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Yang L, Wang Y, Mu X, Liao Y. A visualized and bibliometric analysis of nursing research during the COVID-19 pandemic. Medicine (Baltimore) 2024; 103:e39245. [PMID: 39121302 PMCID: PMC11315485 DOI: 10.1097/md.0000000000039245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 07/19/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The global spread of Coronavirus disease 2019 (COVID-19) has been increasing since December 2019. A total of 8460 publications were obtained from the Web of Science Core Collection from 2019 to 2023, providing insights into the progress of nursing research throughout the COVID-19 pandemic. METHODS Bibliometric analysis was conducted on these articles using CiteSpace. The analysis focused on examining the distribution of these publications in terms of space and time, distribution of authors, subject categories, distribution of topics, and cited references. RESULTS These results may be explained from 3 perspectives. Initially, the number of yearly publications on nursing research consistently increased during the COVID-19 pandemic. Furthermore, a co-occurrence analysis of the countries and the authors revealed that certain countries, including the United States, China, and England, have successfully implemented organized and standardized nursing models. These countries also have well-developed and established nursing research systems. Notably, academic communities in specific regions, such as the team led by MD Stefan Gravenstein, Mor Vincent, and White Elizabeth at Brown University in the United States, have emerged as leaders in this field. Furthermore, examining the papers' subject categories and topic distribution indicate that nursing during the COVID-19 pandemic has been predominantly interdisciplinary, encompassing various disciplines such as clinical medicine, essential medicine, psychology, public health management, and even telematics science. CONCLUSION SUBSECTIONGS Our study provided valuable insights into acquiring knowledge on nursing research during the COVID-19 pandemic, pinpointed possible partners for researchers interested in nursing, and uncovered prevalent research patterns and popular subjects.
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Affiliation(s)
- Lu Yang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yao Wang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xin Mu
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yanbiao Liao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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2
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Demongeot J, Magal P. Data-driven mathematical modeling approaches for COVID-19: A survey. Phys Life Rev 2024; 50:166-208. [PMID: 39142261 DOI: 10.1016/j.plrev.2024.08.004] [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: 07/15/2024] [Accepted: 08/02/2024] [Indexed: 08/16/2024]
Abstract
In this review, we successively present the methods for phenomenological modeling of the evolution of reported and unreported cases of COVID-19, both in the exponential phase of growth and then in a complete epidemic wave. After the case of an isolated wave, we present the modeling of several successive waves separated by endemic stationary periods. Then, we treat the case of multi-compartmental models without or with age structure. Eventually, we review the literature, based on 260 articles selected in 11 sections, ranging from the medical survey of hospital cases to forecasting the dynamics of new cases in the general population. This review favors the phenomenological approach over the mechanistic approach in the choice of references and provides simulations of the evolution of the number of observed cases of COVID-19 for 10 states (California, China, France, India, Israel, Japan, New York, Peru, Spain and United Kingdom).
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Affiliation(s)
- Jacques Demongeot
- Université Grenoble Alpes, AGEIS EA7407, La Tronche, F-38700, France.
| | - Pierre Magal
- Department of Mathematics, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai, 519087, China; Univ. Bordeaux, IMB, UMR 5251, Talence, F-33400, France; CNRS, IMB, UMR 5251, Talence, F-33400, France
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3
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Schmidt K, Pollett SD, Richard SA, Hogan V, Hone E, Rothenberg J, Tant R, Wayman M, Friend C, Thapa K, Ulomi L, Davies J, Michel A, Burgess TH, O’Connell RJ, Simons MP, Tilley DH, Fries AC, Colombo RE. Opportunities for Enhanced Public Health Surveillance via Molecular Detection and Sequencing of Diverse Respiratory Viruses From Self-collected SARS-CoV-2 Antigen Test Swabs. Open Forum Infect Dis 2024; 11:ofae447. [PMID: 39175525 PMCID: PMC11339864 DOI: 10.1093/ofid/ofae447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024] Open
Abstract
We sequenced and genotyped severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, adenovirus, and respiratory syncytial virus, among other pathogens, from residual anterior nasal swabs self-collected for rapid SARS-CoV-2 antigen testing at the US Naval Academy. This is a key proof-of-concept for an acute respiratory infection surveillance approach, which could leverage prevalent SARS-CoV-2 antigen self-testing.
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Affiliation(s)
- Kat Schmidt
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Simon D Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Vivian Hogan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Emily Hone
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Jennifer Rothenberg
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Rezalina Tant
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Michele Wayman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Chantele Friend
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Kamala Thapa
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Lola Ulomi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Julian Davies
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Amber Michel
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Timothy H Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Robert J O’Connell
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Mark P Simons
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | | | - Anthony C Fries
- United States Air Force School of Aerospace Medicine (USAFSAM), Wright-Patterson Air Force Base, Ohio, USA
| | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
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4
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Ferreira da Silva L, Alcantara LCJ, Fonseca V, Frias D, Umaki Zardin MCS, de Castro Lichs GG, Esposito AOP, Xavier J, Fritsch H, Lima M, de Oliveira C, Castilho de Arruda LD, Maziero LDMA, Rodrigues Barretos EC, Tsuha Oshiro PE, Gimenes Mendes Menezes EF, de Freitas Cardoso L, Ferreira Lemos E, Lourenço J, de Albuquerque CFC, do Carmo Said RF, Rosewell A, Ferraz Demarchi LH, Croda J, Giovanetti M, Maymone Gonçalves CC. Insights into SARS-CoV-2 Surveillance among Prison Populations in Mato Grosso do Sul, Brazil, in 2022. Viruses 2024; 16:1143. [PMID: 39066305 PMCID: PMC11281713 DOI: 10.3390/v16071143] [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: 03/14/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
This study examines the epidemiological and genomic characteristics, along with the transmission dynamics, of SARS-CoV-2 within prison units I and II in Campo Grande, Mato Grosso do Sul, Brazil. Conducted between May and October 2022, it reveals how the virus spreads in the confined settings of prisons, emphasizing the roles of overcrowded cells, frequent transfers, and limited healthcare access. The research involved 1927 participants (83.93% of the total prison population) and utilized nasopharyngeal swabs and RT-qPCR testing for detection. Contact tracing monitored exposure within cells. Out of 2108 samples, 66 positive cases were identified (3.13%), mostly asymptomatic (77.27%), with the majority aged 21-29 and varying vaccination statuses. Next-generation sequencing generated 28 whole genome sequences, identifying the Omicron variant (subtypes BA.2 and BA.5) with 99% average coverage. Additionally, the study seeks to determine the relationship between immunization levels and the incidence of SARS-CoV-2 cases within this enclosed population. The findings underscore the necessity of comprehensive control strategies in prisons, including rigorous screening, isolation protocols, vaccination, epidemiological monitoring, and genomic surveillance to mitigate disease transmission and protect both the incarcerated population and the broader community.
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Affiliation(s)
- Liliane Ferreira da Silva
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
| | - Luiz Carlos Junior Alcantara
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Minas Gerais, Brazil; (L.C.J.A.); (J.X.); (H.F.); (M.L.)
- Climate Amplified Diseases and Epidemics (CLIMADE), Bairro Floresta 31110-370, Minas Gerais, Brazil
| | - Vagner Fonseca
- Climate Amplified Diseases and Epidemics (CLIMADE), Bairro Floresta 31110-370, Minas Gerais, Brazil
- Departamento de Ciências Exatas e da Terra, Universidade do Estado da Bahia, Salvador 40301-110, Bahia, Brazil;
- Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Diego Frias
- Departamento de Ciências Exatas e da Terra, Universidade do Estado da Bahia, Salvador 40301-110, Bahia, Brazil;
| | - Marina Castilhos Souza Umaki Zardin
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (M.C.S.U.Z.); (G.G.d.C.L.); (A.O.P.E.); (L.H.F.D.)
| | - Gislene Garcia de Castro Lichs
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (M.C.S.U.Z.); (G.G.d.C.L.); (A.O.P.E.); (L.H.F.D.)
| | - Ana Olivia Pascoto Esposito
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (M.C.S.U.Z.); (G.G.d.C.L.); (A.O.P.E.); (L.H.F.D.)
| | - Joilson Xavier
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Minas Gerais, Brazil; (L.C.J.A.); (J.X.); (H.F.); (M.L.)
| | - Hegger Fritsch
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Minas Gerais, Brazil; (L.C.J.A.); (J.X.); (H.F.); (M.L.)
| | - Mauricio Lima
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Minas Gerais, Brazil; (L.C.J.A.); (J.X.); (H.F.); (M.L.)
| | - Carla de Oliveira
- Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz, Manguinhos 21040-900, Rio de Janeiro, Brazil;
| | - Larissa Domingues Castilho de Arruda
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
| | - Livia de Mello Almeida Maziero
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
| | - Ellen Caroline Rodrigues Barretos
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
| | - Paulo Eduardo Tsuha Oshiro
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
| | - Evellyn Fernanda Gimenes Mendes Menezes
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
| | - Lucélia de Freitas Cardoso
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
| | - Everton Ferreira Lemos
- School of Medicine, Universidade Estadual do Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil;
| | - José Lourenço
- Faculdade de Medicina, Universidade Católica Portuguesa, Biomedical Research Center, 1649-023 Lisbon, Portugal
- Climate Amplified Diseases and Epidemics (CLIMADE), 1749-016 Lisbon, Portugal
| | - Carlos F. C. de Albuquerque
- Coordenação de Vigilância, Preparação e Resposta à Emergências e Desastres (PHE), Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), Brasília 25045-002, Federal District, Brazil; (C.F.C.d.A.); (R.F.d.C.S.); (A.R.)
| | - Rodrigo Fabiano do Carmo Said
- Coordenação de Vigilância, Preparação e Resposta à Emergências e Desastres (PHE), Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), Brasília 25045-002, Federal District, Brazil; (C.F.C.d.A.); (R.F.d.C.S.); (A.R.)
| | - Alexander Rosewell
- Coordenação de Vigilância, Preparação e Resposta à Emergências e Desastres (PHE), Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), Brasília 25045-002, Federal District, Brazil; (C.F.C.d.A.); (R.F.d.C.S.); (A.R.)
| | - Luiz Henrique Ferraz Demarchi
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (M.C.S.U.Z.); (G.G.d.C.L.); (A.O.P.E.); (L.H.F.D.)
| | - Julio Croda
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil;
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT 06510, USA
- Fundação Oswaldo Cruz, Mato Grosso do Sul, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
| | - Marta Giovanetti
- Department of Sciences and Technologies for Sustainable Development and One Health, Universita Campus Bio-Medico di Roma, 00128 Selcetta, Italy
- Oswaldo Cruz Foundation, Manguinhos 21040-900, Rio de Janeiro, Brazil
| | - Crhistinne Cavalheiro Maymone Gonçalves
- Secretaria de Estado de Saúde, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (L.F.d.S.); (L.D.C.d.A.); (L.d.M.A.M.); (E.C.R.B.); (P.E.T.O.); (E.F.G.M.M.); (L.d.F.C.); (C.C.M.G.)
- School of Medicine, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil
- Laboratório Central de Saúde Pública de Mato Grosso do Sul/SES/MS, Campo Grande 79031-350, Mato Grosso do Sul, Brazil; (M.C.S.U.Z.); (G.G.d.C.L.); (A.O.P.E.); (L.H.F.D.)
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Mato Grosso do Sul, Brazil;
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Ragozzino S, Kuehl R, Leuzinger K, Schläpfer P, Urwyler P, Durovic A, Zingg S, von Rotz M, Battegay M, Widmer AF, Hirsch HH, Bassetti S, Tschudin-Sutter S. Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms. Antimicrob Resist Infect Control 2024; 13:73. [PMID: 38971822 PMCID: PMC11227710 DOI: 10.1186/s13756-024-01430-4] [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: 12/18/2023] [Accepted: 06/28/2024] [Indexed: 07/08/2024] Open
Abstract
The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 - 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7-18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.
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Affiliation(s)
- Silvio Ragozzino
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Richard Kuehl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Karoline Leuzinger
- Clinical Virology, Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Pascal Schläpfer
- Clinical Virology, Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Pascal Urwyler
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Ana Durovic
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Sandra Zingg
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Matthias von Rotz
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Hans H Hirsch
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
- Clinical Virology, Laboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Transplantation and Clinical Virology, Department Biomedicine, University of Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, University Basel, Basel, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland.
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, Basel, CH-4031, Switzerland.
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6
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McGarry BE, Gandhi AD, Chughtai MA, Yin J, Barnett ML. Clinical Outcomes After Admission of Patients With COVID-19 to Skilled Nursing Facilities. JAMA Intern Med 2024; 184:799-808. [PMID: 38829646 PMCID: PMC11148790 DOI: 10.1001/jamainternmed.2024.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/20/2024] [Indexed: 06/05/2024]
Abstract
Importance During the COVID-19 pandemic, stabilized COVID-19-positive patients were discharged to skilled nursing facilities (SNFs) to alleviate hospital crowding. These discharges generated controversy due to fears of seeding outbreaks, but there is little empirical evidence to inform policy. Objective To assess the association between the admission to SNFs of COVID-19-positive patients and subsequent COVID-19 cases and death rates among residents. Design, Setting, and Participants This cohort study analyzed survey data from the National Healthcare Safety Network of the Centers for Disease Control and Prevention. The cohort included SNFs in the US from June 2020 to March 2021. Exposed facilities (ie, with initial admission of COVID-19-positive patients) were matched to control facilities (ie, without initial admission of COVID-19-positive patients) in the same county and with similar preadmission case counts. Data were analyzed from June 2023 to February 2024. Exposure The week of the first observable admission of COVID-19-positive patients (defined as those previously diagnosed with COVID-19 and continued to require transmission-based precautions) during the study period. Main Outcomes and Measures Weekly counts of new cases of COVID-19, COVID-19-related deaths, and all-cause deaths per 100 residents in the week prior to the initial admission. A stacked difference-in-differences approach was used to compare outcomes for 10 weeks before and 15 weeks after the first admission. Additional analyses examined whether outcomes differed in facilities with staff or personal protective equipment (PPE) shortages. Results A matched group of 264 exposed facilities and 518 control facilities was identified. Over the 15-week follow-up period, exposed SNFs had a cumulative increase of 6.94 (95% CI, 2.91-10.98) additional COVID-19 cases per 100 residents compared with control SNFs, a 31.3% increase compared with the sample mean (SD) of 22.2 (26.4). Exposed facilities experienced 2.31 (95% CI, 1.39-3.24) additional cumulative COVID-19-related deaths per 100 residents compared with control facilities, representing a 72.4% increase compared with the sample mean (SD) of 3.19 (5.5). Exposed facilities experiencing potential staff shortage and PPE shortage had larger increases in COVID-19 cases per 100 residents (additional 10.97 [95% CI, 2.76-19.19] cases and additional 14.81 [95% CI, 2.38-27.25] cases, respectively) compared with those without such shortages. Conclusion This cohort study suggests that admission of COVID-19-positive patients into SNFs early in the pandemic was associated with preventable COVID-19 cases and mortality among residents, particularly in facilities with potential staff and PPE shortages. The findings speak to the importance of equipping SNFs to adhere to infection-control best practices as they continue to face COVID-19 strains and other respiratory diseases.
