoV-2 proteins, CD8+ T cells from PLWH after 3 shots had more durable effector responses than the non-HIV controls with extended time of stimulation. Conclusion This subtle difference between PLWH and non-HIV people implied immune exhaustion with two shots in non-HIV people. Slightly compromised immunity in PLWH indeed preserved the functional capacity for further response to the third shot or natural infection.
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Affiliation(s)
- Chen-Yiu Hung
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Sung-Han Hsiao
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Shiang Chang
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Guan-Yan Chen
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Lin Huang
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Avijit Dutta
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Tai Huang
- Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Infectious Diseases, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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9
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Popovic ME. XBB.1.5 Kraken cracked: Gibbs energies of binding and biosynthesis of the XBB.1.5 variant of SARS-CoV-2. Microbiol Res 2023; 270:127337. [PMID: 36804126 PMCID: PMC9928726 DOI: 10.1016/j.micres.2023.127337] [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: 01/22/2023] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
The SARS-CoV-2 Hydra with many heads (variants) has been causing the COVID-19 pandemic for 3 years. The appearance of every new head (SARS-CoV-2 variant) causes a new pandemic wave. The last in the series is the XBB.1.5 "Kraken" variant. In the general public (social media) and in the scientific community (scientific journals), during the last several weeks since the variant has appeared, the question was raised of whether the infectivity of the new variant will be greater. This article attempts to provide the answer. Analysis of thermodynamic driving forces of binding and biosynthesis leads to the conclusion that infectivity of the XBB.1.5 variant could be increased to a certain extent. The pathogenicity of the XBB.1.5 variant seems to be unchanged compared to the other Omicron variants.
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Affiliation(s)
- Marko E Popovic
- School of Life Sciences, Technical University of Munich, 85354 Freising, Germany.
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10
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Zhang W, Wu Y, Wen B, Zhang Y, Wang Y, Yin W, Sun S, Wei X, Sun H, Zhang Z, Li S, Guo Y. Non-pharmaceutical interventions for COVID-19 reduced the incidence of infectious diseases: a controlled interrupted time-series study. Infect Dis Poverty 2023; 12:15. [PMID: 36895021 PMCID: PMC9996566 DOI: 10.1186/s40249-023-01066-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) have been implemented worldwide to suppress the spread of coronavirus disease 2019 (COVID-19). However, few studies have evaluated the effect of NPIs on other infectious diseases and none has assessed the avoided disease burden associated with NPIs. We aimed to assess the effect of NPIs on the incidence of infectious diseases during the COVID-19 pandemic in 2020 and evaluate the health economic benefits related to the reduction in the incidence of infectious diseases. METHODS Data on 10 notifiable infectious diseases across China during 2010-2020 were extracted from the China Information System for Disease Control and Prevention. A two-stage controlled interrupted time-series design with a quasi-Poisson regression model was used to examine the impact of NPIs on the incidence of infectious diseases. The analysis was first performed at the provincial-level administrative divisions (PLADs) level in China, then the PLAD-specific estimates were pooled using a random-effect meta-analysis. RESULTS A total of 61,393,737 cases of 10 infectious diseases were identified. The implementation of NPIs was associated with 5.13 million (95% confidence interval [CI] 3.45‒7.42) avoided cases and USD 1.77 billion (95% CI 1.18‒2.57) avoided hospital expenditures in 2020. There were 4.52 million (95% CI 3.00‒6.63) avoided cases for children and adolescents, corresponding to 88.2% of total avoided cases. The top leading cause of avoided burden attributable to NPIs was influenza [avoided percentage (AP): 89.3%; 95% CI 84.5‒92.6]. Socioeconomic status and population density were effect modifiers. CONCLUSIONS NPIs for COVID-19 could effectively control the prevalence of infectious diseases, with patterns of risk varying by socioeconomic status. These findings have important implications for informing targeted strategies to prevent infectious diseases.
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Affiliation(s)
- Wenyi Zhang
- Division of Disease Surveillance, Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Yongming Zhang
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yong Wang
- Division of Disease Surveillance, Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Wenwu Yin
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Shanhua Sun
- Beijing Center for Disease Prevention and Control, Beijing, 100013, China
| | - Xianyu Wei
- Division of Disease Surveillance, Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Hailong Sun
- Division of Disease Surveillance, Chinese PLA Center for Disease Control and Prevention, Beijing, 100071, China
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, 200032, China
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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11
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Sun C, Yau V, Uy JPN, Lowe S, Tian Y. Does viral inoculum play a role in disease severity in COVID-19? J Med Virol 2023; 95:e28532. [PMID: 36704997 DOI: 10.1002/jmv.28532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023]
Affiliation(s)
- Chenyu Sun
- Department of Thyroid and Breast Surgery, Department of General Surgery, The Second Hospital of Anhui Medical University, Hefei, Anhui, China.,AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA
| | - Vicky Yau
- Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - John Patrick Nanola Uy
- Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri, USA
| | - Yanghua Tian
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
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12
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Rohde F, Walther M, Baur F, Windbergs M. A Dual‐Function Electrospun Matrix for the Prevention of Herpes Simplex Virus‐1 Infections after Corneal Transplantation. ADVANCED NANOBIOMED RESEARCH 2023. [DOI: 10.1002/anbr.202200098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Felix Rohde
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Marcel Walther
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Florentin Baur
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
| | - Maike Windbergs
- Institute of Pharmaceutical Technology and Buchmann Institute for Molecular Life Sciences Goethe University Frankfurt Max-von-Laue-Str. 9 60438 Frankfurt am Main Germany
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13
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Zsichla L, Müller V. Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors. Viruses 2023; 15:175. [PMID: 36680215 PMCID: PMC9863423 DOI: 10.3390/v15010175] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease and death. Understanding the risk factors of severe COVID-19 is relevant both in the clinical setting and at the epidemiological level. Here, we provide an overview of host, viral and environmental factors that have been shown or (in some cases) hypothesized to be associated with severe clinical outcomes. The factors considered in detail include the age and frailty, genetic polymorphisms, biological sex (and pregnancy), co- and superinfections, non-communicable comorbidities, immunological history, microbiota, and lifestyle of the patient; viral genetic variation and infecting dose; socioeconomic factors; and air pollution. For each category, we compile (sometimes conflicting) evidence for the association of the factor with COVID-19 outcomes (including the strength of the effect) and outline possible action mechanisms. We also discuss the complex interactions between the various risk factors.
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Affiliation(s)
- Levente Zsichla
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
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14
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Jiang M, Xu Y, Wu H, Zhu R, Sun Y, Chen D, Wang F, Zhou Y, Guo Q, Wu A, Qian Y, Zhou H, Zhao L. Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID-19 in Beijing, China. J Med Virol 2023; 95:e28411. [PMID: 36524893 PMCID: PMC9878212 DOI: 10.1002/jmv.28411] [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: 10/08/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
A series of nonpharmaceutical interventions (NPIs) was launched in Beijing, China, on January 24, 2020, to control coronavirus disease 2019. To reveal the roles of NPIs on the respiratory syncytial virus (RSV), respiratory specimens collected from children with acute respiratory tract infection between July 2017 and Dec 2021 in Beijing were screened by capillary electrophoresis-based multiplex PCR (CEMP) assay. Specimens positive for RSV were subjected to a polymerase chain reaction (PCR) and genotyped by G gene sequencing and phylogenetic analysis using iqtree v1.6.12. The parallel and fixed (paraFix) mutations were analyzed with the R package sitePath. Clinical data were compared using SPSS 22.0 software. Before NPIs launched, each RSV endemic season started from October/November to February/March of the next year in Beijing. After that, the RSV positive rate abruptly dropped from 31.93% in January to 4.39% in February 2020; then, a dormant state with RSV positive rates ≤1% from March to September, a nearly dormant state in October (2.85%) and November (2.98%) and a delayed endemic season in 2020, and abnormal RSV positive rates remaining at approximately 10% in summer until September 2021 were detected. Finally, an endemic RSV season returned in October 2021. There was a game between Subtypes A and B, and RSV-A replaced RSV-B in July 2021 to become the dominant subtype. Six RSV-A and eight RSV-B paraFix mutations were identified on G. The percentage of severe pneumonia patients decreased to 40.51% after NPIs launched. NPIs launched in Beijing seriously interfered with the endemic season of RSV.
