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Oelsner EC, Sun Y, Balte PP, Allen NB, Andrews H, Carson A, Cole SA, Coresh J, Couper D, Cushman M, Daviglus M, Demmer RT, Elkind MSV, Gallo LC, Gutierrez JD, Howard VJ, Isasi CR, Judd SE, Kanaya AM, Kandula NR, Kaplan RC, Kinney GL, Kucharska-Newton AM, Lackland DT, Lee JS, Make BJ, Min YI, Murabito JM, Norwood AF, Ortega VE, Pettee Gabriel K, Psaty BM, Regan EA, Sotres-Alvarez D, Schwartz D, Shikany JM, Thyagarajan B, Tracy RP, Umans JG, Vasan RS, Wenzel SE, Woodruff PG, Xanthakis V, Zhang Y, Post WS. Epidemiologic Features of Recovery From SARS-CoV-2 Infection. JAMA Netw Open 2024; 7:e2417440. [PMID: 38884994 PMCID: PMC11184459 DOI: 10.1001/jamanetworkopen.2024.17440] [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: 01/24/2024] [Accepted: 04/17/2024] [Indexed: 06/18/2024] Open
Abstract
Importance Persistent symptoms and disability following SARS-CoV-2 infection, known as post-COVID-19 condition or "long COVID," are frequently reported and pose a substantial personal and societal burden. Objective To determine time to recovery following SARS-CoV-2 infection and identify factors associated with recovery by 90 days. Design, Setting, and Participants For this prospective cohort study, standardized ascertainment of SARS-CoV-2 infection was conducted starting in April 1, 2020, across 14 ongoing National Institutes of Health-funded cohorts that have enrolled and followed participants since 1971. This report includes data collected through February 28, 2023, on adults aged 18 years or older with self-reported SARS-CoV-2 infection. Exposure Preinfection health conditions and lifestyle factors assessed before and during the pandemic via prepandemic examinations and pandemic-era questionnaires. Main Outcomes and Measures Probability of nonrecovery by 90 days and restricted mean recovery times were estimated using Kaplan-Meier curves, and Cox proportional hazards regression was performed to assess multivariable-adjusted associations with recovery by 90 days. Results Of 4708 participants with self-reported SARS-CoV-2 infection (mean [SD] age, 61.3 [13.8] years; 2952 women [62.7%]), an estimated 22.5% (95% CI, 21.2%-23.7%) did not recover by 90 days post infection. Median (IQR) time to recovery was 20 (8-75) days. By 90 days post infection, there were significant differences in restricted mean recovery time according to sociodemographic, clinical, and lifestyle characteristics, particularly by acute infection severity (outpatient vs critical hospitalization, 32.9 days [95% CI, 31.9-33.9 days] vs 57.6 days [95% CI, 51.9-63.3 days]; log-rank P < .001). Recovery by 90 days post infection was associated with vaccination prior to infection (hazard ratio [HR], 1.30; 95% CI, 1.11-1.51) and infection during the sixth (Omicron variant) vs first wave (HR, 1.25; 95% CI, 1.06-1.49). These associations were mediated by reduced severity of acute infection (33.4% and 17.6%, respectively). Recovery was unfavorably associated with female sex (HR, 0.85; 95% CI, 0.79-0.92) and prepandemic clinical cardiovascular disease (HR, 0.84; 95% CI, 0.71-0.99). No significant multivariable-adjusted associations were observed for age, educational attainment, smoking history, obesity, diabetes, chronic kidney disease, asthma, chronic obstructive pulmonary disease, or elevated depressive symptoms. Results were similar for reinfections. Conclusions and Relevance In this cohort study, more than 1 in 5 adults did not recover within 3 months of SARS-CoV-2 infection. Recovery within 3 months was less likely in women and those with preexisting cardiovascular disease and more likely in those with COVID-19 vaccination or infection during the Omicron variant wave.