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Affiliation(s)
- Brian E. McGarry
- Division of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, New York
| | - Ashvin D. Gandhi
- Anderson School of Management, UCLA (University of California, Los Angeles)
| | - Mah Afroze Chughtai
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jiamin Yin
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Michael L. Barnett
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
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7
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Lu L, Cao L, Zhang J, Lin B. Cutaneous manifestations associated with COVID-19 infection at a university hospital in eastern China. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2024; 13:117-132. [PMID: 39022792 PMCID: PMC11249857 DOI: 10.62347/bduc7952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 06/12/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) affects different organ systems, including the skin. A retrospective analysis of skin manifestations in Chinese outpatient and inpatient settings is lacking. The study aims to analyze cutaneous manifestations in COVID-19 patients and the recurrence or aggravation of previous skin diseases. MATERIALS AND METHODS A retrospective cross-sectional study was conducted from November 2022 to July 2023 in a university hospital in eastern China. It involved reverse transcriptase polymerase chain reaction (RT-PCR)-positive COVID-19 patients, documenting various skin manifestations and the recurrence or aggravation of pre-existing skin conditions. The pattern of skin lesions and other variables were assessed. RESULTS The study included 303 patients, with 127 males and 176 females. Maculopapular rash was the predominant new cutaneous manifestation (54.92%), mainly in middle-aged individuals. Other findings included urticaria (16.39%), herpes zoster (11.89%), and herpes simplex (4.10%), vesicular rashes (2.46%), purpura (2.05%), erythema multiforme (1.64%), livedo reticularis (0.41%) and so on. Severe disease was associated with herpes zoster and livedo reticularis. Critical COVID-19 cases were linked to vesicular rashes, purpura, and erythema multiforme. The mean time for skin lesion emergence post-infection varied from 3 days for seborrheic dermatitis to 17.48 days for herpes zoster. Vasculitic manifestations correlated with elevated D-dimer levels. A total of 59 cases (19.47%) of recurrent or aggravated skin diseases were reported following infection with COVID-19, with dermatitis being the most common, followed by acne and folliculitis, psoriasis, urticaria, bullous pemphigoid, pemphigus, tinea corporis and androgenetic alopecia. CONCLUSION The cutaneous phenotypes delineated in this study expand the dermatologic spectrum associated with COVID-19. Cutaneous manifestations may result from overactive immune responses, complement activation, and microvascular damage. Herpes zoster typically occurs in elderly COVID-19 patients with weaker immune systems or more severe diseases. Purpura and livedo reticularis, although rare, may indicate disease severity. It is possible to predict the course of COVID-19 with different severity through cutaneous manifestations. Recognizing these skin manifestations could aid in predicting COVID-19 severity and guide dermatologists in managing the pandemic response.
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Affiliation(s)
- Lingyi Lu
- Department of Dermatology, The First Affiliated Hospital of Ningbo University No. 59, Liuting Street, Ningbo 315010, Zhejiang, P. R. China
| | - Lu Cao
- Department of Dermatology, The First Affiliated Hospital of Ningbo University No. 59, Liuting Street, Ningbo 315010, Zhejiang, P. R. China
| | - Jing Zhang
- Department of Dermatology, The First Affiliated Hospital of Ningbo University No. 59, Liuting Street, Ningbo 315010, Zhejiang, P. R. China
| | - Bingjiang Lin
- Department of Dermatology, The First Affiliated Hospital of Ningbo University No. 59, Liuting Street, Ningbo 315010, Zhejiang, P. R. China
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8
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Reed DS, McElroy AK, Barbeau DJ, McMillen CM, Tilston-Lunel NL, Nambulli S, Cottle E, Gilliland TC, Rannulu H, Lundy J, Olsen EL, O’Malley KJ, Xia M, Hartman AL, Luke TC, Egland K, Bausch C, Wu H, Sullivan EJ, Klimstra WB, Duprex WP. No evidence for enhanced disease with human polyclonal SARS-CoV-2 antibody in the ferret model. PLoS One 2024; 19:e0290909. [PMID: 38900732 PMCID: PMC11189238 DOI: 10.1371/journal.pone.0290909] [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: 08/17/2023] [Accepted: 05/06/2024] [Indexed: 06/22/2024] Open
Abstract
Since SARS-CoV-2 emerged in late 2019, it spread from China to the rest of the world. An initial concern was the potential for vaccine- or antibody-dependent enhancement (ADE) of disease as had been reported with other coronaviruses. To evaluate this, we first developed a ferret model by exposing ferrets to SARS-CoV-2 by either mucosal inoculation (intranasal/oral/ocular) or inhalation using a small particle aerosol. Mucosal inoculation caused a mild fever and weight loss that resolved quickly; inoculation via either route resulted in virus shedding detected in the nares, throat, and rectum for 7-10 days post-infection. To evaluate the potential for ADE, we then inoculated groups of ferrets intravenously with 0.1, 0.5, or 1 mg/kg doses of a human polyclonal anti-SARS-CoV-2 IgG from hyper-immunized transchromosomic bovines (SAB-185). Twelve hours later, ferrets were challenged by mucosal inoculation with SARS-CoV-2. We found no significant differences in fever, weight loss, or viral shedding after infection between the three antibody groups or the controls. Signs of pathology in the lungs were noted in infected ferrets but no differences were found between control and antibody groups. The results of this study indicate that healthy, young adult ferrets of both sexes are a suitable model of mild COVID-19 and that low doses of specific IgG in SAB-185 are unlikely to enhance the disease caused by SARS-CoV-2.
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Affiliation(s)
- Douglas S. Reed
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Anita K. McElroy
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Dominique J. Barbeau
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Cynthia M. McMillen
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Natasha L. Tilston-Lunel
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Indiana University–Purdue University Indianapolis, Indianapolis, IN, United States of America
| | - Shamkumar Nambulli
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Emily Cottle
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Theron C. Gilliland
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Hasala Rannulu
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jeneveve Lundy
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Emily L. Olsen
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Katherine J. O’Malley
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mengying Xia
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Amy L. Hartman
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Thomas C. Luke
- SAB Biotherapetuics, Sioux Falls, SD, United States of America
| | - Kristi Egland
- SAB Biotherapetuics, Sioux Falls, SD, United States of America
| | | | - Hua Wu
- SAB Biotherapetuics, Sioux Falls, SD, United States of America
| | | | - William B. Klimstra
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - W. Paul Duprex
- Center for Vaccine Research, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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9
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Bani S, Amakye EK, Akomea S, Nyarko EN, Dodoo D, Aidoo C, Fynn-Buadu M, Adom M, Bani F, Obirikorang C. An Evaluation of the Sensitivity and Specificity of Three COVID-19 Rapid Immunochromatographic Test Kits Compared to Real-Time Reverse Transcriptase-Polymerase Chain Reaction (rRT-PCR) Among Clinical Samples. Cureus 2024; 16:e63294. [PMID: 39070382 PMCID: PMC11283276 DOI: 10.7759/cureus.63294] [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] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
Background and objective The coronavirus disease 2019 (COVID-19) pandemic has imposed a significant burden on healthcare systems worldwide. This highlights the need for simple, rapid, and affordable diagnostic tests that can serve as alternatives to the existing costly and demanding polymerase chain reaction (PCR) assay, especially in resource-limited countries like Ghana. In light of this, we aimed to assess the diagnostic efficacy of three COVID-19 rapid immunochromatographic antigen test kits vs. real-time reverse transcriptase-PCR (rRT-PCR). Methods This study evaluated the sensitivity and specificity of three COVID-19 rapid immunochromatographic antigen test kits: DG Rapid, SD Rapid, and SS Rapid. They were compared with the gold standard RT-PCR for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antigen in 75 randomly selected archived nasopharyngeal samples. Results Of the 75 samples tested, 38 (50.7%) were positive and 37 (49.3%) were negative for SARS-CoV-2 RNA by rRT-PCR assay. No false positives were recorded. On the other hand, the DG Rapid kit detected 30 (78.9%) true positives and eight (21.1%) false negatives. SD Rapid kit detected 28 (73.7%) true positives and 10 (26.3%) false negatives, while the SS Rapid kit detected 19 (50.0%) true positives and 19 (50.0%) false negatives. While the specificity of each test kit was 100% (95% CI), the sensitivity of the DG Rapid, SD Rapid, and SS Rapid kits was 79%, 74%, and 50% (95% CI), respectively. Higher sensitivities were recorded among samples with cycle threshold (Ct) values <29.99 for each kit. Also, the DG Rapid kit demonstrated 79% excellent agreement with rRT-PCR, while the SD Rapid and SS Rapid kits demonstrated good agreement with rRT-PCR with 73% and 50% Cohen's kappa values, respectively. Conclusions Based on our findings, DG Rapid and SD Rapid kits are reliable alternatives to rRT-PCR for the detection of SARS-CoV-2 infection, especially in resource-limited settings like Ghana.
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Affiliation(s)
- S Bani
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, GHA
| | - Ebenezer K Amakye
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, GHA
| | - Shanti Akomea
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, GHA
| | - Eric Ny Nyarko
- Chemical Pathology, University of Ghana Medical School, Accra, GHA
| | - Derrick Dodoo
- Department of Medical Laboratory Sciences, Baldwin University College, Accra, GHA
| | - Clement Aidoo
- Department of Medical Laboratory Sciences, Accra Technical University, Accra, GHA
| | - Magdalene Fynn-Buadu
- Department of Medical Laboratory Sciences, Accra Technical University, Accra, GHA
| | - Monica Adom
- Department of Medical Laboratory Sciences, Princess Marie Louise Children's Hospital, Ghana Health Service, Accra, GHA
| | - Fathea Bani
- Department of Medicine, School of Allied Health Sciences, University for Development Studies, Tamale, GHA
| | - Christian Obirikorang
- Global Health and Infectious Diseases Group, Kumasi Centre for Collaborative Research, Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, GHA
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Delazer L, Pressler N, Balestrini S, Xiao F, Clayton LM, Anders‐Cannon J, Salvatierra R, Henry I, Sisodiya SM, Sander JW, Koepp MJ. COVID-19 response in a long-term care facility for people with epilepsy. Epilepsia Open 2024; 9:1059-1066. [PMID: 38593277 PMCID: PMC11145605 DOI: 10.1002/epi4.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/09/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE To assess asymptomatic rates and severity of SARS-CoV-2 infection in people with epilepsy and their healthcare workers in a long-term care facility which had implemented weekly surveillance testing between April 2020 and June 2022. METHODS Questionnaires focused on objective and subjective COVID-19 symptoms for people with epilepsy residing in and their healthcare workers at the Chalfont Centre for Epilepsy in June 2022. Demographic information, comorbidities, and seizure frequency were gathered from medical records. We also collected responses on objective and subjective COVID-19 symptoms from healthcare workers who participated in a prospective study assessing the reaction to COVID-19 vaccinations (SAFER). RESULTS Fifty-five out of 89 (62%) residents tested positive at least once on weekly PCR testing for SARS-CoV-2 during the period of interest; 20 of those (37%) were asymptomatic. In comparison, of those 63 healthcare workers who tested positive at least once on weekly testing during the same period, only four (6%) were asymptomatic. Of the 159 healthcare workers who also participated in the SAFER study, 41 tested positive at least once, and seven (17%) were completely asymptomatic during infection with SARS-CoV-2. SIGNIFICANCE People with epilepsy living in a long-term care facility were more likely to present with asymptomatic SARS-CoV-2 infections than healthcare workers at the same facility. Despite possible bias in the reporting of subjective symptoms due to management-by-proxy, there is no evidence that vulnerable people living in an epilepsy long-term care facility showed reduced resilience towards infections. PLAIN LANGUAGE SUMMARY People with epilepsy living in care home facilities had a surprisingly high degree of asymptomatic infections with SARS-CoV-2. Very few residents had severe or fatal outcomes. This is in stark contrast to the widely reported bad outcomes for people without epilepsy in other care homes. People with epilepsy reported significantly less symptoms than their healthcare workers. No changes in seizure frequency during or after infection were observed.
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Affiliation(s)
- Luisa Delazer
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, Epilepsy CenterLudwig Maximilians UniversityMunichGermany
| | - Noah Pressler
- University of Nottingham, Medical SchoolNottinghamUK
| | - Simona Balestrini
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Neuroscience Department, Children's Hospital A. Meyer IRCSSUniversity of FlorenceFlorenceItaly
| | - Fenglai Xiao
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Lisa M. Clayton
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | | | | | - Ian Henry
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
| | - Sanjay M. Sisodiya
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | - Josemir W. Sander
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
| | - Matthias J. Koepp
- Chalfont Centre for EpilepsyChalfont St Peter, BucksUK
- Department of Clinical & Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
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11
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Berry GJ, Jhaveri TA, Larkin PMK, Mostafa H, Babady NE. ADLM Guidance Document on Laboratory Diagnosis of Respiratory Viruses. J Appl Lab Med 2024; 9:599-628. [PMID: 38695489 DOI: 10.1093/jalm/jfae010] [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: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 06/06/2024]
Abstract
Respiratory viral infections are among the most frequent infections experienced worldwide. The COVID-19 pandemic has highlighted the need for testing and currently several tests are available for the detection of a wide range of viruses. These tests vary widely in terms of the number of viral pathogens included, viral markers targeted, regulatory status, and turnaround time to results, as well as their analytical and clinical performance. Given these many variables, selection and interpretation of testing requires thoughtful consideration. The current guidance document is the authors' expert opinion based on the preponderance of available evidence to address key questions related to best practices for laboratory diagnosis of respiratory viral infections including who to test, when to test, and what tests to use. An algorithm is proposed to help laboratories decide on the most appropriate tests to use for the diagnosis of respiratory viral infections.
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Affiliation(s)
- Gregory J Berry
- Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian-Columbia University Irving Medical Center, New York, NY, United States
| | - Tulip A Jhaveri
- Department of Internal Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, United States
| | - Paige M K Larkin
- University of Chicago Pritzker School of Medicine, NorthShore University Health System, Chicago, IL, United States
| | - Heba Mostafa
- Johns Hopkins School of Medicine, Department of Pathology, Baltimore, MD, United States
| | - N Esther Babady
- Clinical Microbiology and Infectious Disease Services, Department of Pathology and Laboratory Medicine and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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12
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Kannuri S, Patil R, Mukhida S, Bhaumik S, Gandham N. A closer look at the link between cycle threshold, clinical features and biomarkers: An observational study in COVID-19 patients. J Family Med Prim Care 2024; 13:1983-1989. [PMID: 38948616 PMCID: PMC11213427 DOI: 10.4103/jfmpc.jfmpc_967_23] [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: 06/12/2023] [Revised: 06/30/2023] [Accepted: 12/28/2023] [Indexed: 07/02/2024] Open
Abstract
Background Symptoms for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) appear 2-3 days after exposure to the virus. Being a virus, detection is primarily by polymerase chain reaction as this offers superior sensitivity and specificity. There was a misconception that patients with low cycle threshold (Ct) have severe coronavirus disease (COVID), and for individuals with higher Ct, it is the other way around. The prognosis for COVID was derived from various biomarkers and physicians heavily relied on them. Materials and Methods A cross-sectional study spanning a duration of 2 years was conducted at a tertiary care centre in western India. A total of 201 individuals were included and the correlation between Ct, clinical features and biomarkers was studied. Results In the E-gene, 43.28% had lower Ct values and 40.79% had low Ct values in the RdRp gene. 50% of all patients had diabetes, with 60% being between the ages of 61 and 80. 54.1% of hypertension patients belonged to ages between 61 and 80. 90.54% of COVID-positive individuals had lactose dehydrogenase levels ranging from 440 to 760. 79% of patients had a procalcitonin value of more than one but less than six. 79.1% of patients had an erythrocyte sedimentation rate between 36 and 90. Conclusion Ct value though has a research value; it is a poor prognostic marker when compared to the various biomarkers that have been studied earlier. We cannot conclusively state that all our findings are accurate due to a lack of data but further research into the prognostic value of Ct should be conducted which will help in the ongoing scenario.