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Affiliation(s)
- Ming‐Li Jiang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
| | - Yan‐Peng Xu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hui Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Ru‐Nan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Dong‐Mei Chen
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Fang Wang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu‐Tong Zhou
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Qi Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Aiping Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Yuan Qian
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hang‐Yu Zhou
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Lin‐Qing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
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15
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Xu Z, Yang D, Wang L, Demongeot J. Statistical analysis supports UTR (untranslated region) deletion theory in SARS-CoV-2. Virulence 2022; 13:1772-1789. [PMID: 36217240 PMCID: PMC9553139 DOI: 10.1080/21505594.2022.2132059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
It was noticed that the mortality rate of SARS-CoV-2 infection experienced a significant declination in the early stage of the epidemic. We suspect that the sharp deterioration of virus toxicity is related to the deletion of the untranslated region (UTR) of the virus genome. It was found that the genome length of SARS-CoV-2 engaged a significant truncation due to UTR deletion after a mega-sequence analysis. Sequence similarity analysis further indicated that short UTR strains originated from its long UTR ancestors after an irreversible deletion. A good correlation was discovered between genome length and mortality, which demonstrated that the deletion of the virus UTR significantly affected the toxicity of the virus. This correlation was further confirmed in a significance analysis of the genetic influence on the clinical outcomes. The viral genome length of hospitalized patients was significantly more extensive than that of asymptomatic patients. In contrast, the viral genome length of asymptomatic was considerably longer than that of ordinary patients with symptoms. A genome-level mutation scanning was performed to systematically evaluate the influence of mutations at each position on virulence. The results indicated that UTR deletion was the primary driving force in alternating virus virulence in the early evolution. In the end, we proposed a mathematical model to explain why this UTR deletion was not continuous.
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Affiliation(s)
- Zhaobin Xu
- Department of Life Science, Dezhou University, Dezhou, China
| | - Dongying Yang
- Department of Medicine, Dezhou University, Dezhou, China
| | - Liyan Wang
- Department of Life Science, Dezhou University, Dezhou, China
| | - Jacques Demongeot
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), La Tronche, France,CONTACT Jacques Demongeot
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16
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SARS-CoV-2 viral load is associated with risk of transmission to household and community contacts. BMC Infect Dis 2022; 22:672. [PMID: 35931971 PMCID: PMC9354300 DOI: 10.1186/s12879-022-07663-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 07/29/2022] [Indexed: 12/23/2022] Open
Abstract
Background Factors that lead to successful SARS-CoV-2 transmission are still not well described. We investigated the association between a case’s viral load and the risk of transmission to contacts in the context of other exposure-related factors. Methods Data were generated through routine testing and contact tracing at a large university. Case viral loads were obtained from cycle threshold values associated with a positive polymerase chain reaction test result from October 1, 2020 to April 15, 2021. Cases were included if they had at least one contact who tested 3–14 days after the exposure. Case-contact pairs were formed by linking index cases with contacts. Chi-square tests were used to evaluate differences in proportions of contacts testing positive. Generalized estimating equation models with a log link were used to evaluate whether viral load and other exposure-related factors were associated with a contact testing positive. Results Median viral load among the 212 cases included in the study was 5.6 (1.8–10.4) log10 RNA copies per mL of saliva. Among 365 contacts, 70 (19%) tested positive following their exposure; 36 (51%) were exposed to a case that was asymptomatic or pre-symptomatic on the day of exposure. The proportion of contacts that tested positive increased monotonically with index case viral load (12%, 23% and 25% corresponding to < 5, 5–8 and > 8 log10 copies per mL, respectively; X2 = 7.18, df = 2, p = 0.03). Adjusting for cough, time between test and exposure, and physical contact, the risk of transmission to a close contact was significantly associated with viral load (RR = 1.27, 95% CI 1.22–1.32). Conclusions Further research is needed to understand whether these relationships persist for newer variants. For those variants whose transmission advantage is mediated through a high viral load, public health measures could be scaled accordingly. Index cases with higher viral loads could be prioritized for contact tracing and recommendations to quarantine contacts could be made according to the likelihood of transmission based on risk factors such as viral load.
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07663-1.
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17
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Ortiz AT, Kendall M, Storey N, Hatcher J, Dunn H, Roy S, Williams R, Williams C, Goldstein RA, Didelot X, Harris K, Breuer J, Grandjean L. Within-host diversity improves phylogenetic and transmission reconstruction of SARS-CoV-2 outbreaks. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.06.07.495142. [PMID: 35702156 PMCID: PMC9196117 DOI: 10.1101/2022.06.07.495142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Accurate inference of who infected whom in an infectious disease outbreak is critical for the delivery of effective infection prevention and control. The increased resolution of pathogen whole-genome sequencing has significantly improved our ability to infer transmission events. Despite this, transmission inference often remains limited by the lack of genomic variation between the source case and infected contacts. Although within-host genetic diversity is common among a wide variety of pathogens, conventional whole-genome sequencing phylogenetic approaches to reconstruct outbreaks exclusively use consensus sequences, which consider only the most prevalent nucleotide at each position and therefore fail to capture low frequency variation within samples. We hypothesized that including within-sample variation in a phylogenetic model would help to identify who infected whom in instances in which this was previously impossible. Using whole-genome sequences from SARS-CoV-2 multi-institutional outbreaks as an example, we show how within-sample diversity is stable among repeated serial samples from the same host, is transmitted between those cases with known epidemiological links, and how this improves phylogenetic inference and our understanding of who infected whom. Our technique is applicable to other infectious diseases and has immediate clinical utility in infection prevention and control.