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Affiliation(s)
- Sriram Kannuri
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Rajashri Patil
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Sahjid Mukhida
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Shalini Bhaumik
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Nageswari Gandham
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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13
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Rios-Guzman E, Stancovici AG, Simons LM, Barajas G, Glenn K, Weber RT, Ozer EA, Lorenzo-Redondo R, Hultquist JF, Bolon MK. COVID-19 outbreak and genomic investigation in an inpatient behavioral health unit. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2024; 4:e62. [PMID: 38698947 PMCID: PMC11062797 DOI: 10.1017/ash.2024.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 05/05/2024]
Abstract
Background Inpatient behavioral health units (BHUs) had unique challenges in implementing interventions to mitigate coronavirus disease 2019 (COVID-19) transmission, in part due to socialization in BHU settings. The objective of this study was to identify the transmission routes and the efficacy of the mitigation strategies employed during a COVID-19 outbreak in an inpatient BHU during the Omicron surge from December 2021 to January 2022. Methods An outbreak investigation was performed after identifying 2 COVID-19-positive BHU inpatients on December 16 and 20, 2021. Mitigation measures involved weekly point prevalence testing for all inpatients, healthcare workers (HCWs), and staff, followed by infection prevention mitigation measures and molecular surveillance. Whole-genome sequencing on a subset of COVID-19-positive individuals was performed to identify the outbreak source. Finally, an outbreak control sustainability plan was formulated for future BHU outbreak resurgences. Results We identified 35 HCWs and 8 inpatients who tested positive in the BHU between December 16, 2021, and January 17, 2022. We generated severe acute respiratory coronavirus virus 2 (SARS-CoV-2) genomes from 15 HCWs and all inpatients. Phylogenetic analyses revealed 3 distinct but genetically related clusters: (1) an HCW and inpatient outbreak likely initiated by staff, (2) an HCW and inpatient outbreak likely initiated by an inpatient visitor, and (3) an HCW-only cluster initiated by staff. Conclusions Distinct transmission clusters are consistent with multiple, independent SARS-CoV-2 introductions with further inpatient transmission occurring in communal settings. The implemented outbreak control plan comprised of enhanced personal protective equipment requirements, limited socialization, and molecular surveillance likely minimized disruptions to patient care as a model for future pandemics.
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Affiliation(s)
- Estefany Rios-Guzman
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL, USA
| | - Alina G. Stancovici
- Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Lacy M. Simons
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL, USA
| | - Grace Barajas
- Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Katia Glenn
- Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Rachel T. Weber
- Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Egon A. Ozer
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL, USA
| | - Ramon Lorenzo-Redondo
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL, USA
| | - Judd F. Hultquist
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Pathogen Genomics and Microbial Evolution, Northwestern University Havey Institute for Global Health, Chicago, IL, USA
| | - Maureen K. Bolon
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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14
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Jinadatha C, Jones LD, Hailes JM, Marshall EK, Hwang M, Cadnum JL, Choi H, Chatterjee P, Chan ER, Zimmerman PA, Chakhtoura NGE, Saade EA, Donskey CJ. Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Among Residents and Employees in a Veterans Affairs Community Living Center: A 42-Month Prospective Cohort Study. Pathog Immun 2024; 9:91-107. [PMID: 38690562 PMCID: PMC11060326 DOI: 10.20411/pai.v9i1.691] [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: 03/04/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Background Understanding routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in long-term care facilities is essential for the development of effective control measures. Methods Between March 1, 2020, and August 31, 2023, we identified coronavirus disease 2019 (COVID-19) cases among residents and employees in a Veterans Affairs community living center that conducted routine screening for asymptomatic COVID-19. Contact tracing was conducted to identify suspected transmission events, and whole genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples. Results During the 42-month study period, 269 cases of COVID-19 were diagnosed, including 199 employees and 70 residents. A total of 48 (24.1%) employees and 30 (42.9%) residents were asymptomatic. Sequencing analysis provided support for multiple events in which employees transmitted SARS-CoV-2 to co-workers and residents. There was 1 episode of likely transmission of SARS-CoV-2 from one resident to another resident, but no documented transmissions from residents to employees. Conclusions Transmission of SARS-CoV-2 in the community living center predominantly involved transmission from employees to co-workers and residents. There is a need for improved measures to prevent transmission of SARS-CoV-2 by healthcare personnel.
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Affiliation(s)
- Chetan Jinadatha
- Medical Service, Central Texas Veterans Healthcare System, Temple, Texas
- School of Medicine, Texas A&M University, Bryan, Texas
| | - Lucas D. Jones
- Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jennifer M. Hailes
- Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland Ohio
| | - Emma K. Marshall
- Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland Ohio
| | - Munok Hwang
- Research Service, Central Texas Veterans Healthcare System, Temple, Texas
| | - Jennifer L. Cadnum
- Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland Ohio
| | - Hosoon Choi
- Research Service, Central Texas Veterans Healthcare System, Temple, Texas
| | - Piyali Chatterjee
- Research Service, Central Texas Veterans Healthcare System, Temple, Texas
| | - Ernest R. Chan
- Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
| | - Peter A. Zimmerman
- The Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio
| | - Nadim G. El Chakhtoura
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | - Elie A. Saade
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Curtis J. Donskey
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
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Jiang D, Soo N, Tan CY, Dankwa S, Wang HY, Theriot BS, Ardeshir A, Siddiqui NY, Van Rompay KKA, De Paris K, Permar SR, Goswami R, Surana NK. Commensal bacteria inhibit viral infections via a tryptophan metabolite. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.21.589969. [PMID: 38659737 PMCID: PMC11042330 DOI: 10.1101/2024.04.21.589969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
There is growing appreciation that commensal bacteria impact the outcome of viral infections, though the specific bacteria and their underlying mechanisms remain poorly understood. Studying a simian-human immunodeficiency virus (SHIV)-challenged cohort of pediatric nonhuman primates, we bioinformatically associated Lactobacillus gasseri and the bacterial family Lachnospiraceae with enhanced resistance to infection. We experimentally validated these findings by demonstrating two different Lachnospiraceae isolates, Clostridium immunis and Ruminococcus gnavus, inhibited HIV replication in vitro and ex vivo. Given the link between tryptophan catabolism and HIV disease severity, we found that an isogenic mutant of C. immunis that lacks the aromatic amino acid aminotransferase (ArAT) gene, which is key to metabolizing tryptophan into 3-indolelactic acid (ILA), no longer inhibits HIV infection. Intriguingly, we confirmed that a second commensal bacterium also inhibited HIV in an ArAT-dependent manner, thus establishing the generalizability of this finding. In addition, we found that purified ILA inhibited HIV infection by agonizing the aryl hydrocarbon receptor (AhR). Given that the AhR has been implicated in the control of multiple viral infections, we demonstrated that C. immunis also inhibited human cytomegalovirus (HCMV) infection in an ArAT-dependent manner. Importantly, metagenomic analysis of individuals at-risk for HIV revealed that those who ultimately acquired HIV had a lower fecal abundance of the bacterial ArAT gene compared to individuals who did not, which indicates our findings translate to humans. Taken together, our results provide mechanistic insights into how commensal bacteria decrease susceptibility to viral infections. Moreover, we have defined a microbiota-driven antiviral pathway that offers the potential for novel therapeutic strategies targeting a broad spectrum of viral pathogens.
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Pallari CT, Achilleos S, Quattrocchi A, Gabel J, Critselis E, Athanasiadou M, Rahmanian Haghighi MR, Papatheodorou S, Liu T, Artemiou A, Rodriguez-Llanes JM, Bennett CM, Zimmermann C, Schernhammer E, Bustos Sierra N, Ekelson R, Lobato J, Macedo L, Mortensen LH, Critchley J, Goldsmith L, Denissov G, Le Meur N, Kandelaki L, Athanasakis K, Binyaminy B, Maor T, Stracci F, Ambrosio G, Davletov K, Glushkova N, Martial C, Chan Sun M, Hagen TP, Chong M, Barron M, Łyszczarz B, Erzen I, Arcos Gonzalez P, Burström B, Pidmurniak N, Verstiuk O, Huang Q, Polemitis A, Charalambous A, Demetriou CA. Magnitude and determinants of excess total, age-specific and sex-specific all-cause mortality in 24 countries worldwide during 2020 and 2021: results on the impact of the COVID-19 pandemic from the C-MOR project. BMJ Glob Health 2024; 9:e013018. [PMID: 38637119 PMCID: PMC11029481 DOI: 10.1136/bmjgh-2023-013018] [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: 06/01/2023] [Accepted: 01/06/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION To examine the impact of the COVID-19 pandemic on mortality, we estimated excess all-cause mortality in 24 countries for 2020 and 2021, overall and stratified by sex and age. METHODS Total, age-specific and sex-specific weekly all-cause mortality was collected for 2015-2021 and excess mortality for 2020 and 2021 was calculated by comparing weekly 2020 and 2021 age-standardised mortality rates against expected mortality, estimated based on historical data (2015-2019), accounting for seasonality, and long-term and short-term trends. Age-specific weekly excess mortality was similarly calculated using crude mortality rates. The association of country and pandemic-related variables with excess mortality was investigated using simple and multilevel regression models. RESULTS Excess cumulative mortality for both 2020 and 2021 was found in Austria, Brazil, Belgium, Cyprus, England and Wales, Estonia, France, Georgia, Greece, Israel, Italy, Kazakhstan, Mauritius, Northern Ireland, Norway, Peru, Poland, Slovenia, Spain, Sweden, Ukraine, and the USA. Australia and Denmark experienced excess mortality only in 2021. Mauritius demonstrated a statistically significant decrease in all-cause mortality during both years. Weekly incidence of COVID-19 was significantly positively associated with excess mortality for both years, but the positive association was attenuated in 2021 as percentage of the population fully vaccinated increased. Stringency index of control measures was positively and negatively associated with excess mortality in 2020 and 2021, respectively. CONCLUSION This study provides evidence of substantial excess mortality in most countries investigated during the first 2 years of the pandemic and suggests that COVID-19 incidence, stringency of control measures and vaccination rates interacted in determining the magnitude of excess mortality.
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Affiliation(s)
- Chryso Th Pallari
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - John Gabel
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Elena Critselis
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Maria Athanasiadou
- Health Monitoring Unit, Government of the Republic of Cyprus Ministry of Health, Nicosia, Cyprus
| | | | - Stefania Papatheodorou
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Tianyu Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Andreas Artemiou
- School of Information Technologies, University of Limassol, Limassol, Cyprus
| | | | - Catherine M Bennett
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Claudia Zimmermann
- Department of Epidemiology, Medical University of Vienna Center for Public Health, Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Medical University of Vienna Center for Public Health, Vienna, Austria
| | | | - Reindert Ekelson
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Jackeline Lobato
- Department of Epidemiology and Biostatistics, Institute of Collective Health (ISC), Federal Fluminense University, Niteroi, Brazil
| | - Laylla Macedo
- Institute of Studies in Collective Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Julia Critchley
- Population Health Research Institute, St George's University of London, London, UK
| | - Lucy Goldsmith
- Division of Health Services Research and Management, School of Health and Psychological Sciences, University of London, City, London, UK
| | - Gleb Denissov
- Department of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Nolwenn Le Meur
- UMR CNRS 6051 - INSERM U1309, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Levan Kandelaki
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Kostas Athanasakis
- Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece
| | - Binyamin Binyaminy
- Israeli Center of Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel
| | - Tamar Maor
- Israeli Center of Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel
| | - Fabrizio Stracci
- Department of Medicine, Public Health Section, University of Perugia, School of Medicine, Perugia, Italy
| | - Giuseppe Ambrosio
- Department of Cardiology, University of Perugia School of Medicine, Perugia, Italy
| | - Kairat Davletov
- Rector Administration, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Nataliya Glushkova
- Department of Epidemiology, Evidence-Based Medicine and Biostatistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Cyndy Martial
- Department of Medicine, University of Mauritius Faculty of Science, Reduit, Mauritius
| | - Marie Chan Sun
- Department of Medicine, University of Mauritius Faculty of Science, Reduit, Mauritius
| | - Terje P Hagen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Mario Chong
- Departamento de Ingeniería, Universidad del Pacifico, Lima, Peru
| | - Manuel Barron
- Departamento de Economia, Universidad del Pacifico, Lima, Peru
| | - Błażej Łyszczarz
- Department of Health Economics, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Ivan Erzen
- Public Health School, National Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia
| | - Pedro Arcos Gonzalez
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nataliia Pidmurniak
- Department of Internal Medicine, Bogomolets National Medical University, Kyiv, Ukraine
| | - Olesia Verstiuk
- Department of Medical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Qian Huang
- Center for Rural Health Research, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | | | | | - Christiana A Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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17
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Dong TQ, Brown ER. A joint Bayesian hierarchical model for estimating SARS-CoV-2 genomic and subgenomic RNA viral dynamics and seroconversion. Biostatistics 2024; 25:336-353. [PMID: 37490631 DOI: 10.1093/biostatistics/kxad016] [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: 01/09/2023] [Revised: 04/26/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023] Open
Abstract
Understanding the viral dynamics of and natural immunity to the severe acute respiratory syndrome coronavirus 2 is crucial for devising better therapeutic and prevention strategies for coronavirus disease 2019 (COVID-19). Here, we present a Bayesian hierarchical model that jointly estimates the genomic RNA viral load, the subgenomic RNA (sgRNA) viral load (correlated to active viral replication), and the rate and timing of seroconversion (correlated to presence of antibodies). Our proposed method accounts for the dynamical relationship and correlation structure between the two types of viral load, allows for borrowing of information between viral load and antibody data, and identifies potential correlates of viral load characteristics and propensity for seroconversion. We demonstrate the features of the joint model through application to the COVID-19 post-exposure prophylaxis study and conduct a cross-validation exercise to illustrate the model's ability to impute the sgRNA viral trajectories for people who only had genomic RNA viral load data.
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Affiliation(s)
- Tracy Q Dong
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, 1100 Fairview Avenue N, Seattle, WA 98109, USA
| | - Elizabeth R Brown
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, 1100 Fairview Avenue N, Seattle, WA 98109, USA
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Seattle, WA 98195, USA
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18
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Connor AA, Adelman MW, Mobley CM, Moaddab M, Erhardt AJ, Hsu DE, Brombosz EW, Sanghvi M, Cheah YL, Simon CJ, Hobeika MJ, Saharia AS, Victor DW, Kodali S, Basra T, Graviss EA, Nguyen DT, Elsaiey A, Moore LW, Nigo M, Drews AL, Grimes KA, Arias CA, Li XC, Gaber AO, Ghobrial RM. Single-center Outcomes After Liver Transplantation With SARS-CoV-2-Positive Donors: An Argument for Increased Utilization. Transplant Direct 2024; 10:e1590. [PMID: 38464428 PMCID: PMC10923316 DOI: 10.1097/txd.0000000000001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 03/12/2024] Open
Abstract
Background The COVID-19 pandemic has led to an increase in SARS-CoV-2-test positive potential organ donors. The benefits of life-saving liver transplantation (LT) must be balanced against the potential risk of donor-derived viral transmission. Although emerging evidence suggests that the use of COVID-19-positive donor organs may be safe, granular series thoroughly evaluating safety are still needed. Results of 29 consecutive LTs from COVID-19-positive donors at a single center are presented here. Methods A retrospective cohort study of LT recipients between April 2020 and December 2022 was conducted. Differences between recipients of COVID-19-positive (n = 29 total; 25 index, 4 redo) and COVID-19-negative (n = 472 total; 454 index, 18 redo) deceased donor liver grafts were compared. Results COVID-19-positive donors were significantly younger (P = 0.04) and had lower kidney donor profile indices (P = 0.04) than COVID-19-negative donors. Recipients of COVID-19-positive donor grafts were older (P = 0.04) but otherwise similar to recipients of negative donors. Donor SARS-CoV-2 infection status was not associated with a overall survival of recipients (hazard ratio, 1.11; 95% confidence interval, 0.24-5.04; P = 0.89). There were 3 deaths among recipients of liver grafts from COVID-19-positive donors. No death seemed virally mediated because there was no qualitative association with peri-LT antispike antibody titers, post-LT prophylaxis, or SARS-CoV-2 variants. Conclusions The utilization of liver grafts from COVID-19-positive donors was not associated with a decreased overall survival of recipients. There was no suggestion of viral transmission from donor to recipient. The results from this large single-center study suggest that COVID-19-positive donors may be used safely to expand the deceased donor pool.
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Affiliation(s)
- Ashton A. Connor
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - Max W. Adelman
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX
- Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, HMH, Houston TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Constance M. Mobley
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - Mozhgon Moaddab
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Pharmacy, Houston Methodist Hospital, Houston, TX
| | - Alexandra J. Erhardt
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
| | - David E. Hsu
- Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, TX
| | | | - Mansi Sanghvi
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
| | - Yee Lee Cheah
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
| | - Caroline J. Simon
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
| | - Mark J. Hobeika
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - Ashish S. Saharia
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - David W. Victor
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX
| | - Sudha Kodali
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX
| | - Tamneet Basra
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX
| | - Edward A. Graviss
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
| | - Duc T. Nguyen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Ahmed Elsaiey
- Department of Surgery, Houston Methodist Hospital, Houston, TX
| | - Linda W. Moore
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - Masayuki Nigo
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX
- Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Ashley L. Drews
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX
- Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Kevin A. Grimes
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX
- Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Cesar A. Arias
- Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, TX
- Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Xian C. Li
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
- Immunobiology and Transplant Science Center, Houston Methodist Hospital, Houston, TX
| | - A. Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
| | - R. Mark Ghobrial
- Department of Surgery, Houston Methodist Hospital, Houston, TX
- JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX
- Department of Surgery, Weill Cornell Medical College, New York, NY
- Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX
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Chen Y, Guo M, Xie K, Lei M, Chai Y, Zhang Z, Deng Z, Peng Q, Cao J, Lin S, Xu F. Progranulin promotes regulatory T cells plasticity by mitochondrial metabolism through AMPK/PGC-1α pathway in ARDS. Clin Immunol 2024; 261:109940. [PMID: 38365048 DOI: 10.1016/j.clim.2024.109940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/01/2024] [Accepted: 02/10/2024] [Indexed: 02/18/2024]
Abstract
As the aging population increases, the focus on elderly patients with acute respiratory distress syndrome (ARDS) is also increasing. In this article, we found progranulin (PGRN) differential expression in ARDS patients and healthy controls, even in young and old ARDS patients. Its expression strongly correlates with several cytokines in both young and elderly ARDS patients. PGRN has comparable therapeutic effects in young and elderly mice with lipopolysaccharide-induced acute lung injury, manifesting as lung injury, apoptosis, inflammation, and regulatory T cells (Tregs) differentiation. Considering that Tregs differentiation relies on metabolic reprogramming, we discovered that Tregs differentiation was mediated by mitochondrial function, especially in the aged population. Furthermore, we demonstrated that PGRN alleviated the mitochondrial damage during Tregs differentiation through the AMPK/PGC-1α pathway in T cells. Collectively, PGRN may regulate mitochondria function to promote Tregs differentiation through the AMPK/PGC-1α pathway to improve ARDS.
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Affiliation(s)
- Yanqing Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Minkang Guo
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ke Xie
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Lei
- Department of Critical Care Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yusen Chai
- Department of Anaesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus Dresden at Technische Universität Dresden, Dresden, Germany
| | - Zhengtao Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenhua Deng
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiaozhi Peng
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ju Cao
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shihui Lin
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Fang Xu
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Aboagye FT, Annison L, Hackman HK, Acquah ME, Ashong Y, Owusu-Frimpong I, Egyam BC, Annison S, Osei-Adjei G, Antwi-Baffour S. Molecular Epidemiology of SARS-CoV-2 within Accra Metropolis Postlockdown. Adv Virol 2024; 2024:2993144. [PMID: 38584794 PMCID: PMC10997420 DOI: 10.1155/2024/2993144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Currently, sequencing has been the only tool for the identification of circulating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants. However, it is known to be an expensive and laborious approach involving high technical expertise. Considering the reduced adherence to preventive measures postlockdown in Accra, this study presents an alternative method that leverages polymerase chain reaction (PCR) to identify circulating SARS-CoV-2 variants in the Accra Metropolis postlockdown. Methods This prospective cross-sectional study was conducted between July and December 2022. Nasopharyngeal samples were collected from 268 consenting participants. Samples were subjected to nucleic acid extraction and followed by real-time polymerase chain reaction for the detection and quantification of SARS-CoV-2 RNA. SARS-CoV-2 positive samples were subsequently subjected to variant identification using rapid PCR. Findings. The prevalence of SARS-CoV-2 within the Accra Metropolis was 30.2%. The majority of the SARS-CoV-2 infection was diagnosed in females, participants aged 41-50 years, and symptomatic participants. Participants aged ≤10 years and females recorded the highest viral load while participants aged 41-50 years recorded the highest number of infections. The SARS-CoV-2 variants detected were Alpha (64.2%), Delta (22.2%), and Omicron (13.6%). Predictors of SARS-CoV-2 infection identified were chills, cough, headache, body weakness, sore throat, and dyspnoea in order of decreasing association with SARS-CoV-2 infection. There was a strong association between symptom status, gender, age, and SARS-CoV-2 infection. Conclusion There was a high prevalence of SARS-CoV-2 within the Accra Metropolis postlockdown within the sampling period. The Alpha variant of SARS-CoV-2 is the predominant circulating variant, and persons presenting with symptoms are most likely to be diagnosed with COVID-19. Children aged ≤10 years serve as a reservoir for infection transmission.
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Affiliation(s)
- Frank T. Aboagye
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
- Biomedical and Public Health Research Unit, Council for Scientific and Industrial Research–Water Research Institute, Accra, Ghana
| | - Lawrence Annison
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Henry Kwadwo Hackman
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Maame E. Acquah
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Yvonne Ashong
- Department of Parasitology, Noguchi Memorial Institute of Medical Research, College of Medical Sciences, University of Ghana, Legon, Accra, Ghana
| | - Isaac Owusu-Frimpong
- Biomedical and Public Health Research Unit, Council for Scientific and Industrial Research–Water Research Institute, Accra, Ghana
| | - Bill C. Egyam
- Department of Molecular Biology, MDS Lancet Laboratories Ghana Limited, East Legon, Accra, Ghana
| | - Sharon Annison
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - George Osei-Adjei
- Department of Medical Laboratory Technology, Faculty of Applied Sciences, Accra Technical University, Accra, Ghana
| | - Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
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Dzieciolowska S, Charest H, Roy T, Fafard J, Carazo S, Levade I, Longtin J, Parkes L, Beaulac SN, Villeneuve J, Savard P, Corbeil J, De Serres G, Longtin Y. Timing and Predictors of Loss of Infectivity Among Healthcare Workers With Mild Primary and Recurrent COVID-19: A Prospective Observational Cohort Study. Clin Infect Dis 2024; 78:613-624. [PMID: 37675577 PMCID: PMC10954326 DOI: 10.1093/cid/ciad535] [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: 06/20/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND There is a need to understand the duration of infectivity of primary and recurrent coronavirus disease 2019 (COVID-19) and identify predictors of loss of infectivity. METHODS Prospective observational cohort study with serial viral culture, rapid antigen detection test (RADT) and reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens of healthcare workers with COVID-19. The primary outcome was viral culture positivity as indicative of infectivity. Predictors of loss of infectivity were determined using multivariate regression model. The performance of the US Centers for Disease Control and Prevention (CDC) criteria (fever resolution, symptom improvement, and negative RADT) to predict loss of infectivity was also investigated. RESULTS In total, 121 participants (91 female [79.3%]; average age, 40 years) were enrolled. Most (n = 107, 88.4%) had received ≥3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine doses, and 20 (16.5%) had COVID-19 previously. Viral culture positivity decreased from 71.9% (87/121) on day 5 of infection to 18.2% (22/121) on day 10. Participants with recurrent COVID-19 had a lower likelihood of infectivity than those with primary COVID-19 at each follow-up (day 5 odds ratio [OR], 0.14; P < .001]; day 7 OR, 0.04; P = .003]) and were all non-infective by day 10 (P = .02). Independent predictors of infectivity included prior COVID-19 (adjusted OR [aOR] on day 5, 0.005; P = .003), an RT-PCR cycle threshold [Ct] value <23 (aOR on day 5, 22.75; P < .001) but not symptom improvement or RADT result.The CDC criteria would identify 36% (24/67) of all non-infectious individuals on day 7. However, 17% (5/29) of those meeting all the criteria had a positive viral culture. CONCLUSIONS Infectivity of recurrent COVID-19 is shorter than primary infections. Loss of infectivity algorithms could be optimized.
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Affiliation(s)
| | - Hugues Charest
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Tonya Roy
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Judith Fafard
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Sara Carazo
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Ines Levade
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Jean Longtin
- CHU de Québec—Université Laval, Québec City, Canada
| | - Leighanne Parkes
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
| | - Sylvie Nancy Beaulac
- Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada
- Institut National de Santé Publique du Québec, Québec City, Canada
| | | | - Patrice Savard
- Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal (CHUM) and CHUM Research Center, Montréal, Canada
| | | | - Gaston De Serres
- Institut National de Santé Publique du Québec, Québec City, Canada
- Université Laval, Québec City, Canada
| | - Yves Longtin
- McGill University Faculty of Medicine, Montréal, Canada
- Jewish General Hospital Sir Mortimer B. Davis, Montréal, Canada
- Lady Davis Research Institute, Montréal, Canada
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22
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Abuyousef S, Alnaimi S, Omar NE, Elajez R, Elmekaty E, Abdelfattah-Arafa E, Barazi R, Ghasoub R, Rahhal A, Hamou F, Al-Amri M, Karawia A, Ajaj F, Alkhawaja R, Kardousha A, Awaisu A, Abou-Ali A, Khatib M, Aboukamar M, Al-Hail M. Early predictors of intensive care unit admission among COVID-19 patients in Qatar. Front Public Health 2024; 12:1278046. [PMID: 38572008 PMCID: PMC10987715 DOI: 10.3389/fpubh.2024.1278046] [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: 08/15/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Background COVID-19 is associated with significant morbidity and mortality. This study aimed to explore the early predictors of intensive care unit (ICU) admission among patients with COVID-19. Methods This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29-May 29, 2020. For each case enrolled, one control was matched by age and gender. Results A total of 1,560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range = 18). Predictors independently associated with ICU admission were cardiovascular disease (adjusted odds ratio (aOR) = 1.64, 95% confidence interval (CI): 1.16-2.32, p = 0.005), diabetes (aOR = 1.52, 95% CI: 1.08-2.13, p = 0.016), obesity (aOR = 1.46, 95% CI: 1.03-2.08, p = 0.034), lymphopenia (aOR = 2.69, 95% CI: 1.80-4.02, p < 0.001), high AST (aOR = 2.59, 95% CI: 1.53-4.36, p < 0.001), high ferritin (aOR = 1.96, 95% CI: 1.40-2.74, p < 0.001), high CRP (aOR = 4.09, 95% CI: 2.81-5.96, p < 0.001), and dyspnea (aOR = 2.50, 95% CI: 1.77-3.54, p < 0.001). Conclusion Having cardiovascular disease, diabetes, obesity, lymphopenia, dyspnea, and increased AST, ferritin, and CRP were independent predictors for ICU admission in patients with COVID-19.
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Affiliation(s)
- Safae Abuyousef
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Shaikha Alnaimi
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | - Nabil E. Omar
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Health Sciences Program, Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | - Reem Elajez
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Eman Elmekaty
- Department of Pharmacy, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Raja Barazi
- Department of Pharmacy, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rola Ghasoub
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ala Rahhal
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Hamou
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maha Al-Amri
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Karawia
- Department of Pharmacy, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Ajaj
- Department of Pharmacy, Home Health Care, Hamad Medical Corporation, Doha, Qatar
| | - Raja Alkhawaja
- Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Kardousha
- Department of Pharmacy, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Adel Abou-Ali
- Astellas Pharma Global Development, Inc., Northbrook, IL, United States
| | - Mohamad Khatib
- Department of Critical Care, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Aboukamar
- Department of Infectious Disease, Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al-Hail
- Department of Pharmacy, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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23
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Joshi S, Arshad S, Lindsay A, Heinonen J, Misikir H, Zervos J, Prentiss T, Verkler J, Numi M, Czander B, David RE, Mossing M, Kilgore PE, Rehman N, Zervos M. Control of SARS-CoV-2 infection in skilled nursing facilities in Detroit, Michigan: a model for emerging infectious diseases. Infect Control Hosp Epidemiol 2024:1-3. [PMID: 38505952 DOI: 10.1017/ice.2024.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
An infection prevention bundle that consisted of the development of a response team, public-academic partnership, daily assessment, regular testing, isolation, and environmental controls was implemented in 26 skilled nursing facilities in Detroit, Michigan (March 2020-April 2021). This intervention was associated with sustained control of severe acute respiratory coronavirus virus 2 infection among residents and staff.
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Affiliation(s)
- Seema Joshi
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Samia Arshad
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Abigail Lindsay
- Detroit Health Department, Detroit, MI, USA
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Jessica Heinonen
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Helina Misikir
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - John Zervos
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Tyler Prentiss
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Jelena Verkler
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | - Mariia Numi
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
| | | | - Randy E David
- Detroit Health Department, Detroit, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Michael Mossing
- Detroit Health Department, Detroit, MI, USA
- CDC Foundation, Atlanta, GE, USA
| | - Paul E Kilgore
- School of Medicine, Wayne State University, Detroit, MI, USA
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Najibah Rehman
- Detroit Health Department, Detroit, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Marcus Zervos
- Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
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24
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Li Y, Jiang X, Qiu Y, Gao F, Xin H, Li D, Qin Y, Li Z. Latent and incubation periods of Delta, BA.1, and BA.2 variant cases and associated factors: a cross-sectional study in China. BMC Infect Dis 2024; 24:294. [PMID: 38448822 PMCID: PMC10916204 DOI: 10.1186/s12879-024-09158-7] [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: 01/04/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The latent and incubation periods characterize the transmission of infectious viruses and are the basis for the development of outbreak prevention and control strategies. However, systematic studies on the latent period and associated factors with the incubation period for SAS-CoV-2 variants are still lacking. We inferred the two durations of Delta, BA.1, and BA.2 cases and analyzed the associated factors. METHODS The Delta, BA.1, and BA.2 (and its lineages BA.2.2 and BA.2.76) cases with clear transmission chains and infectors from 10 local SAS-CoV-2 epidemics in China were enrolled. The latent and incubation periods were fitted by the Gamma distribution, and associated factors were analyzed using the accelerated failure time model. RESULTS The mean latent period for 672 Delta, 208 BA.1, and 677 BA.2 cases was 4.40 (95%CI: 4.24 ~ 4.63), 2.50 (95%CI: 2.27 ~ 2.76), and 2.58 (95%CI: 2.48 ~ 2.69) days, respectively, with 85.65% (95%CI: 83.40 ~ 87.77%), 97.80% (95%CI: 96.35 ~ 98.89%), and 98.87% (95%CI: 98.40 ~ 99.27%) of them starting to shed viruses within 7 days after exposure. In 405 Delta, 75 BA.1, and 345 BA.2 symptomatic cases, the mean latent period was 0.76, 1.07, and 0.79 days shorter than the mean incubation period [5.04 (95%CI: 4.83 ~ 5.33), 3.42 (95%CI: 3.00 ~ 3.89), and 3.39 (95%CI: 3.24 ~ 3.55) days], respectively. No significant difference was observed in the two durations between BA.1 and BA.2 cases. After controlling for the sex, clinical severity, vaccination history, number of infectors, the length of exposure window and shedding window, the latent period [Delta: exp(β) = 0.81, 95%CI: 0.66 ~ 0.98, p = 0.034; Omicron: exp(β) = 0.82, 95%CI: 0.71 ~ 0.94, p = 0.004] and incubation period [Delta: exp(β) = 0.69, 95%CI: 0.55 ~ 0.86, p < 0.001; Omicron: exp(β) = 0.83, 95%CI: 0.72 ~ 0.96, p = 0.013] were significantly shorter in 18 ~ 49 years but did not change significantly in ≥ 50 years compared with 0 ~ 17 years. CONCLUSION Pre-symptomatic transmission can occur in Delta, BA.1, and BA.2 cases. The latent and incubation periods between BA.1 and BA.2 were similar but shorter compared with Delta. Age may be associated with the latent and incubation periods of SARS-CoV-2.