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Affiliation(s)
| | - Michelle Kendall
- Department of Statistics, University of Warwick, Coventry, CV4 7AL
| | - Nathaniel Storey
- Department of Microbiology, Great Ormond Street Hospital, London WC1N 3JH
| | - James Hatcher
- Department of Microbiology, Great Ormond Street Hospital, London WC1N 3JH
| | - Helen Dunn
- Department of Microbiology, Great Ormond Street Hospital, London WC1N 3JH
| | - Sunando Roy
- Department of Infection, Immunity and Inflammation, Institute of Child Health, UCL, London WC1N 1EH
| | - Rachel Williams
- UCL Genomics, Institute of Child Health, UCL, London WC1N 1EH
| | | | | | - Xavier Didelot
- Department of Statistics, University of Warwick, Coventry, CV4 7AL
| | - Kathryn Harris
- Department of Microbiology, Great Ormond Street Hospital, London WC1N 3JH
- Department of Virology, East South East London Pathology Partnership, Royal London Hospital, Barts Health NHS Trust, London E12ES
| | - Judith Breuer
- Department of Infection, Immunity and Inflammation, Institute of Child Health, UCL, London WC1N 1EH
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, Institute of Child Health, UCL, London WC1N 1EH
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18
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Godbout A, Drolet M, Mondor M, Simard M, Sauvageau C, De Serres G, Brisson M. Time trends in social contacts of individuals according to comorbidity and vaccination status, before and during the COVID-19 pandemic. BMC Med 2022; 20:199. [PMID: 35606803 PMCID: PMC9126104 DOI: 10.1186/s12916-022-02398-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND As we are confronted with more transmissible/severe variants with immune escape and the waning of vaccine efficacy, it is particularly relevant to understand how the social contacts of individuals at greater risk of COVID-19 complications evolved over time. We described time trends in social contacts of individuals according to comorbidity and vaccination status before and during the first three waves of the COVID-19 pandemic in Quebec, Canada. METHODS We used data from CONNECT, a repeated cross-sectional population-based survey of social contacts conducted before (2018/2019) and during the pandemic (April 2020 to July 2021). We recruited non-institutionalized adults from Quebec, Canada, by random digit dialling. We used a self-administered web-based questionnaire to measure the number of social contacts of participants (two-way conversation at a distance ≤2 m or a physical contact, irrespective of masking). We compared the mean number of contacts/day according to the comorbidity status of participants (pre-existing medical conditions with symptoms/medication in the past 12 months) and 1-dose vaccination status during the third wave. All analyses were performed using weighted generalized linear models with a Poisson distribution and robust variance. RESULTS A total of 1441 and 5185 participants with and without comorbidities, respectively, were included in the analyses. Contacts significantly decreased from a mean of 6.1 (95%CI 4.9-7.3) before the pandemic to 3.2 (95%CI 2.5-3.9) during the first wave among individuals with comorbidities and from 8.1 (95%CI 7.3-9.0) to 2.7 (95%CI 2.2-3.2) among individuals without comorbidities. Individuals with comorbidities maintained fewer contacts than those without comorbidities in the second wave, with a significant difference before the Christmas 2020/2021 holidays (2.9 (95%CI 2.5-3.2) vs 3.9 (95%CI 3.5-4.3); P<0.001). During the third wave, contacts were similar for individuals with (4.1, 95%CI 3.4-4.7) and without comorbidities (4.5, 95%CI 4.1-4.9; P=0.27). This could be partly explained by individuals with comorbidities vaccinated with their first dose who increased their contacts to the level of those without comorbidities. CONCLUSIONS It will be important to closely monitor COVID-19-related outcomes and social contacts by comorbidity and vaccination status to inform targeted or population-based interventions (e.g., booster doses of the vaccine).
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Affiliation(s)
- Aurélie Godbout
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada
| | - Mélanie Drolet
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada
| | - Myrto Mondor
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada
| | - Marc Simard
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Chantal Sauvageau
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada.,Institut National de Santé Publique du Québec, Québec, Canada
| | - Gaston De Serres
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada.,Laval University, Québec, Canada.,Institut National de Santé Publique du Québec, Québec, Canada
| | - Marc Brisson
- Centre de recherche du CHU de Québec-Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, Canada. .,Laval University, Québec, Canada. .,MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
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19
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Souverein D, van Stralen K, van Lelyveld S, van Gemeren C, Haverkort M, Snijders D, Soetekouw R, Kapteijns E, de Jong E, Hermanides G, Aronson S, Herpers B, den Boer J, Wagemakers A, Euser S. Initial SARS-CoV-2 viral load is associated with disease severity: a retrospective cohort study. Open Forum Infect Dis 2022; 9:ofac223. [PMID: 35821732 PMCID: PMC9272435 DOI: 10.1093/ofid/ofac223] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality. Methods All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal swab that was collected between 17 March 2020 and 31 March 2021 in public health testing facilities were included. Results From 20 207 SARS-CoV-2–positive persons, 310 (1.5%) were hospitalized within 30 days. High viral loads (crossing point [Cp] <25) were associated with an increased risk of hospitalization as compared to low viral loads (Cp >30), adjusted for age and sex (adjusted odds ratio [aOR], 1.57 [95% confidence interval {CI}, 1.11–2.26]). The same association was seen for ICU admission (aOR, 7.06 [95% CI, 2.15–43.57]). The median [interquartile range] Cp value of the 17 patients who died in hospital was significantly lower compared to the 226 survivors (22.7 [3.4] vs 25.0 [5.2]). Conclusions Higher initial SARS-CoV-2 viral load is associated with an increased risk of hospital admission, ICU admission, and in-hospital mortality. Our findings emphasize the added value of reporting SARS-CoV-2 viral load or cycle threshold/Cp values to identify persons who are at the highest risk of adverse outcomes such as hospital or ICU admission and who therefore may benefit from more intensive monitoring or early initiation of antiviral therapy.
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Affiliation(s)
- Dennis Souverein
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | | | | | | | - Milly Haverkort
- Public Health Service Kennemerland, Haarlem, the Netherlands
| | | | | | | | | | | | - Sem Aronson
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
- Spaarne Gasthuis, Hoofddorp/Haarlem, the Netherlands
| | - Bjorn Herpers
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Jeroen den Boer
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Alex Wagemakers
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Sjoerd Euser
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
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20
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Xiao A, Wu F, Bushman M, Zhang J, Imakaev M, Chai PR, Duvallet C, Endo N, Erickson TB, Armas F, Arnold B, Chen H, Chandra F, Ghaeli N, Gu X, Hanage WP, Lee WL, Matus M, McElroy KA, Moniz K, Rhode SF, Thompson J, Alm EJ. Metrics to relate COVID-19 wastewater data to clinical testing dynamics. WATER RESEARCH 2022; 212:118070. [PMID: 35101695 PMCID: PMC8758950 DOI: 10.1016/j.watres.2022.118070] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 05/02/2023]
Abstract
Wastewater surveillance has emerged as a useful tool in the public health response to the COVID-19 pandemic. While wastewater surveillance has been applied at various scales to monitor population-level COVID-19 dynamics, there is a need for quantitative metrics to interpret wastewater data in the context of public health trends. 24-hour composite wastewater samples were collected from March 2020 through May 2021 from a Massachusetts wastewater treatment plant and SARS-CoV-2 RNA concentrations were measured using RT-qPCR. The relationship between wastewater copy numbers of SARS-CoV-2 gene fragments and COVID-19 clinical cases and deaths varies over time. We demonstrate the utility of three new metrics to monitor changes in COVID-19 epidemiology: (1) the ratio between wastewater copy numbers of SARS-CoV-2 gene fragments and clinical cases (WC ratio), (2) the time lag between wastewater and clinical reporting, and (3) a transfer function between the wastewater and clinical case curves. The WC ratio increases after key events, providing insight into the balance between disease spread and public health response. Time lag and transfer function analysis showed that wastewater data preceded clinically reported cases in the first wave of the pandemic but did not serve as a leading indicator in the second wave, likely due to increased testing capacity, which allows for more timely case detection and reporting. These three metrics could help further integrate wastewater surveillance into the public health response to the COVID-19 pandemic and future pandemics.
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Affiliation(s)
- Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Fuqing Wu
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Mary Bushman
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Jianbo Zhang
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; The Fenway Institute, Fenway Health, Boston, MA USA; The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology USA; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute USA
| | | | | | - Timothy B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; Harvard Humanitarian Initiative, Harvard University USA
| | - Federica Armas
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Brian Arnold
- Department of Computer Science, Princeton University USA; Center for Statistics and Machine Learning, Princeton University USA
| | - Hongjie Chen
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Franciscus Chandra
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | - Xiaoqiong Gu
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - William P Hanage
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Wei Lin Lee
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | | | - Katya Moniz
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Janelle Thompson
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA; Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Broad Institute of MIT and Harvard, Cambridge, MA USA.
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21
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Valiati NC, Villela DA. Modelling policy combinations of vaccination and transmission suppression of SARS-CoV-2 in Rio de Janeiro, Brazil. Infect Dis Model 2022; 7:231-242. [PMID: 35005325 PMCID: PMC8719375 DOI: 10.1016/j.idm.2021.12.007] [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: 09/30/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/29/2022] Open
Abstract
COVID-19 vaccination in Brazil required a phased program, with priorities for age groups, health workers, and vulnerable people. Social distancing and isolation interventions have been essential to mitigate the advance of the pandemic in several countries. We developed a mathematical model capable of capturing the dynamics of the SARS-CoV-2 dissemination aligned with social distancing, isolation measures, and vaccination. Surveillance data from the city of Rio de Janeiro provided a case study to analyze possible scenarios, including non-pharmaceutical interventions and vaccination in the epidemic scenario. Our results demonstrate that the combination of vaccination and policies of transmission suppression potentially lowered the number of hospitalized cases by 380+ and 66+ thousand cases, respectively, compared to an absence of such policies. On top of transmission suppression-only policies, vaccination impacted more than 230+ thousand averted hospitalized cases and 43+ thousand averted deaths. Therefore, health surveillance activities should be maintained along with vaccination planning in scheduled groups until a large vaccinated coverage is reached. Furthermore, this analytical framework enables evaluation of such scenarios.
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Affiliation(s)
| | - Daniel A.M. Villela
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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22
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Rathinasabapathy T, Sakthivel LP, Komarnytsky S. Plant-Based Support of Respiratory Health during Viral Outbreaks. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:2064-2076. [PMID: 35147032 DOI: 10.1021/acs.jafc.1c06227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Respiratory viruses are linked to major epidemic events that have plagued humans through recorded history and possibly much earlier, ranging from common colds, influenza, and coronavirus infections to measles. However, difficulty in developing effective pharmaceutical solutions to treat infected individuals has hindered efforts to manage and minimize respiratory viral outbreaks and the associated mortality. Here we highlight a series of botanical interventions with different and often overlapping putative mechanisms of action to support the respiratory system, for which the bioactive pharmacophore was suggested and the initial structure-activity relationships have been explored (Bupleurum spp., Glycyrrhiza spp., Andrographis spp.), have been proposed with uncertainty (Echinacea spp., Zingiber spp., Verbascum spp., Marrubium spp.), or remained to be elucidated (Sambucus spp., Urtica spp.). Investigating these metabolites and their botanical sources holds potential to uncover new mediators of the respiratory health outcomes as well as molecular targets for future break-through therapeutic interventions targeting respiratory viral outbreaks.
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Affiliation(s)
- Thirumurugan Rathinasabapathy
- Plants for Human Health Institute, North Carolina State University, North Carolina Research Campus, 600 Laureate Way, Kannapolis, North Carolina 28081, United States
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, North Carolina 27695, United States
| | - Lakshmana Prabu Sakthivel
- Department of Pharmaceutical Technology, College of Engineering, Anna University BIT Campus, Tiruchirappalli, Tamil Nadu 620024, India
| | - Slavko Komarnytsky
- Plants for Human Health Institute, North Carolina State University, North Carolina Research Campus, 600 Laureate Way, Kannapolis, North Carolina 28081, United States
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, 400 Dan Allen Drive, Raleigh, North Carolina 27695, United States
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23
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Lovell-Read FA, Shen S, Thompson RN. Estimating local outbreak risks and the effects of non-pharmaceutical interventions in age-structured populations: SARS-CoV-2 as a case study. J Theor Biol 2022; 535:110983. [PMID: 34915042 PMCID: PMC8670853 DOI: 10.1016/j.jtbi.2021.110983] [Citation(s) in RCA: 10] [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: 05/05/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022]
Abstract
During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) including school closures, workplace closures and social distancing policies have been employed worldwide to reduce transmission and prevent local outbreaks. However, transmission and the effectiveness of NPIs depend strongly on age-related factors including heterogeneities in contact patterns and pathophysiology. Here, using SARS-CoV-2 as a case study, we develop a branching process model for assessing the risk that an infectious case arriving in a new location will initiate a local outbreak, accounting for the age distribution of the host population. We show that the risk of a local outbreak depends on the age of the index case, and we explore the effects of NPIs targeting individuals of different ages. Social distancing policies that reduce contacts outside of schools and workplaces and target individuals of all ages are predicted to reduce local outbreak risks substantially, whereas school closures have a more limited impact. In the scenarios considered here, when different NPIs are used in combination the risk of local outbreaks can be eliminated. We also show that heightened surveillance of infectious individuals reduces the level of NPIs required to prevent local outbreaks, particularly if enhanced surveillance of symptomatic cases is combined with efforts to find and isolate nonsymptomatic infected individuals. Our results reflect real-world experience of the COVID-19 pandemic, during which combinations of intense NPIs have reduced transmission and the risk of local outbreaks. The general modelling framework that we present can be used to estimate local outbreak risks during future epidemics of a range of pathogens, accounting fully for age-related factors.
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Affiliation(s)
| | - Silvia Shen
- Mathematical Institute, University of Oxford, Oxford, United Kingdom; Pembroke College, University of Oxford, Oxford, United Kingdom
| | - Robin N Thompson
- Mathematics Institute, University of Warwick, Coventry, United Kingdom; The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
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24
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Huang Z, Su Y, Zhang T, Xia N. A review of the safety and efficacy of current COVID-19 vaccines. Front Med 2022; 16:39-55. [PMID: 35122210 PMCID: PMC8815389 DOI: 10.1007/s11684-021-0893-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/24/2021] [Indexed: 01/06/2023]
Abstract
Vaccination is the most effective and feasible way to contain the Coronavirus disease 2019 (COVID-19) pandemic. The rapid development of effective COVID-19 vaccines is an extraordinary achievement. This study reviewed the efficacy/effectiveness, immunogenicity, and safety profile of the 12 most progressed COVID-19 vaccines and discussed the challenges and prospects of the vaccine-based approaches in a global crisis. Overall, most of the current vaccines have shown safety and efficacy/effectiveness during actual clinical trials or in the real-world studies, indicating a development of pandemic control. However, many challenges are faced by pandemic control in terms of maximizing the effect of vaccines, such as rapid vaccine coverage, strategies to address variants with immune escape capability, and surveillance of vaccine safety in the medium- and long-terms.
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Affiliation(s)
- Zehong Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Tianying Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, 361102, China.
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25
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Suwono B, Steffen A, Schweickert B, Schönfeld V, Brandl M, Sandfort M, Willrich N, Eckmanns T, Haller S. SARS-CoV-2 outbreaks in hospitals and long-term care facilities in Germany: a national observational study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 14:100303. [PMID: 35043103 PMCID: PMC8759004 DOI: 10.1016/j.lanepe.2021.100303] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background Outbreaks of coronavirus disease (COVID-19) in hospitals and long-term care facilities (LTCFs) pose serious public health threats. We analysed how frequency and size of SARS-CoV-2 outbreaks in hospitals and LTCFs have altered since the beginning of the pandemic, in particular since the start of the vaccination campaign. Methods We used mandatory notification data on SARS-CoV-2 cases in Germany and stratified by outbreak cases in hospitals and LTCFs. German vaccination coverage data were analysed. We studied the association of the occurrence of SARS-CoV-2 outbreaks and outbreak cases with SARS-CoV-2 cases in Germany throughout the four pandemic waves. We built also counterfactual scenarios with the first pandemic wave as the baseline. Findings By 21 September 2021, there were 4,147,387 SARS-CoV-2 notified cases since March 2020. About 20% of these cases were reported as being related to an outbreak, with 1% of the cases in hospitals and 4% in LTCFs. The median number of outbreak cases in the different phases was smaller (≤5) in hospitals than in LTCFs (>10). In the first and second pandemic waves, we observed strong associations in both facility types between SARS-CoV-2 outbreak cases and total number of notified SARS-CoV-2 cases. However, during the third pandemic wave we observed a decline in outbreak cases in both facility types and only a weak association between outbreak cases and all cases. Interpretation The vaccination campaign and non-pharmaceutical interventions have been able to protect vulnerable risk groups in hospitals and LTCFs. Funding No specific funding.