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Affiliation(s)
- Yu Li
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Xinli Jiang
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yan Qiu
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Feng Gao
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Hualei Xin
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Science (CAMS), Peking Union Medical College (PUMC), No. 9, Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Dan Li
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Ying Qin
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Zhongjie Li
- Division of Infectious Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
- School of Population Medicine and Public Health, Chinese Academy of Medical Science (CAMS), Peking Union Medical College (PUMC), No. 9, Dongdan Santiao, Dongcheng District, Beijing, 100730, China.
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25
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Zhang GH, Zhu QH, Zhang L, Li L, Fu J, Wang SL, Yuan WL, He L, Tao GH. Bio-based ionic liquid filter with enhanced electrostatic attraction for outside filtration and inside collection of viral aerosols. JOURNAL OF HAZARDOUS MATERIALS 2024; 465:133480. [PMID: 38219589 DOI: 10.1016/j.jhazmat.2024.133480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/26/2023] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
Hazardous biological pathogens in the air pose a significant public environmental health concern as infected individuals emit virus-laden aerosols (VLAs) during routine respiratory activities. Mask-wearing is a key preventive measure, but conventional filtration methods face challenges, particularly in high humidity conditions, where electrostatic charge decline increases the risk of infection. This study introduces a bio-based air filter comprising glycine ionic liquids (GILs) and malleable polymer composite (GILP) with high polarity and functional group density, which are wrapped around a melamine-formaldehyde (MF) resin skeleton, forming a conductive, porous GIL functionized ionic network air filter (GILP@MF). When subjected to low voltage, the GILP@MF composite efficiently captures VLAs including nanoscale virus particles through the enhanced electrostatic attraction, especially in facing high humidity bioaerosols exhaled by human body. The filtration/collection efficiency and quality factor can reach 98.3% and 0.264 Pa-1 at 0.1 m s-1, respectively. This innovative filter provides effective VLA protection and offers potential for non-invasive respiratory virus sampling, advancing medical diagnosis efforts.
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Affiliation(s)
- Guo-Hao Zhang
- College of Chemistry, Sichuan University, Chengdu 610064, China; School of National Defence Science and Technology, Southwest University of Science and Technology, Mianyang 621010, China
| | - Qiu-Hong Zhu
- College of Chemistry, Sichuan University, Chengdu 610064, China; School of National Defence Science and Technology, Southwest University of Science and Technology, Mianyang 621010, China
| | - Lei Zhang
- College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Lei Li
- MGI Tech. Co., Ltd., Shenzhen 518083, China
| | - Jie Fu
- College of Chemistry, Sichuan University, Chengdu 610064, China
| | | | - Wen-Li Yuan
- College of Chemistry, Sichuan University, Chengdu 610064, China
| | - Ling He
- College of Chemistry, Sichuan University, Chengdu 610064, China.
| | - Guo-Hong Tao
- College of Chemistry, Sichuan University, Chengdu 610064, China.
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26
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Keck JW, Adatorwovor R, Liversedge M, Mijotavich B, Olsson C, Strike WD, Amirsoleimani A, Noble A, Torabi S, Rockward A, Banadaki MD, Smith T, Lacy P, Berry SM. Wastewater Surveillance for Identifying SARS-CoV-2 Infections in Long-Term Care Facilities, Kentucky, USA, 2021-2022. Emerg Infect Dis 2024; 30:530-538. [PMID: 38407144 PMCID: PMC10902530 DOI: 10.3201/eid3003.230888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Persons living in long-term care facilities (LTCFs) were disproportionately affected by COVID-19. We used wastewater surveillance to detect SARS-CoV-2 infection in this setting by collecting and testing 24-hour composite wastewater samples 2-4 times weekly at 6 LTCFs in Kentucky, USA, during March 2021-February 2022. The LTCFs routinely tested staff and symptomatic and exposed residents for SARS-CoV-2 using rapid antigen tests. Of 780 wastewater samples analyzed, 22% (n = 173) had detectable SARS-CoV-2 RNA. The LTCFs reported 161 positive (of 16,905) SARS-CoV-2 clinical tests. The wastewater SARS-CoV-2 signal showed variable correlation with clinical test data; we observed the strongest correlations in the LTCFs with the most positive clinical tests (n = 45 and n = 58). Wastewater surveillance was 48% sensitive and 80% specific in identifying SARS-CoV-2 infections found on clinical testing, which was limited by frequency, coverage, and rapid antigen test performance.
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Affiliation(s)
| | - Reuben Adatorwovor
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | | | - Blazan Mijotavich
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Cullen Olsson
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - William D. Strike
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Atena Amirsoleimani
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Ann Noble
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Soroosh Torabi
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Alexus Rockward
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Mohammad Dehghan Banadaki
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Ted Smith
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Parker Lacy
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
| | - Scott M. Berry
- University of Kentucky, Lexington, Kentucky, USA (J.W. Keck, R. Adatorwovor, M. Liversedge, C. Olsson, W.D. Strike, A. Amirsoleimani, A. Noble, S. Torabi, A. Rockward, M. Dehghan Banadaki, S.M. Berry)
- University of Louisville, Louisville, Kentucky, USA (T. Smith)
- Trilogy Health Services, LLC, Louisville (P. Lacy)
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27
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Onyegbutulem HC, Dogo D, Henry-Onyegbutulem PI, Olorunfemi DS, Schwarz PEH, Bornstein SR. Belief, knowledge, attitude and practices towards COVID-19 amongst residents of Abuja, Nigeria: implications for pandemic preparedness. Pan Afr Med J 2024; 47:98. [PMID: 38799188 PMCID: PMC11126750 DOI: 10.11604/pamj.2024.47.98.34331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 12/26/2023] [Indexed: 05/29/2024] Open
Abstract
Introduction coronavirus disease, (COVID-19), was a pandemic with high global morbidity and mortality, partly due to a lack of preparedness. People´s knowledge, belief, attitude, and perception of disease outbreaks may affect their response, and this may impact their health-related behavior. This study was designed to determine the pattern of belief, knowledge, attitude, and practices (BKAP) of residents of Abuja, Nigeria, towards the COVID-19 pandemic. The outcome of the study may help to make informed decisions on future pandemic preparedness. Methods a cross-sectional study with data collected online about the local perceptions and common concerns, beliefs, misconceptions, attitudes, and conspiracy theories amongst residents of the FCT. A self-reported validated e-questionnaire prepared on Google Forms was used. The obtained data was downloaded on Excel sheet and then exported to SPSS for analysis. Results there were one thousand eight hundred and seventy-three (1,873) respondents, 1017 (54.3%) females and 856 (45.7%) males. Participants were majorly knowledgeable, the majority (31.2%) were in the 41-50 years age group. Surprisingly, about 17% did not know that wearing a face mask could prevent COVID-19. About 25% still met in crowded places, and slightly more than 33% did not wear outdoor masks. The highest knowledge of COVID-19 was found among people in the age range 41-50 years, females, University graduates, married people, and healthcare personnel, particularly doctors. Conclusion our study concludes that the overall population of Abuja had good knowledge and, a positive attitude, with pockets of poor attitudes and bad practices born out of misconceptions and infodemics.
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Affiliation(s)
- Henry Chijioke Onyegbutulem
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
- Department of Internal Medicine, Nile University Teaching Hospital, Abuja, Nigeria
| | - Dilli Dogo
- Department of Surgery Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
- Department of Surgery, Nile University Teaching Hospital, Abuja, Nigeria
| | - Peace Ijeoma Henry-Onyegbutulem
- Department of Maxillofacial Surgery, Maitama District Hospital, Maitama, Abuja, Nigeria
- Department of Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Kaduna state, Nigeria
| | - David Samuel Olorunfemi
- Department of Internal Medicine, College of Health Sciences Bingham University, Bingham University Teaching Hospital, Jos Plateau State, Nigeria
| | - Peter Egbert Hermann Schwarz
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan Richard Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King´s College London, London, United Kingdom
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28
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Yeo LLL, Chan ACY, Jing MX, Dan YY, Loh TKS, Fisher D, Ong JJY. Protecting high-risk institutionalised residents from COVID-19: a Singapore dormitory experience. Singapore Med J 2024; 65:S9-S11. [PMID: 35611519 PMCID: PMC11073656 DOI: 10.11622/smedj.2022059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Leonard Leong Litt Yeo
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Amanda Chee Yun Chan
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming Xue Jing
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yock Young Dan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Thomas Kwok Seng Loh
- Department of Otolaryngology, Head and Neck Surgery, National University Health System, Singapore
| | - Dale Fisher
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore
| | - Jonathan Jia Yuan Ong
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Brogna C, Montano L, Zanolin ME, Bisaccia DR, Ciammetti G, Viduto V, Fabrowski M, Baig AM, Gerlach J, Gennaro I, Bignardi E, Brogna B, Frongillo A, Cristoni S, Piscopo M. A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID-19 patients. J Med Virol 2024; 96:e29507. [PMID: 38504586 DOI: 10.1002/jmv.29507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 03/21/2024]
Abstract
The bacteriophage behavior of SARS-CoV-2 during the acute and post-COVID-19 phases appears to be an important factor in the development of the disease. The early use of antibiotics seems to be crucial to inhibit disease progression-to prevent viral replication in the gut microbiome, and control toxicological production from the human microbiome. To study the impact of specific antibiotics on recovery from COVID-19 and long COVID (LC) taking into account: vaccination status, comorbidities, SARS-CoV-2 wave, time of initiation of antibiotic therapy and concomitant use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). A total of 211 COVID-19 patients were included in the study: of which 59 were vaccinated with mRNA vaccines against SARS-CoV-2 while 152 were unvaccinated. Patients were enrolled in three waves: from September 2020 to October 2022, corresponding to the emergence of the pre-Delta, Delta, and Omicron variants of the SARS-CoV-2 virus. The three criteria for enrolling patients were: oropharyngeal swab positivity or fecal findings; moderate symptoms with antibiotic intake; and measurement of blood oxygen saturation during the period of illness. The use of antibiotic combinations, such as amoxicillin with clavulanic acid (875 + 125 mg tablets, every 12 h) plus rifaximin (400 mg tablets every 12 h), as first choice, as suggested from the previous data, or azithromycin (500 mg tablets every 24 h), plus rifaximin as above, allows healthcare professionals to focus on the gut microbiome and its implications in COVID-19 disease during patient care. The primary outcome measured in this study was the estimated average treatment effect, which quantified the difference in mean recovery between patients receiving antibiotics and those not receiving antibiotics at 3 and 9 days after the start of treatment. In the analysis, both vaccinated and unvaccinated groups had a median illness duration of 7 days (interquartile range [IQR] 6-9 days for each; recovery crude hazard ratio [HR] = 0.94, p = 0.700). The median illness duration for the pre-Delta and Delta waves was 8 days (IQR 7-10 days), while it was shorter, 6.5 days, for Omicron (IQR 6-8 days; recovery crude HR = 1.71, p < 0.001). These results were confirmed by multivariate analysis. Patients with comorbidities had a significantly longer disease duration: median 8 days (IQR 7-10 days) compared to 7 days (IQR 6-8 days) for those without comorbidities (crude HR = 0.75, p = 0.038), but this result was not confirmed in multivariate analysis as statistical significance was lost. Early initiation of antibiotic therapy resulted in a significantly shorter recovery time (crude HR = 4.74, p < 0.001). Concomitant use of NSAIDs did not reduce disease duration and in multivariate analysis prolonged the disease (p = 0.041). A subgroup of 42 patients receiving corticosteroids for a median of 3 days (IQR 3-6 days) had a longer recovery time (median 9 days, IQR 8-10 days) compared to others (median 7 days, IQR 6-8 days; crude HR = 0.542, p < 0.001), as confirmed also by the adjusted HR. In this study, a statistically significant reduction in recovery time was observed among patients who received early antibiotic treatment. Early initiation of antibiotics played a crucial role in maintaining higher levels of blood oxygen saturation. In addition, it is worth noting that a significant number of patients who received antibiotics in the first 3 days and for a duration of 7 days, during the acute phase did not develop LC.
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Affiliation(s)
- Carlo Brogna
- Craniomed Group Srl. Research Facility, Bresso, Italy
| | - Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in Uro-Andrology, Local Health Authority (ASL), Salerno, Italy
| | | | | | - Gianluca Ciammetti
- Otorhinolaryngology Unit, Hospital Ferdinando Veneziale Isernia, Regional Health Authority of Molise, Italy
| | | | - Mark Fabrowski
- Department of Emergency Medicine, Royal Sussex County Hospital, University Hospitals Sussex, Brighton, UK
| | - Abdul M Baig
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Iapicca Gennaro
- Pineta Grande Hospital Group, Department of Urology, Santa Rita Clinic, Atripalda, Italy
| | | | - Barbara Brogna
- Department of Radiology, Moscati Hospital, Avellino, Italy
| | | | | | - Marina Piscopo
- Department of Biology, University of Naples Federico II, Naples, Italy
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Ali S, Cella E, Johnston C, Rojas AC, Brown AN, Deichen M, Azarian T. Environmental surface monitoring as a noninvasive method for SARS-CoV-2 surveillance in community settings: Lessons from a university campus study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169456. [PMID: 38123097 DOI: 10.1016/j.scitotenv.2023.169456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Environmental testing of high-touch objects is a potential noninvasive approach for monitoring population-level trends of SARS-CoV-2 and other respiratory viruses within a defined setting. We aimed to determine the association between SARS-CoV-2 contamination on high-touch environmental surfaces, community level case incidence, and university student health data. Environmental swabs were collected from January 2022 to November 2022 from high-touch objects and surfaces from five locations on a large university campus in Florida, USA. RT-qPCR was used to detect and quantify viral RNA, and a subset of positive samples was analyzed by viral genome sequencing to identify circulating lineages. During the study period, we detected SARS-CoV-2 viral RNA on 90.7 % of 162 tested samples. Levels of environmental viral RNA correlated with trends in community-level activity and case reports from the student health center. A significant positive correlation was observed between the estimated viral gene copy number in environmental samples and the weekly confirmed cases at the university. Viral sequencing data from environmental samples identified lineages concurrently circulating in the local community and state based on genomic surveillance data. Further, we detected emerging variants in environmental samples prior to their identification by clinical genomic surveillance. Our results demonstrate the utility of viral monitoring on high-touch environmental surfaces for SARS-CoV-2 surveillance at a community level. In communities with delayed or limited testing facilities, immediate environmental surface testing may considerably inform epidemic dynamics.
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Affiliation(s)
- Sobur Ali
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Catherine Johnston
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Ana C Rojas
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA
| | - Ashley N Brown
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA
| | - Michael Deichen
- Student Health Services, University of Central Florida, Orlando, FL, USA
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA.
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Pulido J, Barrio G, Donat M, Politi J, Moreno A, Cea-Soriano L, Guerras JM, Huertas L, Mateo-Urdiales A, Ronda E, Martínez D, Lostao L, Belza MJ, Regidor E. Excess Mortality During 2020 in Spain: The Most Affected Population, Age, and Educational Group by the COVID-19 Pandemic. Disaster Med Public Health Prep 2024; 18:e27. [PMID: 38372080 DOI: 10.1017/dmp.2024.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The objective of this work was to study mortality increase in Spain during the first and second academic semesters of 2020, coinciding with the first 2 waves of the Covid-19 pandemic; by sex, age, and education. METHODS An observational study was carried out, using linked populations and deaths' data from 2017 to 2020. The mortality rates from all causes and leading causes other than Covid-19 during each semester of 2020, compared to the 2017-2019 averages for the same semester, was also estimated. Mortality rate ratios (MRR) and differences were used for comparison. RESULTS All-cause mortality rates increased in 2020 compared to pre-covid, except among working-age, (25-64 years) highly-educated women. Such increases were larger in lower-educated people between the working age range, in both 2020 semesters, but not at other ages. In the elderly, the MMR in the first semester in women and men were respectively, 1.14, and 1.25 among lower-educated people, and 1.28 and 1.23 among highly-educated people. In the second semester, the MMR were 1.12 in both sexes among lower-educated people and 1.13 in women and 1.16 in men among highly-educated people. CONCLUSION Lower-educated people within working age and highly-educated people at older ages showed the greatest increase in all-cause mortality in 2020, compared to the pre-pandemic period.
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Affiliation(s)
- José Pulido
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Moreno
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Miguel Guerras
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Huertas
- Instituto Valenciano de Estadística, Valencia, Spain
- National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Ronda
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
| | - David Martínez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lourdes Lostao
- Department of Sociology, Universidad Pública de Navarra, Spain
| | - María José Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Fernández-Soto D, García-Jiménez ÁF, Casasnovas JM, Valés-Gómez M, Reyburn HT. Elevated levels of cell-free NKG2D-ligands modulate NKG2D surface expression and compromise NK cell function in severe COVID-19 disease. Front Immunol 2024; 15:1273942. [PMID: 38410511 PMCID: PMC10895954 DOI: 10.3389/fimmu.2024.1273942] [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: 08/07/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction It is now clear that coronavirus disease 19 (COVID-19) severity is associated with a dysregulated immune response, but the relative contributions of different immune cells is still not fully understood. SARS CoV-2 infection triggers marked changes in NK cell populations, but there are contradictory reports as to whether these effector lymphocytes play a protective or pathogenic role in immunity to SARS-CoV-2. Methods To address this question we have analysed differences in the phenotype and function of NK cells in SARS-CoV-2 infected individuals who developed either very mild, or life-threatening COVID-19 disease. Results Although NK cells from patients with severe disease appeared more activated and the frequency of adaptive NK cells was increased, they were less potent mediators of ADCC than NK cells from patients with mild disease. Further analysis of peripheral blood NK cells in these patients revealed that a population of NK cells that had lost expression of the activating receptor NKG2D were a feature of patients with severe disease and this correlated with elevated levels of cell free NKG2D ligands, especially ULBP2 and ULBP3 in the plasma of critically ill patients. In vitro, culture in NKG2DL containing patient sera reduced the ADCC function of healthy donor NK cells and this could be blocked by NKG2DL-specific antibodies. Discussion These observations of reduced NK function in severe disease are consistent with the hypothesis that defects in immune surveillance by NK cells permit higher levels of viral replication, rather than that aberrant NK cell function contributes to immune system dysregulation and immunopathogenicity.
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Affiliation(s)
- Daniel Fernández-Soto
- Department of Immunology and Oncology, National Centre for Biotechnology (CNB), Spanish National Research Council (CSIC), Madrid, Spain
| | - Álvaro F. García-Jiménez
- Department of Immunology and Oncology, National Centre for Biotechnology (CNB), Spanish National Research Council (CSIC), Madrid, Spain
| | - José M. Casasnovas
- Department of Macromolecular Structures, National Centre for Biotechnology (CNB), Spanish National Research Council (CSIC), Madrid, Spain
| | - Mar Valés-Gómez
- Department of Immunology and Oncology, National Centre for Biotechnology (CNB), Spanish National Research Council (CSIC), Madrid, Spain
| | - Hugh T. Reyburn
- Department of Immunology and Oncology, National Centre for Biotechnology (CNB), Spanish National Research Council (CSIC), Madrid, Spain
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Adler JM, Martin Vidal R, Langner C, Vladimirova D, Abdelgawad A, Kunecova D, Lin X, Nouailles G, Voss A, Kunder S, Gruber AD, Wu H, Osterrieder N, Kunec D, Trimpert J. An intranasal live-attenuated SARS-CoV-2 vaccine limits virus transmission. Nat Commun 2024; 15:995. [PMID: 38307868 PMCID: PMC10837132 DOI: 10.1038/s41467-024-45348-2] [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: 11/17/2023] [Accepted: 01/17/2024] [Indexed: 02/04/2024] Open
Abstract
The development of effective SARS-CoV-2 vaccines has been essential to control COVID-19, but significant challenges remain. One problem is intramuscular administration, which does not induce robust mucosal immune responses in the upper airways-the primary site of infection and virus shedding. Here we compare the efficacy of a mucosal, replication-competent yet fully attenuated virus vaccine, sCPD9-ΔFCS, and the monovalent mRNA vaccine BNT162b2 in preventing transmission of SARS-CoV-2 variants B.1 and Omicron BA.5 in two scenarios. Firstly, we assessed the protective efficacy of the vaccines by exposing vaccinated male Syrian hamsters to infected counterparts. Secondly, we evaluated transmission of the challenge virus from vaccinated and subsequently challenged male hamsters to naïve contacts. Our findings demonstrate that the live-attenuated vaccine (LAV) sCPD9-ΔFCS significantly outperformed the mRNA vaccine in preventing virus transmission in both scenarios. Our results provide evidence for the advantages of locally administered LAVs over intramuscularly administered mRNA vaccines in preventing infection and reducing virus transmission.
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Affiliation(s)
- Julia M Adler
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
| | | | | | | | - Azza Abdelgawad
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
| | - Daniela Kunecova
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
| | - Xiaoyuan Lin
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
- School of Life Sciences, Chongqing University, Chongqing, China
| | - Geraldine Nouailles
- Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Voss
- Institut für Tierpathologie, Freie Universität Berlin, Berlin, Germany
| | - Sandra Kunder
- Institut für Tierpathologie, Freie Universität Berlin, Berlin, Germany
| | - Achim D Gruber
- Institut für Tierpathologie, Freie Universität Berlin, Berlin, Germany
| | - Haibo Wu
- School of Life Sciences, Chongqing University, Chongqing, China
| | | | - Dusan Kunec
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany
| | - Jakob Trimpert
- Institut für Virologie, Freie Universität Berlin, Berlin, Germany.
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Le Bert N, Samandari T. Silent battles: immune responses in asymptomatic SARS-CoV-2 infection. Cell Mol Immunol 2024; 21:159-170. [PMID: 38221577 PMCID: PMC10805869 DOI: 10.1038/s41423-024-01127-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/16/2024] Open
Abstract
SARS-CoV-2 infections manifest with a broad spectrum of presentations, ranging from asymptomatic infections to severe pneumonia and fatal outcomes. This review centers on asymptomatic infections, a widely reported phenomenon that has substantially contributed to the rapid spread of the pandemic. In such asymptomatic infections, we focus on the role of innate, humoral, and cellular immunity. Notably, asymptomatic infections are characterized by an early and robust innate immune response, particularly a swift type 1 IFN reaction, alongside a rapid and broad induction of SARS-CoV-2-specific T cells. Often, antibody levels tend to be lower or undetectable after asymptomatic infections, suggesting that the rapid control of viral replication by innate and cellular responses might impede the full triggering of humoral immunity. Even if antibody levels are present in the early convalescent phase, they wane rapidly below serological detection limits, particularly following asymptomatic infection. Consequently, prevalence studies reliant solely on serological assays likely underestimate the extent of community exposure to the virus.
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Affiliation(s)
- Nina Le Bert
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
| | - Taraz Samandari
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
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Montoya A, Park P, Bynum J, Chang CH. Transfer Trauma Among Nursing Home Residents: Development of a Composite Measure. THE GERONTOLOGIST 2024; 64:gnad085. [PMID: 37392460 DOI: 10.1093/geront/gnad085] [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: 01/30/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Nursing home (NH)-to-NH transfers place NH residents at risk for developing transfer trauma. We aimed to develop a composite measure of transfer trauma and apply it among those transferring before and during the pandemic. RESEARCH DESIGN AND METHODS Cross-sectional cohort analysis of long-stay NH residents with a NH-to-NH transfer. Minimum Data Set data (2018-2020) were used to create the cohorts. A composite measure of transfer trauma was developed (2018 cohort) and applied to the 2019 and 2020 cohorts. We analyzed resident characteristics and conducted logistic regression analyses to compare rates of transfer trauma between periods. RESULTS In 2018, 794 residents were transferred; 242 (30.5%) met the criteria for transfer trauma. In the 2019 and 2020, 750 residents (2019) and 795 (2020) were transferred. In 2019 cohort, 30.7% met the criteria for transfer trauma, and 21.9% in 2020 cohort. During the pandemic, a higher proportion of transferred residents left the facility before the first quarterly assessment. Among residents who stayed in NH for their quarterly assessment, after adjusting for demographic characteristics, residents in the 2020 cohort were less likely to experience transfer trauma than those in the 2019 cohort (adjusted odds ratio [AOR] = 0.64, 95% confidence interval [CI]: 0.51, 0.81). However, residents in 2020 cohort were two times more likely to die (AOR = 1.94, 95% CI: 1.15, 3.26) and 3 times more likely to discharge within 90 days after transfer (AOR = 2.86, 95% CI: 2.30, 3.56) compared with those in 2019 cohort. DISCUSSION AND IMPLICATIONS These findings highlight how common transfer trauma is after NH-to-NH transfer and the need for further research to mitigate negative outcomes associated with the transfer in this vulnerable population.
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Affiliation(s)
- Ana Montoya
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Pil Park
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Julie Bynum
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Chiang-Hua Chang
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
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36
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Alavinejad M, Tosato M, Bragazzi NL, McCarthy Z, Wu J, Bourouiba L. Markers of community outbreak and facility type for mitigation of COVID-19 in long-term care homes in Ontario, Canada: Insights and implications from a time-series analysis. Ann Epidemiol 2024; 90:9-20. [PMID: 37690739 DOI: 10.1016/j.annepidem.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE The resident deaths among Long Term Care Home (LTCH) accounted for more than 65% of total deaths in the province of Ontario, Canada, during March 29 to June 3, 2020, yet not all LTCHs were severely affected. METHODS We carried out a retrospective cohort study, with case control for questions for which data allowed, with LTCH COVID-19 databases obtained from Ontario's Ministry of Long Term Care. We performed a combined temporal and spatial data analysis of COVID-19 cases and deaths among LTCH residents, identified trends, contributing factors, and early markers of LTCH outbreak severity. RESULTS Our analysis shows that for-profit LTCHs had higher death-to-bed ratio, also with an average rate of increase of death-to-bed ratio higher for for-profit homes than other types of management. We find from uni- and multi-variable analyses (linear and nonlinear) that staff infection has the strongest association with death-to-bed ratio from among the descriptor variables considered, reflecting the risk of the disease in the health region/community. We also identify a delay of up to 8 days between the trends in fatalities among individuals outside LTCHs and that of LTCH residents. We did find an association between policy change to single LTCH/staff and reduction in weekly LTCH resident death, albeit with an expected time delay of about 7-10 days. CONCLUSIONS The association between the risk of COVID-19 in the health region and the deaths among LTCH residents, and the delay between fatality among individuals residing outside and inside LTCHs suggests that fatality in a health region could be a predictor of outbreak in LTCHs within the same health region.
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Affiliation(s)
- M Alavinejad
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - M Tosato
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - N L Bragazzi
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Z McCarthy
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - J Wu
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - L Bourouiba
- Mathematical Modelling of COVID-19 Task Force, Fields Laboratory of Mathematics for Public Health, University of Toronto, Ontario, Canada; The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts In stitute of Technology, Cambridge, MA, USA.
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Markewitz R, Dargvainiene J, Junker R, Wandinger KP. Cycle threshold of SARS-CoV-2 RT-PCR as a driver of retesting. Sci Rep 2024; 14:2423. [PMID: 38287120 PMCID: PMC10825127 DOI: 10.1038/s41598-024-52984-7] [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: 07/18/2023] [Accepted: 01/25/2024] [Indexed: 01/31/2024] Open
Abstract
SARS-CoV-2 RT-PCR is a critical and, at times, limited resource. Frequent Retesting of patients may strain testing infrastructure unduly. Recommendations that include cycle threshold (Ct) cutoffs may incentivize early retesting when the Ct value is reported. We aimed to investigate patterns of retesting in association with initial Ct-values. We performed a retrospective analysis of RT-PCR results (including Ct-values) for patients from whom ≥ 2 samples were collected within 14 days, the first of which had to be positive. We calculated absolute and baseline-corrected kinetics of Ct-values over time, as well as the median initial Ct-values in dependence of the timing of the first retesting and the time until RT-PCR negativity for SARS-CoV-2. Retesting after an initial positive SARS-CoV-2 RT-PCR was most commonly performed on day 7, with patients being retested as early as day 1. The majority of patients retested within 14 days remained SARS-CoV-2 positive in the RT-PCR. Baseline-corrected Ct-values showed a quasi-linear increase over 14 days since the initial positive result. Both the timing until the first retesting and until RT-PCR negativity were inversely correlated with the initial Ct-value. The timing of retesting after a positive SARS-CoV-2 RT-PCR appears to be significantly influenced by the initial Ct-value. Although it can be assumed that Ct-values will increase steadily over time, strategies that rely on rigid Ct-cutoffs should be discussed critically, not only because of methodological caveats but also because of the strain on testing infrastructure caused by the incentive for early retesting that Ct-values apparently represent.
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Affiliation(s)
- Robert Markewitz
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Justina Dargvainiene
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Ralf Junker
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Klaus-Peter Wandinger
- Institute of Clinical Chemistry, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany
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Uno S, Goto R, Honda K, Uchida S, Uwamino Y, Namkoong H, Yoshifuji A, Mikita K, Takano Y, Matsumoto M, Kitagawa Y, Hasegawa N. Cost-Effectiveness of Universal Asymptomatic Preoperative SARS-CoV-2 Polymerase Chain Reaction Screening: A Cost-Utility Analysis. Clin Infect Dis 2024; 78:57-64. [PMID: 37556365 PMCID: PMC10810706 DOI: 10.1093/cid/ciad463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND An early report has shown the clinical benefit of the asymptomatic preoperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening test, and some clinical guidelines recommended this test. However, the cost-effectiveness of asymptomatic screening was not evaluated. We aimed to investigate the cost-effectiveness of universal preoperative screening of asymptomatic patients for SARS-CoV-2 using polymerase chain reaction (PCR) testing. METHODS We evaluated the cost-effectiveness of asymptomatic screening using a decision tree model from a payer perspective, assuming that the test-positive rate was 0.07% and the screening cost was 8500 Japanese yen (JPY) (approximately 7601 US dollars [USD]). The input parameter was derived from the available evidence reported in the literature. A willingness-to-pay threshold was set at 5 000 000 JPY/quality-adjusted life-year (QALY). RESULTS The incremental cost of 1 death averted was 74 469 236 JPY (approximately 566 048 USD) and 291 123 368 JPY/QALY (approximately 2 212 856 USD/QALY), which was above the 5 000 000 JPY/QALY willingness-to-pay threshold. The incremental cost-effectiveness ratio fell below 5 000 000 JPY/QALY only when the test-positive rate exceeded 0.739%. However, when the probability of developing a postoperative pulmonary complication among SARS-CoV-2-positive patients was below 0.22, asymptomatic screening was never cost-effective, regardless of how high the test-positive rate became. CONCLUSIONS Asymptomatic preoperative universal SARS-CoV-2 PCR screening is not cost-effective in the base case analysis. The cost-effectiveness mainly depends on the test-positive rate, the frequency of postoperative pulmonary complications, and the screening costs; however, no matter how high the test-positive rate, the cost-effectiveness is poor if the probability of developing postoperative pulmonary complications among patients positive for SARS-CoV-2 is sufficiently reduced.