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Affiliation(s)
- Beneditta Suwono
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Annika Steffen
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Birgitta Schweickert
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Viktoria Schönfeld
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Michael Brandl
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Mirco Sandfort
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Niklas Willrich
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Tim Eckmanns
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - Sebastian Haller
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
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26
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Andrejko KL, Pry J, Myers JF, Openshaw J, Watt J, Birkett N, DeGuzman JL, Barbaduomo CM, Dong ZN, Fang AT, Frost PM, Ho T, Javadi MH, Li SS, Tran VH, Wan C, Jain S, Lewnard JA. Predictors of SARS-CoV-2 infection following high-risk exposure. Clin Infect Dis 2021; 75:e276-e288. [PMID: 34932817 PMCID: PMC8903328 DOI: 10.1093/cid/ciab1040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPIs) are recommended for COVID-19 prevention. However, the effectiveness of NPIs in preventing SARS-CoV-2 transmission remains poorly quantified. METHODS We conducted a test-negative design case-control study enrolling cases (testing positive for SARS-CoV-2) and controls (testing negative) with molecular SARS-CoV-2 diagnostic test results reported to California Department of Public Health between 24 February-12 November, 2021. We used conditional logistic regression to estimate adjusted odds ratios (aORs) of case status among participants who reported contact with an individual known or suspected to have been infected with SARS-CoV-2 ("high-risk exposure") ≤14 days before testing. RESULTS 751 of 1448 cases (52%) and 255 of 1443 controls (18%) reported high-risk exposures ≤14 days before testing. Adjusted odds of case status were 3.02-fold (95% confidence interval: 1.75-5.22) higher when high-risk exposures occurred with household members (vs. other contacts), 2.10-fold (1.05-4.21) higher when exposures occurred indoors (vs. outdoors only), and 2.15-fold (1.27-3.67) higher when exposures lasted ≥3 hours (vs. shorter durations) among unvaccinated and partially-vaccinated individuals; excess risk associated with such exposures was mitigated among fully-vaccinated individuals. Cases were less likely than controls to report mask usage during high-risk exposures (aOR=0.50 [0.29-0.85]). The adjusted odds of case status was lower for fully-vaccinated (aOR=0.25 [0.15-0.43]) participants compared to unvaccinated participants. Benefits of mask usage were greatest among unvaccinated and partially-vaccinated participants, and in interactions involving non-household contacts or interactions occurring without physical contact. CONCLUSIONS NPIs reduced the likelihood of SARS-CoV-2 infection following high-risk exposure. Vaccine effectiveness was substantial for partially and fully vaccinated persons.
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Affiliation(s)
- Kristin L Andrejko
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States
| | - Jake Pry
- California Department of Public Health, Richmond, California, United States
| | - Jennifer F Myers
- California Department of Public Health, Richmond, California, United States
| | - John Openshaw
- California Department of Public Health, Richmond, California, United States
| | - James Watt
- California Department of Public Health, Richmond, California, United States
| | - Nozomi Birkett
- California Department of Public Health, Richmond, California, United States
| | | | | | - Zheng N Dong
- California Department of Public Health, Richmond, California, United States
| | - Anna T Fang
- California Department of Public Health, Richmond, California, United States
| | - Paulina M Frost
- California Department of Public Health, Richmond, California, United States
| | - Timothy Ho
- California Department of Public Health, Richmond, California, United States
| | - Mahsa H Javadi
- California Department of Public Health, Richmond, California, United States
| | - Sophia S Li
- California Department of Public Health, Richmond, California, United States
| | - Vivian H Tran
- California Department of Public Health, Richmond, California, United States
| | - Christine Wan
- California Department of Public Health, Richmond, California, United States
| | - Seema Jain
- California Department of Public Health, Richmond, California, United States
| | - Joseph A Lewnard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States.,Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, United States.,Center for Computational Biology, College of Engineering, University of California, Berkeley, California, United States
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27
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Clapham HE, Chia WN, Tan LWL, Kumar V, Lim JM, Shankar N, Tun ZM, Zahari M, Hsu LY, Sun LJ, Wang LF, Tam CC. Contrasting SARS-CoV-2 epidemics in Singapore: cohort studies in migrant workers and the general population. Int J Infect Dis 2021; 115:72-78. [PMID: 34864193 PMCID: PMC8636323 DOI: 10.1016/j.ijid.2021.11.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 12/24/2022] Open
Abstract
Importance Since January 2020, Singapore has implemented comprehensive measures to suppress SARS-CoV-2. Despite this, the country has experienced contrasting epidemics, with limited transmission in the community and explosive outbreaks in migrant worker dormitories. Objective To estimate SARS-CoV-2 infection incidence among migrant workers and the general population in Singapore. Design Prospective serological cohort studies. Setting Two cohort studies — in a migrant worker dormitory and in the general population in Singapore. Participants 478 residents of a SARS-CoV-2-affected migrant worker dormitory were followed up between May and July 2020, with blood samples collected on recruitment and after 2 and 6 weeks. In addition, 937 community-dwelling adult Singapore residents, for whom pre-pandemic sera were available, were recruited. These individuals also provided a serum sample on recruitment in November/December 2020. Exposure Exposure to SARS-CoV-2 in a densely populated migrant worker dormitory and in the general population. Main outcomes and measures The main outcome measures were the incidences of SARS-CoV-2 infection in migrant workers and in the general population, as determined by the detection of neutralizing antibodies against SARS-CoV-2, and adjusting for assay sensitivity and specificity using a Bayesian modeling framework. Results No evidence of community SARS-CoV-2 exposure was found in Singapore prior to September 2019. It was estimated that < 2 per 1000 adult residents in the community were infected with SARS-CoV-2 in 2020 (cumulative seroprevalence: 0.16%; 95% CrI: 0.008–0.72%). Comparison with comprehensive national case notification data suggested that around 1 in 4 infections in the general population were associated with symptoms. In contrast, in the migrant worker cohort, almost two-thirds had been infected by July 2020 (cumulative seroprevalence: 63.8%; 95% CrI: 57.9–70.3%); no symptoms were reported in almost all of these infections. Conclusions and relevance Our findings demonstrate that SARS-CoV-2 suppression is possible with strict and rapid implementation of border restrictions, case isolation, contact tracing, quarantining, and social-distancing measures. However, the risk of large-scale epidemics in densely populated environments requires specific consideration in preparedness planning. Prioritization of these settings in vaccination strategies should minimize the risk of future resurgences and potential spillover of transmission to the wider community.