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Affiliation(s)
- Shunsuke Uno
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
- Health Technology Assessment Unit, Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Rei Goto
- Health Technology Assessment Unit, Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
- Graduate School of Business Administration, Keio University, Kanagawa, Japan
- Graduate School of Health Management, Keio University, Kanagawa, Japan
| | - Kimiko Honda
- Health Technology Assessment Unit, Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
- Graduate School of Health Management, Keio University, Kanagawa, Japan
- Center of Health Economics and Health Technology Assessment, Keio University Global Research Institute, Tokyo, Japan
| | - Sho Uchida
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ho Namkoong
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Ayumi Yoshifuji
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Kei Mikita
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Yaoko Takano
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedics, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
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Zhang W, Wu H, Guo Q, Xu X, Pu Y, Chen C, Cao M, Sun D, Lu W, Yi H, Zhou S, Fang B. Association of clinical characteristics and vaccines with risk of persistently viral clearance in patients infected with SARS-CoV-2 Omicron variant in Shanghai, China. Heliyon 2024; 10:e23256. [PMID: 38192786 PMCID: PMC10772582 DOI: 10.1016/j.heliyon.2023.e23256] [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: 06/22/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
Importance The global COVID-19 pandemic does not appear to end in the near future. Currently, limited data are available on the risk factors for delayed viral clearance in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection. Objective This study aimed to investigate the association of clinical characteristics and vaccination with prolonged viral clearance. Methods This retrospective cohort included 16,985 patients who had contracted the SARS-CoV-2 Omicron variant between April 5 and May 30, 2022, in Shanghai, China, and had mild or no symptoms. The patients were admitted to the quarantine venue at the Shanghai New International Expo Center. Results Of the 16,985 participants, the occurrence of viral clearance was ≤8 and > 8 days in 11,009 (64.8 %) and 5976 (35.2 %) participants, respectively. Risk factors related to patients who remained persistently polymerase chain reaction (PCR)-positive were sex (Male, odds ratio [OR] 1.221, p < 0.001), older age (35-49, OR 1.389, p < 0.001; 50-64, OR 1.659, p < 0.001; ≥65, OR 2.139, p < 0.001), presence of symptoms (OR 1.093, p = 0.030), number of vaccinations (two doses, OR 0.753, p < 0.001; three doses, OR 0.797, p < 0.001; four doses, OR 0.543, p < 0.001), and cycle threshold (Ct) value for ORF1ab gene at diagnosis (25-35, OR 0.235, p < 0.001; >35, OR 0.079, p < 0.001). The lower rates of increase in Ct values were observed in the later viral shedding group than in the early viral shedding group for ORF1ab (β = -0.791, p < 0.001) and N genes (β = -0.825, p < 0.001). Conclusion Prolonged SARS-CoV-2 RNA detection and higher viral concentrations were associated with factors such as male sex, older age, symptomatic status, and fewer doses of vaccination in patients admitted to Shanghai Makeshift Hospital between April 5 and May 30, 2022.
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Affiliation(s)
- Wen Zhang
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Hongze Wu
- Jiujiang Traditional Chinese Medicine Hospital, Jiujiang, 332005, Jiangxi, PR China
| | - Quan Guo
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Xiangru Xu
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Yuting Pu
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Caiyu Chen
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Min Cao
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Ding Sun
- Department of Rheumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Wei Lu
- Department of Nursing, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Hui Yi
- Jiujiang Traditional Chinese Medicine Hospital, Jiujiang, 332005, Jiangxi, PR China
| | - Shuang Zhou
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Zhangjiang Hi Tech Park, Pudong New Area, Shanghai 201203, PR China
| | - Bangjiang Fang
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
- Institute of Emergency and Critical Care Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
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40
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Oltean HN, Black A, Lunn SM, Smith N, Templeton A, Bevers E, Kibiger L, Sixberry M, Bickel JB, Hughes JP, Lindquist S, Baseman JG, Bedford T. Changing genomic epidemiology of COVID-19 in long-term care facilities during the 2020-2022 pandemic, Washington State. BMC Public Health 2024; 24:182. [PMID: 38225567 PMCID: PMC10789038 DOI: 10.1186/s12889-023-17461-2] [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: 08/28/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Long-term care facilities (LTCFs) are vulnerable to disease outbreaks. Here, we jointly analyze SARS-CoV-2 genomic and paired epidemiologic data from LTCFs and surrounding communities in Washington state (WA) to assess transmission patterns during 2020-2022, in a setting of changing policy. We describe sequencing efforts and genomic epidemiologic findings across LTCFs and perform in-depth analysis in a single county. METHODS We assessed genomic data representativeness, built phylogenetic trees, and conducted discrete trait analysis to estimate introduction sizes over time, and explored selected outbreaks to further characterize transmission events. RESULTS We found that transmission dynamics among cases associated with LTCFs in WA changed over the course of the COVID-19 pandemic, with variable introduction rates into LTCFs, but decreasing amplification within LTCFs. SARS-CoV-2 lineages circulating in LTCFs were similar to those circulating in communities at the same time. Transmission between staff and residents was bi-directional. CONCLUSIONS Understanding transmission dynamics within and between LTCFs using genomic epidemiology on a broad scale can assist in targeting policies and prevention efforts. Tracking facility-level outbreaks can help differentiate intra-facility outbreaks from high community transmission with repeated introduction events. Based on our study findings, methods for routine tree building and overlay of epidemiologic data for hypothesis generation by public health practitioners are recommended. Discrete trait analysis added valuable insight and can be considered when representative sequencing is performed. Cluster detection tools, especially those that rely on distance thresholds, may be of more limited use given current data capture and timeliness. Importantly, we noted a decrease in data capture from LTCFs over time. Depending on goals for use of genomic data, sentinel surveillance should be increased or targeted surveillance implemented to ensure available data for analysis.
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Affiliation(s)
- Hanna N Oltean
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA.
- University of Washington, 1410 NE Campus Parkway, Seattle, Washington, 98195, USA.
| | - Allison Black
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Stephanie M Lunn
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Nailah Smith
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Allison Templeton
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Elyse Bevers
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Lynae Kibiger
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
| | - Melissa Sixberry
- Yakima Health District, 1210 Ahtanum Ridge Dr, Union Gap, Washington, 98903, USA
| | - Josina B Bickel
- Yakima Health District, 1210 Ahtanum Ridge Dr, Union Gap, Washington, 98903, USA
| | - James P Hughes
- University of Washington, 1410 NE Campus Parkway, Seattle, Washington, 98195, USA
| | - Scott Lindquist
- Department of Health, Washington State, 1610 NE 150th St, Shoreline, Washington, 98155, USA
- University of Washington, 1410 NE Campus Parkway, Seattle, Washington, 98195, USA
| | - Janet G Baseman
- University of Washington, 1410 NE Campus Parkway, Seattle, Washington, 98195, USA
| | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, Washington, 98109, USA
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Grant RL, Sauser J, Atkinson A, D’Incau S, Buetti N, Zanella MC, Harbarth S, Marschall J, Catho G. Comparison of clinical outcomes over time of inpatients with healthcare-associated or community-acquired coronavirus disease 2019 (COVID-19): A multicenter, prospective cohort study. Infect Control Hosp Epidemiol 2024; 45:75-81. [PMID: 37529850 PMCID: PMC10782206 DOI: 10.1017/ice.2023.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE To compare clinical outcomes over time of inpatients with healthcare-associated coronavirus disease 2019 (HA-COVID-19) versus community-acquired COVID-19 (CA-COVID-19). DESIGN We conducted a multicenter, prospective observational cohort study of inpatients with COVID-19. SETTING The study was conducted across 16 acute-care hospitals in Switzerland. PARTICIPANTS AND METHODS We compared HA-COVID-19 cases, defined as patients with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) test > 5 days after hospital admission, with hospitalized CA-COVID-19 cases, defined as those who tested positive within 5 days of admission. The composite primary outcome was patient transfer to an intensive care unit (ICU) or an intermediate care unit (IMCU) and/or all-cause in-hospital mortality. We used cause-specific Cox regression and Fine-Gray regression to model the time to the composite clinical outcome, adjusting for confounders and accounting for the competing event of discharge from hospital. We compared our results to those from a conventional approach using an adjusted logistic regression model where time-varying effects and competitive risk were ignored. RESULTS Between February 19, 2020, and December 31, 2020, we included 1,337 HA-COVID-19 cases and 9,068 CA-COVID-19 cases. HA-COVID-19 patients were significantly older: median, 80 (interquartile range [IQR], 71-87) versus median 70 (IQR, 57-80) (P < .001). A greater proportion of HA-COVID-19 patients had a Charlson comorbidity index ≥ 5 (79% vs 55%; P < .001) than did CA-COVID-19 patients. In time-varying analyses, between day 0 and 8, HA-COVID-19 cases had a decreased risk of death or ICU or IMCU transfer compared to CA-COVID-19 cases (cause-specific hazard ratio [csHR], 0.43; 95% confidence interval [CI], 0.33-0.56). In contrast, from day 8 to 30, HA-COVID-19 cases had an increased risk of death or ICU or IMCU transfer (csHR, 1.49; 95% CI, 1.20-1.85), with no significant effect on the rate of discharge (csHR, 0.83; 95% CI, 0.61-1.14). In the conventional logistic regression model, HA-COVID-19 was protective against transfer to an ICU or IMCU and/or all-cause in-hospital mortality (adjusted odds ratio [aOR], 0.79, 95% CI, 0.67-0.93). CONCLUSIONS The risk of adverse clinical outcomes for HA-COVID-19 cases increased substantially over time in hospital and exceeded that for CA-COVID-19. Using approaches that do not account for time-varying effects or competing events may not fully capture the true risk of HA-COVID-19 compared to CA-COVID-19.
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Affiliation(s)
- Rebecca L. Grant
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Julien Sauser
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Andrew Atkinson
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Stéphanie D’Incau
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Division of Infectious Diseases, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Niccolò Buetti
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marie-Céline Zanella
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Jonas Marschall
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Division of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland
| | - Gaud Catho
- Infection Control Program and WHO Collaborating Centre, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland
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Chen R, Kezhekkekara SG, Kunasekaran MP, MacIntyre CR. Universal masking during COVID-19 outbreaks in aged care settings: A systematic review and meta-analysis. Ageing Res Rev 2024; 93:102138. [PMID: 38007047 DOI: 10.1016/j.arr.2023.102138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/11/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Aged care facilities (ACF) are a high-risk COVID-19 transmission setting, and older residents are at greater risk of severe outcomes. This systematic review and meta-analysis assessed whether universal masking and COVID-19 vaccination reduce SARS-CoV-2 attack rates (ARs) in ACF. Articles published between 1 December 2019 and 28 February 2022 were screened across five databases (Medline, Embase, PubMed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL)). Risk of bias was assessed using relevant Joanna Briggs Institute critical appraisal tools. Meta-analysis of single proportions, subgroup analysis, and meta-regression were performed to compare the effects of universal masking and vaccine doses on pooled SARS-CoV-2 ARs. Of 99 included articles, SARS-CoV-2 ARs for residents were available in 86 studies (representing 139 outbreaks), and for staff in 49 studies (78 outbreaks). Universal masking was associated with lower SARS-CoV-2 ARs in ACF outbreaks (AR = 34.9% [95% CI: 27.2-42.6%]) compared to facilities without universal masking (67.3% [54.2-80.4%], p < .0001). In ACF with universal masking prior to outbreak onset, facility-wide testing, and documentation of asymptomatic infection, the asymptomatic AR at time of testing was 11.4% (6.5-17.4%) in residents. Receipt of zero, one and two vaccination doses were associated with ARs of 64.9% (49.6-80.2%), 54.9% (33.7-76.1%) and 45.2% (29.2-61.3%), respectively. To protect residents from COVID-19, ACF should provide vaccination of residents and staff, universal masking for staff, and facility-wide testing during times of heightened community transmission.
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Affiliation(s)
- Rosalie Chen
- Kirby Institute, The University of New South Wales, Sydney, NSW, Australia; School of Population Health, The University of New South Wales, Sydney, NSW, Australia.
| | - Shwetha G Kezhekkekara
- Kirby Institute, The University of New South Wales, Sydney, NSW, Australia; School of Population Health, The University of New South Wales, Sydney, NSW, Australia; Australian Centre for Integration of Oral Health (ACIOH), Western Sydney University, Sydney, Australia
| | | | - C Raina MacIntyre
- Kirby Institute, The University of New South Wales, Sydney, NSW, Australia; Watts College of Public Service and Community Solutions, Arizona State University, Phoenix, AZ, United States
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Chen YY, Yang MH, Lai JZ, Chen JW, Wang YL, Wei ST, Hou SM, Chen CJ, Wu HS. Seroprevalence of Anti-SARS-CoV-2 Remained Extremely Low in Taiwan Until the Vaccination Program Was Implemented. Open Forum Infect Dis 2024; 11:ofad614. [PMID: 38192381 PMCID: PMC10773475 DOI: 10.1093/ofid/ofad614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/13/2023] [Indexed: 01/10/2024] Open
Abstract
Background The Taiwanese government made a concerted effort to contain a coronavirus disease 2019 (COVID-19) nosocomial outbreak of variant B.1.429, shortly before universal vaccination program implementation. This study aimed to investigate seroprevalence in the highest-risk regions. Methods Between January and February 2021, we retrieved 10 000 repository serum samples from blood donors to examine for antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) and spike (S) antigens. A positive result was confirmed if anti-N and anti-S antibodies were positive. Overall, 2000 donors residing in the highest-risk district and donating blood in January 2021 were further examined for SARS-CoV-2 RNA. We estimated seroprevalence and compared the epidemic curve between confirmed COVID-19 cases and blood donors with positive antibodies or viral RNA. Results Twenty-one cases with COVID-19 were confirmed in the nosocomial cluster, with an incidence of 1.27/100 000 in the COVID-affected districts. Among 4888 close contacts of the nosocomial cases, 20 (0.4%) became confirmed cases during isolation. Anti-SARS-CoV-2 was detected in 2 of the 10000 blood donors, showing a seroprevalence of 2/10000 (95% CI, 0.55-7.29). None of the 2000 donors who underwent tests for SARS-CoV-2 RNA were positive. The SARS-CoV-2 infection epidemic curve was observed sporadically in blood donors compared with the nosocomial cluster. Conclusions In early 2021, an extremely low anti-SARS-CoV-2 seroprevalence among blood donors was observed. Epidemic control measures through precise close contact tracing, testing, and isolation effectively contained SARS-CoV-2 transmission before universal vaccination program implementation.
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Affiliation(s)
| | | | | | - Jen-Wei Chen
- Taiwan Blood Services Foundation, Taipei, Taiwan
| | | | | | - Sheng-Mou Hou
- Taiwan Blood Services Foundation, Taipei, Taiwan
- Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | | | - Ho-Sheng Wu
- Hsinchu Blood Center, Hsinchu, Taiwan
- Taipei Medical University, Taipei, Taiwan
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Yin C, Mpofu E, Brock K, Ingman S. Nursing Home Residents' COVID-19 Infections in the United States: A Systematic Review of Personal and Contextual Factors. Gerontol Geriatr Med 2024; 10:23337214241229824. [PMID: 38370579 PMCID: PMC10870703 DOI: 10.1177/23337214241229824] [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: 08/16/2023] [Revised: 12/22/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Background: This mixed methods systemic review synthesizes the evidence about nursing home risks for COVID-19 infections. Methods: Four electronic databases (PubMed, Web of Science, Scopus, and Sage Journals Online) were searched between January 2020 and October 2022. Inclusion criteria were studies reported on nursing home COVID-19 infection risks by geography, demography, type of nursing home, staffing and resident's health, and COVID-19 vaccination status. The Mixed Methods Appraisal Tool (MMAT) was used to assess the levels of evidence for quality, and a narrative synthesis for reporting the findings by theme. Results: Of 579 initial articles, 48 were included in the review. Findings suggest that highly populated counties and urban locations had a higher likelihood of COVID-19 infections. Larger nursing homes with a low percentage of fully vaccinated residents also had increased risks for COVID-19 infections than smaller nursing homes. Residents with advanced age, of racial minority, and those with chronic illnesses were at higher risk for COVID-19 infections. Discussion and implications: Findings suggest that along with known risk factors for COVID-19 infections, geographic and resident demographics are also important preventive care considerations. Access to COVID-19 vaccinations for vulnerable residents should be a priority.