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Affiliation(s)
- Hannah E Clapham
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Wan Ni Chia
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Vishakha Kumar
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Jane M Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nivedita Shankar
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Zaw Myo Tun
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Louisa Jin Sun
- Infectious Diseases, Alexandra Hospital, National University Health System, Singapore
| | - Lin Fa Wang
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Clarence C Tam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; London School of Hygiene and Tropical Medicine, London, United Kingdom.
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28
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Miracle JE, Ganesh PR, Rose J, Terebuh P, Stange KC, Wolfe HM, Szabo A, Gullett H, Pope R. COVID-19 in Pregnancy: Occupations With Higher Density of Population Exposure Associated With More Severe Disease. J Occup Environ Med 2021; 63:1024-1028. [PMID: 34483305 PMCID: PMC8630925 DOI: 10.1097/jom.0000000000002374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To define the symptomatology of SARS-CoV-2 infection in pregnancy and associations between occupation, sociodemographic factors, and comorbidities with the severity of COVID-19 disease in pregnancy in all trimesters, regardless of hospitalization. METHODS We studied a retrospective cohort of a public health surveillance sample of persons with COVID-19 infection diagnosed during pregnancy. Data was collected March 2020 to August 2020 regarding symptoms, disease severity, comorbidities, obstetric history, and occupation. RESULTS One hundred sixty-three individuals were identified. Constitutional (64%) and lower respiratory symptoms (61%) were most common. Seventeen individuals (13.6%) were hospitalized, and one person (0.7%) died due to COVID-19. Risk factors for severe disease were age and an occupation that had high intensity exposure to people. CONCLUSIONS Occupational exposure is a risk factor for severe COVID-19 disease in pregnancy, justifying policy measures to ensure protection of this vulnerable population.
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Affiliation(s)
- Jill E Miracle
- Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Miracle, Dr Ganesh, Dr Rose, Dr Terebuh, Dr Stange, Ms Szabo, and Dr Gullett); University Hospitals Cleveland Medical Center, Cleveland, Ohio (Dr Miracle, Dr Ganesh, Dr Terebuh, and Dr Pope); Cuyahoga County Board of Health, Parma, Ohio (Dr Miracle, Dr Ganesh, Dr Rose, Dr Terebuh, Dr Wolfe, Szabo, Dr Gullett, and Dr Pope)
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29
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Seres G, Balleyer A, Cerutti N, Friedrichsen J, Süer M. Face mask use and physical distancing before and after mandatory masking: No evidence on risk compensation in public waiting lines. JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2021; 192:765-781. [PMID: 34840368 PMCID: PMC8604556 DOI: 10.1016/j.jebo.2021.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 05/07/2023]
Abstract
During the COVID-19 pandemic, the introduction of mandatory face mask usage triggered a heated debate. A major point of controversy is whether community use of masks creates a false sense of security that would diminish physical distancing, counteracting any potential direct benefit from masking. We conducted a randomized field experiment in Berlin, Germany, to investigate how masks affect distancing and whether the mask effect interacts with the introduction of an indoor mask mandate. Joining waiting lines in front of stores, we measured distances kept from the experimenter in two treatment conditions - the experimenter wore a mask in one and no face covering in the other - in two time spans - before and after mask use becoming mandatory in stores. We find no evidence that mandatory masking has a negative effect on distance kept toward a masked person. To the contrary, masks significantly increase distancing and the effect does not differ between the two periods. However, we show that after the mandate distances are shorter in locations where more non-essential stores, which were closed before the mandate, had reopened. We argue that the relaxations in general restrictions that coincided with the mask mandate led individuals to reduce other precautions, like keeping a safe distance.
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Affiliation(s)
| | | | - Nicola Cerutti
- Mercator Research Institute on Global Commons and Climate Change (MCC), Germany
| | - Jana Friedrichsen
- Freie Universität Berlin, Humboldt-Universität zu Berlin, WZB Berlin Social Science Center, and DIW Berlin, Germany
| | - Müge Süer
- Humboldt-Universität zu Berlin, Germany
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30
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陆 权. [Reflections on the Global Pandemic of COVID-19 and the Response Strategies]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2021; 52:936-938. [PMID: 34841757 PMCID: PMC10408832 DOI: 10.12182/20211160103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Indexed: 11/23/2022]
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to ravage the world, posing great challenges to the public health system and threatening the health and survival of humans. The outbreak of COVID-19 leaves us with much to reflect on and calls on our attention to respiratory infectious diseases, especially new outbreaks of respiratory infectious diseases that are zoonotic. The importance of identifying viral pathogens should be highlighted because it is related to the prevention and treatment strategy of childhood pneumonia. Due to the highly infectious nature of COVID-19, the rapid mutation of the virus, and the lack of specific drugs, vaccines are currently the most effective means of prevention, and a global immune barrier must be established as soon as possible.
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Affiliation(s)
- 权 陆
- 上海交通大学附属儿童医院 (上海 200062)Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
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31
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Amruta N, Engler-Chiurazzi EB, Murray-Brown IC, Gressett TE, Biose IJ, Chastain WH, Befeler JB, Bix G. In Vivo protection from SARS-CoV-2 infection by ATN-161 in k18-hACE2 transgenic mice. Life Sci 2021; 284:119881. [PMID: 34389403 PMCID: PMC8352850 DOI: 10.1016/j.lfs.2021.119881] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infectious disease that has spread worldwide. Current treatments are limited in both availability and efficacy, such that improving our understanding of the factors that facilitate infection is urgently needed to more effectively treat infected individuals and to curb the pandemic. We and others have previously demonstrated the significance of interactions between the SARS-CoV-2 spike protein, integrin α5β1, and human ACE2 to facilitate viral entry into host cells in vitro. We previously found that inhibition of integrin α5β1 by the clinically validated small peptide ATN-161 inhibits these spike protein interactions and cell infection in vitro. In continuation with our previous findings, here we have further evaluated the therapeutic potential of ATN-161 on SARS-CoV-2 infection in k18-hACE2 transgenic (SARS-CoV-2 susceptible) mice in vivo. We discovered that treatment with single or repeated intravenous doses of ATN-161 (1 mg/kg) within 48 h after intranasal inoculation with SARS-CoV-2 lead to a reduction of lung viral load, viral immunofluorescence, and improved lung histology in a majority of mice 72 h post-infection. Furthermore, ATN-161 reduced SARS-CoV-2-induced increased expression of lung integrin α5 and αv (an α5-related integrin that has also been implicated in SARS-CoV-2 interactions) as well as the C-X-C motif chemokine ligand 10 (Cxcl10), further supporting the potential involvement of these integrins, and the anti-inflammatory potential of ATN-161, respectively, in SARS-CoV-2 infection. To the best of our knowledge, this is the first study demonstrating the potential therapeutic efficacy of targeting integrin α5β1 in SARS-CoV-2 infection in vivo and supports the development of ATN-161 as a novel SARS-CoV-2 therapy.
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Affiliation(s)
- Narayanappa Amruta
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Elizabeth B Engler-Chiurazzi
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA; Tulane Brain Institute, Tulane University, New Orleans, LA 70112, USA; Department of Neurology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Isabel C Murray-Brown
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Timothy E Gressett
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Ifechukwude J Biose
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Wesley H Chastain
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Jaime B Befeler
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Gregory Bix
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, LA 70112, USA; Tulane Brain Institute, Tulane University, New Orleans, LA 70112, USA; Department of Neurology, Tulane University School of Medicine, New Orleans, LA 70112, USA; Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA; Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70122, USA.
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Al Kassaa I, El Omari S, Abbas N, Papon N, Drider D, Kassem II, Osman M. High association of COVID-19 severity with poor gut health score in Lebanese patients. PLoS One 2021; 16:e0258913. [PMID: 34673813 PMCID: PMC8530309 DOI: 10.1371/journal.pone.0258913] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has affected millions of lives globally. However, the disease has presented more extreme challenges for developing countries that are experiencing economic crises. Studies on COVID-19 symptoms and gut health are scarce and have not fully analyzed possible associations between gut health and disease pathophysiology. Therefore, this study aimed to demonstrate a potential association between gut health and COVID-19 severity in the Lebanese community, which has been experiencing a severe economic crisis. Methods This cross-sectional study investigated SARS-CoV-2 PCR-positive Lebanese patients. Participants were interviewed and gut health, COVID-19 symptoms, and different metrics were analyzed using simple and multiple logistic regression models. Results Analysis of the data showed that 25% of participants were asymptomatic, while an equal proportion experienced severe symptoms, including dyspnea (22.7%), oxygen need (7.5%), and hospitalization (3.1%). The mean age of the participants was 38.3 ±0.8 years, and the majority were males (63.9%), married (68.2%), and currently employed (66.7%). A negative correlation was found between gut health score and COVID-19 symptoms (Kendall’s tau-b = -0.153, P = 0.004); indicating that low gut health was associated with more severe COVID-19 cases. Additionally, participants who reported unhealthy food intake were more likely to experience severe symptoms (Kendall’s tau-b = 0.118, P = 0.049). When all items were taken into consideration, multiple ordinal logistic regression models showed a significant association between COVID-19 symptoms and each of the following variables: working status, flu-like illness episodes, and gut health score. COVID-19 severe symptoms were more common among patients having poor gut health scores (OR:1.31, 95%CI:1.07–1.61; P = 0.008), experiencing more than one episode of flu-like illness per year (OR:2.85, 95%CI:1.58–5.15; P = 0.001), and owning a job (OR:2.00, 95%CI:1.1–3.65; P = 0.023). Conclusions To our knowledge, this is the first study that showed the impact of gut health and exposure to respiratory viruses on COVID-19 severity in Lebanon. These findings can facilitate combating the pandemic in Lebanon.
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Affiliation(s)
- Imad Al Kassaa
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Doctoral School of Science and Technology, Lebanese University, Beirut, Lebanon
- * E-mail: (IAK); , (MO)
| | - Sarah El Omari
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nada Abbas
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nicolas Papon
- Univ Angers, Univ Brest, GEIHP, SFR ICAT, Angers, France
| | - Djamel Drider
- UMR Transfrontalière BioEcoAgro1158, Univ. Lille, INRAE, Univ. Liège, UPJV, YNCREA, Univ. Artois, Univ. Littoral Côte d’Opale, ICV—Institut Charles Viollette, Lille, France
| | - Issmat I. Kassem
- Center for Food Safety and Department of Food Science and Technology, University of Georgia, Griffin, GA, United States of America
| | - Marwan Osman
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
- * E-mail: (IAK); , (MO)
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Hopfer S, Fields EJ, Lu Y, Ramakrishnan G, Grover T, Bai Q, Huang Y, Li C, Mark G. The social amplification and attenuation of COVID-19 risk perception shaping mask wearing behavior: A longitudinal twitter analysis. PLoS One 2021; 16:e0257428. [PMID: 34555060 PMCID: PMC8460003 DOI: 10.1371/journal.pone.0257428] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Twitter represents a mainstream news source for the American public, offering a valuable vehicle for learning how citizens make sense of pandemic health threats like Covid-19. Masking as a risk mitigation measure became controversial in the US. The social amplification risk framework offers insight into how a risk event interacts with psychological, social, institutional, and cultural communication processes to shape Covid-19 risk perception. METHODS Qualitative content analysis was conducted on 7,024 mask tweets reflecting 6,286 users between January 24 and July 7, 2020, to identify how citizens expressed Covid-19 risk perception over time. Descriptive statistics were computed for (a) proportion of tweets using hyperlinks, (b) mentions, (c) hashtags, (d) questions, and (e) location. RESULTS Six themes emerged regarding how mask tweets amplified and attenuated Covid-19 risk: (a) severity perceptions (18.0%) steadily increased across 5 months; (b) mask effectiveness debates (10.7%) persisted; (c) who is at risk (26.4%) peaked in April and May 2020; (d) mask guidelines (15.6%) peaked April 3, 2020, with federal guidelines; (e) political legitimizing of Covid-19 risk (18.3%) steadily increased; and (f) mask behavior of others (31.6%) composed the largest discussion category and increased over time. Of tweets, 45% contained a hyperlink, 40% contained mentions, 33% contained hashtags, and 16.5% were expressed as a question. CONCLUSIONS Users ascribed many meanings to mask wearing in the social media information environment revealing that COVID-19 risk was expressed in a more expanded range than objective risk. The simultaneous amplification and attenuation of COVID-19 risk perception on social media complicates public health messaging about mask wearing.
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Affiliation(s)
- Suellen Hopfer
- Department of Health, Society & Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Emilia J. Fields
- Department of Health, Society & Behavior, Program in Public Health, University of California, Irvine, Irvine, California, United States of America
| | - Yuwen Lu
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Ganesh Ramakrishnan
- Department of Psychological Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Ted Grover
- Department of Informatics, University of California, Irvine, Irvine, California, United States of America
| | - Quishi Bai
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Yicong Huang
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Chen Li
- Department of Computer Science, University of California, Irvine, CA, United States of America
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, Irvine, California, United States of America
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Nixon DF, Marín-Hernández D, Hupert N. Extreme immunotherapy: emergency immunology to defeat pandemics. Mol Med 2021; 27:112. [PMID: 34530723 PMCID: PMC8444162 DOI: 10.1186/s10020-021-00366-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
The ongoing global COVID-19 pandemic has thrown into sharp relief the gap between modern biology's ability to investigate and respond to a novel pathogen and modern medicine's ability to marshal effective front-line interventions to limit its immediate health impact. While we have witnessed the rapid development of innovative vaccines against SARS-CoV-2 using novel molecular platforms, these have yet to alter the pandemic's long-term trajectory in all but a handful of high-income countries. Health workers at the clinical front lines have little more in their clinical armamentarium than was available a century ago-chiefly oxygen and steroids-and yet advances in modern immunology and immunotherapeutics suggest an underuse of extant and effective, if unorthodox, therapies, which we now call "Extreme Immunotherapies for Pandemics (EIPs)."
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Affiliation(s)
- Douglas F Nixon
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, Belfer Research Building, Room 530, 413 E. 69th Street, New York, NY, 10065, USA.
| | - Daniela Marín-Hernández
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, Belfer Research Building, Room 530, 413 E. 69th Street, New York, NY, 10065, USA
| | - Nathaniel Hupert
- Department of Population Health Sciences, Weill Cornell Medicine, 402 E. 67th Street, New York, NY, 10065, USA
- Cornell Institute for Disease and Disaster Preparedness, Weill Cornell Medicine, 402 E. 67th Street, New York, NY, 10065, USA
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Spinelli MA, Glidden DV, Gennatas ED, Rutherford GW, Gandhi M. Effectiveness of Adding a Mask Recommendation to Other Public Health Measures. Ann Intern Med 2021; 174:1193. [PMID: 34399080 DOI: 10.7326/l21-0397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - David V Glidden
- University of California, San Francisco, San Francisco, California
| | | | | | - Monica Gandhi
- University of California, San Francisco, San Francisco, California
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Puius YA, Bartash RM, Zingman BS. Maintaining mask momentum in transplant recipients. Transpl Infect Dis 2021; 23:e13697. [PMID: 34324251 PMCID: PMC8420158 DOI: 10.1111/tid.13697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022]
Abstract
The widespread use of facemasks has been a crucial element in the control of the SARS‐CoV‐2 pandemic. With mounting evidence for mask efficacy against respiratory infectious diseases and greater acceptability of this intervention, it is proposed that masking should continue after the pandemic has abated to protect some of our most vulnerable patients, recipients of stem cell and solid organ transplants. This may involve not only masking these high‐risk patients, but possibly their close contacts and the healthcare workers involved in their care. We review the evidence for mask efficacy in prevention of respiratory viruses other than SARS‐CoV‐2 and address the burden of disease in transplant recipients. Although we acknowledge that there are limited data on masking to prevent infection in transplant recipients, we propose a framework for the study and implementation of routine masking as a part of infection prevention interventions after transplantation.