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Affiliation(s)
- Cheng Yin
- University of North Texas, Denton, USA
| | - Elias Mpofu
- University of North Texas, Denton, USA
- University of Sydney, Australia
- University of Johannesburg, South Africa
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45
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Evers J, Geraedts M. Impact of nursing home characteristics on COVID-19 infections among residents and staff. Am J Infect Control 2024; 52:15-20. [PMID: 37591313 DOI: 10.1016/j.ajic.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Excess mortality occurred in nursing homes during the SARS-CoV pandemic. This study aimed to identify risk factors for COVID-19 infection and mortality in nursing home residents and staff in Hesse, Germany. METHODS A retrospective cohort study of 687 nursing homes was performed. We used t tests and logistic regressions to quantify the role of nursing homes' size, location, staff qualification, and room occupancy as potential risk factors. RESULTS The bivariate statistics show that a higher proportion of infected staff and for-profit operations were associated with an increase in infections among residents and staff, while more single rooms and registered nurses showed protective effects. Our model calculations also show that the presence of a higher ratio of registered nurses was a significant protective factor against resident infection (odds ratios [OR]: 0.969, P = .002), resident mortality (OR: 0.973, P = .006), and safeguarded staff (OR: 0.979, P = .034). In contrast, more single rooms (OR: 0.993, P = .029) were protective for residents, while increased risk factors included more beds (OR: 1.006, P = .006 for residents' infections, OR: 1.008, P < .001 for mortality) and infected staff (OR: 2.363, P < .001 for residents' infections). For staff, medium population density (OR: 2.322, P = .016) and infected residents (OR: 1.308, P < .001) were associated with elevated risk. CONCLUSIONS Preventing infection outbreaks among residents and staff is crucial to reduce mortality. Strategies include increasing single-occupancy rooms, improving staff qualifications, and targeting facilities with lower registered nurse ratios and single-occupancy rooms for inspection.
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Affiliation(s)
- Janis Evers
- Institute for Health Services Research and Clinical Epidemiology, School of Medicine, Philipps University of Marburg, Germany.
| | - Max Geraedts
- Institute for Health Services Research and Clinical Epidemiology, School of Medicine, Philipps University of Marburg, Germany.
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Yang Q, Meyerson NR, Paige CL, Morrison JH, Clark SK, Fattor WT, Decker CJ, Steiner HR, Lian E, Larremore DB, Perera R, Poeschla EM, Parker R, Dowell RD, Sawyer SL. Human mRNA in saliva can correctly identify individuals harboring acute infection. mBio 2023; 14:e0171223. [PMID: 37943059 PMCID: PMC10746177 DOI: 10.1128/mbio.01712-23] [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: 07/03/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023] Open
Abstract
IMPORTANCE There are a variety of clinical and laboratory criteria available to clinicians in controlled healthcare settings to help them identify whether an infectious disease is present. However, in situations such as a new epidemic caused by an unknown infectious agent, in health screening contexts performed within communities and outside of healthcare facilities or in battlefield or potential biowarfare situations, this gets more difficult. Pathogen-agnostic methods for rapid screening and triage of large numbers of people for infection status are needed, in particular methods that might work on an easily accessible biospecimen like saliva. Here, we identify a small, core set of approximately 70 human genes whose transcripts serve as saliva-based biomarkers of infection in the human body, in a way that is agnostic to the specific pathogen causing infection.
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Affiliation(s)
- Qing Yang
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Nicholas R Meyerson
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Darwin Biosciences, Inc., Boulder, Colorado, USA
| | - Camille L Paige
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Darwin Biosciences, Inc., Boulder, Colorado, USA
| | - James H Morrison
- Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Stephen K Clark
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Darwin Biosciences, Inc., Boulder, Colorado, USA
| | - Will T Fattor
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Carolyn J Decker
- Department of Biochemistry, University of Colorado Boulder, Boulder, Colorado, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Halley R Steiner
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Biochemistry, University of Colorado Boulder, Boulder, Colorado, USA
| | - Elena Lian
- Center for Vector-Borne Infectious Diseases and Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Daniel B Larremore
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Computer Science, University of Colorado Boulder, Boulder, Colorado, USA
- Santa Fe Institute, Santa Fe, New Mexico, USA
| | - Rushika Perera
- Center for Vector-Borne Infectious Diseases and Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Eric M Poeschla
- Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Roy Parker
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Biochemistry, University of Colorado Boulder, Boulder, Colorado, USA
- Howard Hughes Medical Institute, Chevy Chase, Maryland, USA
| | - Robin D Dowell
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Computer Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - Sara L Sawyer
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
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47
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Bahr KO, Bhavsar GP, Zhao D. "We are still tired": staff and administrators' experiences during the COVID-19 pandemic within California residential care facilities for older adults. BMC Geriatr 2023; 23:868. [PMID: 38110888 PMCID: PMC10726520 DOI: 10.1186/s12877-023-04537-2] [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: 06/02/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Extensive research has been conducted on the impacts of the COVID-19 pandemic on long-term care workers in specialized care facilities. However, little is known about the impacts faced by facilities that provide generalized long-term support and care, such as residential care facilities for older adults (RCFs). This study describes the challenges experienced by staff and administrators of RCFs during the COVID-19 pandemic. METHODS An electronic questionnaire collecting data using both closed- and open-ended questions on staff experiences was sent to 5,721 unique RCF administrator emails within the state of California between June-December 2021. Email addresses were obtained from the public database of RCFs available through the California Health and Human Services Open Data Portal. Descriptive statistics were calculated on quantitative data regarding staff preparedness training, access to resources, and administrators' confidence in meeting recommended guidelines during the pandemic. Inductive thematic analysis was conducted on qualitative data regarding the confidence levels in meeting pandemic guidelines and challenges faced related to staff stress and morale. RESULTS A total of 150 RCF administrators across California (response rate of 2.6%) completed the survey. Over three-fourths of respondents indicated their facilities had a designated staff member to train other staff members on emergency preparedness plans and the most frequently used resources during the COVID-19 pandemic were the Department of Social Services Community Care Licensing Division (88.7%), the county health department (86.7%), and the Centers for Disease Control and Prevention (80.7%). Administrators felt least confident in their facilities' ability to maintain adequate staffing (52.0%), communication with nearby hospitals (62.1%) and communication with state and local public health officials (69.8%) during the pandemic. Three central themes emerged from the thematic analysis on staff stress and morale: (1) physical safety, mental and emotional impact of the COVID-19 pandemic; (2) staffing issues; and (3) challenges with guidelines in managing the ongoing pandemic. CONCLUSIONS Findings from this research study can be used to actively target training resources for facility administrators and staff that have been identified as most frequently used and relevant for emergency preparedness in these understudied facilities. Additionally, developing a better understanding of the staffing stress and morale difficulties in RCFs can provide insight on how policymakers can assist these critical facilities in better preparing for future crises.
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Affiliation(s)
- Kaitlin O Bahr
- Public Health Program, California State University Northridge, 18111 Nordhoff St., Northridge, CA, 91330, USA.
| | - Grishma P Bhavsar
- Health Administration Program, California State University Northridge, 18111 Nordhoff St., Northridge, CA, 91330, USA
| | - David Zhao
- Public Health Program, California State University Northridge, 18111 Nordhoff St., Northridge, CA, 91330, USA
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48
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Moradi Marjaneh M, Challenger JD, Salas A, Gómez-Carballa A, Sivananthan A, Rivero-Calle I, Barbeito-Castiñeiras G, Foo CY, Wu Y, Liew F, Jackson HR, Habgood-Coote D, D'Souza G, Nichols SJ, Wright VJ, Levin M, Kaforou M, Thwaites RS, Okell LC, Martinón-Torres F, Cunnington AJ. Analysis of blood and nasal epithelial transcriptomes to identify mechanisms associated with control of SARS-CoV-2 viral load in the upper respiratory tract. J Infect 2023; 87:538-550. [PMID: 37863321 DOI: 10.1016/j.jinf.2023.10.009] [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: 07/14/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES The amount of SARS-CoV-2 detected in the upper respiratory tract (URT viral load) is a key driver of transmission of infection. Current evidence suggests that mechanisms constraining URT viral load are different from those controlling lower respiratory tract viral load and disease severity. Understanding such mechanisms may help to develop treatments and vaccine strategies to reduce transmission. Combining mathematical modelling of URT viral load dynamics with transcriptome analyses we aimed to identify mechanisms controlling URT viral load. METHODS COVID-19 patients were recruited in Spain during the first wave of the pandemic. RNA sequencing of peripheral blood and targeted NanoString nCounter transcriptome analysis of nasal epithelium were performed and gene expression analysed in relation to paired URT viral load samples collected within 15 days of symptom onset. Proportions of major immune cells in blood were estimated from transcriptional data using computational differential estimation. Weighted correlation network analysis (adjusted for cell proportions) and fixed transcriptional repertoire analysis were used to identify associations with URT viral load, quantified as standard deviations (z-scores) from an expected trajectory over time. RESULTS Eighty-two subjects (50% female, median age 54 years (range 3-73)) with COVID-19 were recruited. Paired URT viral load samples were available for 16 blood transcriptome samples, and 17 respiratory epithelial transcriptome samples. Natural Killer (NK) cells were the only blood cell type significantly correlated with URT viral load z-scores (r = -0.62, P = 0.010). Twenty-four blood gene expression modules were significantly correlated with URT viral load z-score, the most significant being a module of genes connected around IFNA14 (Interferon Alpha-14) expression (r = -0.60, P = 1e-10). In fixed repertoire analysis, prostanoid-related gene expression was significantly associated with higher viral load. In nasal epithelium, only GNLY (granulysin) gene expression showed significant negative correlation with viral load. CONCLUSIONS Correlations between the transcriptional host response and inter-individual variations in SARS-CoV-2 URT viral load, revealed many molecular mechanisms plausibly favouring or constraining viral replication. Existing evidence corroborates many of these mechanisms, including likely roles for NK cells, granulysin, prostanoids and interferon alpha-14. Inhibition of prostanoid production and administration of interferon alpha-14 may be attractive transmission-blocking interventions.
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Affiliation(s)
- Mahdi Moradi Marjaneh
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK; Section of Virology, Department of Infectious Diseases, Imperial College London, London, UK.
| | - Joseph D Challenger
- Medical Research Council Centre for Global Infections Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Antonio Salas
- Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain; Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Alberto Gómez-Carballa
- Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain; Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
| | - Abilash Sivananthan
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Irene Rivero-Calle
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain; Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Gema Barbeito-Castiñeiras
- Servicio de Microbiología y Parasitología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Cher Y Foo
- School of Medicine, Imperial College London, London, UK
| | - Yue Wu
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London, UK
| | - Felicity Liew
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Heather R Jackson
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Dominic Habgood-Coote
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Giselle D'Souza
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Samuel J Nichols
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Victoria J Wright
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Michael Levin
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Myrsini Kaforou
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK
| | - Ryan S Thwaites
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Lucy C Okell
- Medical Research Council Centre for Global Infections Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Federico Martinón-Torres
- Genetics, Vaccines and Infections Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain; Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Aubrey J Cunnington
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK; Centre for Paediatrics and Child Health, Imperial College London, London, UK.
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Vargas-De-León C, Cureño-Díaz MA, Salazar MI, Cruz-Cruz C, Loyola-Cruz MÁ, Durán-Manuel EM, Zamora-Pacheco ER, Bravata-Alcántara JC, Lugo-Zamudio GE, Fernández-Sánchez V, Bello-López JM, Ibáñez-Cervantes G. Neutralizing Antibodies against SARS-CoV-2: Importance of Comorbidities in Health Personnel against Reinfections. Viruses 2023; 15:2354. [PMID: 38140595 PMCID: PMC10747730 DOI: 10.3390/v15122354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
One of the priority lines of action to contain the SARS-CoV-2 pandemic was vaccination programs for healthcare workers. However, with the emergence of highly contagious strains, such as the Omicron variant, it was necessary to know the serological status of health personnel to make decisions for the application of reinforcements. The aim of this work was to determine the seroprevalence against SARS-CoV-2 in healthcare workers in a Mexican hospital after six months of the administration of the Pfizer-BioNTech vaccine (two doses, 4 weeks apart) and to investigate the association between comorbidities, response to the vaccine, and reinfections. Neutralizing antibodies against SARS-CoV-2 were determined using ELISA assays for 262 employees of Hospital Juárez de México with and without a history of COVID-19. A beta regression analysis was performed to study the associated comorbidities and their relationship with the levels of antibodies against SARS-CoV-2. Finally, an epidemiological follow-up was carried out to detect reinfections in this population. A significant difference in SARS-CoV-2 seroprevalence was observed in workers with a history of COVID-19 prior to vaccination compared to those without a history of the disease (MD: 0.961 and SD: 0.049; <0.001). Beta regression showed that workers with a history of COVID-19 have greater protection compared to those without a history of the infection. Neutralizing antibodies were found to be decreased in alcoholic and diabetic subjects (80.1%). Notably, eight cases of Omicron reinfections were identified, and gender and obesity were associated with the presence of reinfections (6.41 OR; 95% BCa CI: 1.15, 105.0). The response to the vaccine was influenced by the history of SARS-CoV-2 infection and associated comorbidities. The above highlights the importance of prioritizing this segment of the population for reinforcements in periods of less than one year to guarantee their effectiveness against new variants.
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Affiliation(s)
- Cruz Vargas-De-León
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 07738, Mexico;
| | | | - Ma. Isabel Salazar
- Laboratorio Nacional de Vacunología y Virus Tropicales, Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional, Ciudad de México 11340, México;
| | - Clemente Cruz-Cruz
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
| | - Miguel Ángel Loyola-Cruz
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
| | - Emilio Mariano Durán-Manuel
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
| | - Edwin Rodrigo Zamora-Pacheco
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 07738, Mexico;
| | | | | | - Verónica Fernández-Sánchez
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
| | - Juan Manuel Bello-López
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
| | - Gabriela Ibáñez-Cervantes
- División de Investigación, Hospital Juárez de México, Ciudad de México 07760, Mexico; (C.V.-D.-L.); (C.C.-C.); (M.Á.L.-C.); (E.M.D.-M.)
- Laboratorio de Modelación Bioestadística para la Salud, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 07738, Mexico;
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50
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Liviero F, Volpin A, Furlan P, Battistella M, Broggio A, Fabris L, Favretto F, Mason P, Cocchio S, Cozzolino C, Baldo V, Moretto A, Scapellato ML. The impact of SARS-CoV-2 on healthcare workers of a large University Hospital in the Veneto Region: risk of infection and clinical presentation in relation to different pandemic phases and some relevant determinants. Front Public Health 2023; 11:1250911. [PMID: 38098828 PMCID: PMC10720910 DOI: 10.3389/fpubh.2023.1250911] [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: 06/30/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Aim The aim of this study is to evaluate the incidence of SARS-CoV-2 infection and the prevalence of COVID-19-related symptoms in relation to pandemic phases and some relevant variables in a cohort of 8,029 HCWs from one of the largest Italian University Hospitals. Methods A single-center retrospective study was performed on data collected during SARS-CoV-2 infection surveillance of HCWs. Cox's multiple regression was performed to estimate hazard ratios of SARS-CoV-2 infection. Logistic multivariate regression was used to assess the risk of asymptomatic infections and the onset of the most frequent symptoms. All analyses were adjusted for sociodemographic and occupational factors, pandemic phases, vaccination status, and previous infections. Results A total of 3,760 HCWs resulted positive (2.0%-18.6% across five study phases). The total incidence rate of SARS-CoV-2 infection was 7.31 cases per 10,000 person-days, significantly lower in phase 1 and higher in phases 4 and 5, compared to phase 3. Younger HCWs, healthcare personnel, and unvaccinated subjects showed a higher risk of infection. Overall, 24.5% were asymptomatic infections, with a higher probability for men, physicians, and HCWs tested for screening, fully vaccinated, and those with previous infection. The clinical presentation changed over the phases in relation to vaccination status and the emergence of new variants. Conclusion The screening activities of HCWs allowed for the early detection of asymptomatic cases, limiting the epidemic clusters inside the hospital wards. SARS-CoV-2 vaccination reduced infections and symptomatic cases, demonstrating again its paramount value as a preventive tool for occupational and public health.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Anna Volpin
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Patrizia Furlan
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Monica Battistella
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessia Broggio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Laura Fabris
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Francesco Favretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Claudia Cozzolino
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Preventive Medicine and Risk Assessment Unit, University Hospital of Padova, Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
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