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Affiliation(s)
- Yoram A Puius
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.,Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rachel M Bartash
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Barry S Zingman
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Helle KB, Sadiku A, Zelleke GM, Ibrahim TB, Bouba A, Tsoungui Obama HC, Appiah V, Ngwa GA, Teboh-Ewungkem MI, Schneider KA. Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity? PLoS One 2021; 16:e0253758. [PMID: 34270576 PMCID: PMC8284653 DOI: 10.1371/journal.pone.0253758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection. METHODS AND FINDINGS We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to 'multi-infections', either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction ("lockdown") at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths. CONCLUSIONS Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.
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Affiliation(s)
- Kristina Barbara Helle
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
| | - Arlinda Sadiku
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
| | - Girma Mesfin Zelleke
- African Institute for Mathematical Sciences Cameroon, Limbe, Cameroon
- Department of Mathematics, University of Buea, Buea, Cameroon
| | - Toheeb Babatunde Ibrahim
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
- African Institute for Mathematical Sciences Cameroon, Limbe, Cameroon
| | - Aliou Bouba
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
- African Institute for Mathematical Sciences Cameroon, Limbe, Cameroon
| | | | - Vincent Appiah
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Gideon Akumah Ngwa
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
- Department of Mathematics, University of Buea, Buea, Cameroon
| | | | - Kristan Alexander Schneider
- Department of Applied Computer- and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
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Xiao A, Wu F, Bushman M, Zhang J, Imakaev M, Chai PR, Duvallet C, Endo N, Erickson TB, Armas F, Arnold B, Chen H, Chandra F, Ghaeli N, Gu X, Hanage WP, Lee WL, Matus M, McElroy KA, Moniz K, Rhode SF, Thompson J, Alm EJ. Metrics to relate COVID-19 wastewater data to clinical testing dynamics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.06.10.21258580. [PMID: 34159339 PMCID: PMC8219106 DOI: 10.1101/2021.06.10.21258580] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Wastewater surveillance has emerged as a useful tool in the public health response to the COVID-19 pandemic. While wastewater surveillance has been applied at various scales to monitor population-level COVID-19 dynamics, there is a need for quantitative metrics to interpret wastewater data in the context of public health trends. We collected 24-hour composite wastewater samples from March 2020 through May 2021 from a Massachusetts wastewater treatment plant and measured SARS-CoV-2 RNA concentrations using RT-qPCR. We show that the relationship between wastewater viral titers and COVID-19 clinical cases and deaths varies over time. We demonstrate the utility of three new metrics to monitor changes in COVID-19 epidemiology: (1) the ratio between wastewater viral titers and clinical cases (WC ratio), (2) the time lag between wastewater and clinical reporting, and (3) a transfer function between the wastewater and clinical case curves. We find that the WC ratio increases after key events, providing insight into the balance between disease spread and public health response. We also find that wastewater data preceded clinically reported cases in the first wave of the pandemic but did not serve as a leading indicator in the second wave, likely due to increased testing capacity. These three metrics could complement a framework for integrating wastewater surveillance into the public health response to the COVID-19 pandemic and future pandemics.
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Affiliation(s)
- Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
| | - Fuqing Wu
- Department of Biological Engineering, Massachusetts Institute of Technology
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
| | - Mary Bushman
- Harvard T.H. Chan School of Public Health, Harvard University
| | - Jianbo Zhang
- Department of Biological Engineering, Massachusetts Institute of Technology
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
| | | | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School
- The Fenway Institute, Fenway Health, Boston, MA
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute
| | | | | | - Timothy B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School
- Harvard Humanitarian Initiative, Harvard University
| | - Federica Armas
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Brian Arnold
- Department of Computer Science, Princeton University
- Center for Statistics and Machine Learning, Princeton University
| | - Hongjie Chen
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Franciscus Chandra
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | - Xiaoqiong Gu
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | - Wei Lin Lee
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | | | - Katya Moniz
- Department of Biological Engineering, Massachusetts Institute of Technology
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
| | | | - Janelle Thompson
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore
- Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology
- Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
- Broad Institute of MIT and Harvard, Cambridge, MA
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Repeated Exposure to Subinfectious Doses of SARS-CoV-2 May Promote T Cell Immunity and Protection against Severe COVID-19. Viruses 2021; 13:v13060961. [PMID: 34067349 PMCID: PMC8224680 DOI: 10.3390/v13060961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
Europe is experiencing a third wave of COVID-19 due to the spread of highly transmissible SARS-CoV-2 variants. A number of positive and negative factors constantly shape the rates of COVID-19 infections, hospitalization, and mortality. Among these factors, the rise in increasingly transmissible variants on one side and the effect of vaccinations on the other side create a picture deeply different from that of the first pandemic wave. Starting from the observation that in several European countries the number of COVID-19 infections in the second and third pandemic wave increased without a proportional rise in disease severity and mortality, we hypothesize the existence of an additional factor influencing SARS-CoV-2 dynamics. This factor consists of an immune defence against severe COVID-19, provided by SARS-CoV-2-specific T cells progressively developing upon natural exposure to low virus doses present in populated environments. As suggested by recent studies, low-dose viral particles entering the respiratory and intestinal tracts may be able to induce T cell memory in the absence of inflammation, potentially resulting in different degrees of immunization. In this scenario, non-pharmaceutical interventions would play a double role, one in the short term by reducing the detrimental spreading of SARS-CoV-2 particles, and one in the long term by allowing the development of a widespread (although heterogeneous and uncontrollable) form of immune protection.
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Lowering SARS-CoV-2 viral load might affect transmission but not disease severity in secondary cases - Authors' reply. THE LANCET. INFECTIOUS DISEASES 2021; 21:915-916. [PMID: 33864804 PMCID: PMC8046414 DOI: 10.1016/s1473-3099(21)00210-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022]
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Trunfio M, Calcagno A, Bonora S, Di Perri G. Lowering SARS-CoV-2 viral load might affect transmission but not disease severity in secondary cases. THE LANCET. INFECTIOUS DISEASES 2021; 21:914-915. [PMID: 33864803 PMCID: PMC8046410 DOI: 10.1016/s1473-3099(21)00205-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/26/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Mattia Trunfio
- University of Torino, Department of Medical Sciences at the Unit of Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy; Clinica Universitaria I Piano, Ospedale Amedeo di Savoia, 10149 Torino, Italy.
| | - Andrea Calcagno
- University of Torino, Department of Medical Sciences at the Unit of Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy
| | - Stefano Bonora
- University of Torino, Department of Medical Sciences at the Unit of Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy
| | - Giovanni Di Perri
- University of Torino, Department of Medical Sciences at the Unit of Infectious Diseases, Amedeo di Savoia Hospital, Torino, Italy
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