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Affiliation(s)
- Elizabeth C. Oelsner
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Yifei Sun
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Pallavi P. Balte
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Norrina B. Allen
- Center for Epidemiology and Population Health, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - April Carson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | | | - Josef Coresh
- Departments of Medicine and Public Health, NYU Grossman School of Medicine, New York, New York
| | - David Couper
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina, Chapel Hill
| | - Mary Cushman
- Division of Hematology/Oncology, Department of Medicine, Larner School of Medicine, University of Vermont, Burlington
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago
| | - Ryan T. Demmer
- Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
| | - Mitchell S. V. Elkind
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
- American Heart Association, Dallas, Texas
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, California
| | - Jose D. Gutierrez
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Virginia J. Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Suzanne E. Judd
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Alka M. Kanaya
- Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco
| | - Namratha R. Kandula
- Center for Epidemiology and Population Health, Northwestern Feinberg School of Medicine, Chicago, Illinois
- Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Daniel T. Lackland
- Department of Neurology, Medical University of South Carolina, Charleston
| | - Joyce S. Lee
- Division of Pulmonary and Critical Care, Department of Medicine, University of Colorado, Aurora
| | - Barry J. Make
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Yuan-I. Min
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | | | - Arnita F. Norwood
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Victor E. Ortega
- Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Bruce M. Psaty
- Departments of Epidemiology and Medicine, University of Washington, Seattle
| | - Elizabeth A. Regan
- Division of Rheumatology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina, Chapel Hill
| | - David Schwartz
- Division of Pulmonary and Critical Care, Department of Medicine, University of Colorado, Aurora
| | - James M. Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis
| | - Russell P. Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington
| | - Jason G. Umans
- MedStar Health Research Institute, School of Medicine, Georgetown University, Washington, District of Columbia
| | | | - Sally E. Wenzel
- Department of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pittsburgh, Pennsylvania
| | - Prescott G. Woodruff
- Divison of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Ying Zhang
- Departments of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Wendy S. Post
- Division of Cardiology, Departments of Medicine and Epidemiology, Johns Hopkins University, Baltimore, Maryland
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McGroder CF, Salvatore MM, D'Souza BM, Hoffman EA, Baldwin MR, Garcia CK. Improved pulmonary function and exercise tolerance despite persistent pulmonary fibrosis over 1 year after severe COVID-19 infection. Thorax 2024; 79:472-475. [PMID: 38514184 PMCID: PMC11044919 DOI: 10.1136/thorax-2023-220370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
We conducted a prospective single-centre cohort study of 104 multi-ethnic severe COVID-19 survivors from the first wave of the pandemic 15 months after hospitalisation. Of those who were assessed at 4 and 15 months, improvement of ground glass opacities correlated with worsened fibrotic reticulations. Despite a high prevalence of fibrotic patterns (64%), pulmonary function, grip strength, 6 min walk distance and frailty normalised. Overall, dyspnoea, cough and exhaustion did not improve and were not correlated with pulmonary function or radiographic fibrosis at 15 months, suggesting non-respiratory aetiologies. Monitoring persistent, and often subclinical, fibrotic interstitial abnormalities will be needed to determine their potential for future progression.
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Affiliation(s)
- Claire F McGroder
- Medicine/Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Mary M Salvatore
- Radiology, Columbia University Medical Center, New York, New York, USA
| | - Belinda M D'Souza
- Radiology, Columbia University Medical Center, New York, New York, USA
| | - Eric A Hoffman
- Radiology/Medicine/Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Matthew R Baldwin
- Medicine/Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Christine Kim Garcia
- Medicine/Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Precision Medicine Initiative and the Center for Precision Medicine and Genomics, Columbia University, New York, NY, USA
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3
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Berman K, Van Slyke G, Novak H, Rock JM, Bievenue R, Damjanovic AK, DeRosa KL, Mirabile G, Girardin RC, Dupuis AP, McDonough KA, Parker MM, Styer LM, Mantis NJ. Quantitating SARS-CoV-2 Neutralizing Antibodies from Human Dried Blood Spots. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.18.585599. [PMID: 38562708 PMCID: PMC10983952 DOI: 10.1101/2024.03.18.585599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background In the earliest days of COVID-19 pandemic, the collection of dried blood spots (DBS) enabled public health laboratories to undertake population-scale seroprevalence studies to estimate rates of SARS-CoV-2 exposure. With SARS-CoV-2 seropositivity levels now estimated to exceed 94% in the United States, attention has turned to using DBS to assess functional (neutralizing) antibodies within cohorts of interest. Methods Contrived DBS eluates from convalescent, fully vaccinated and pre-COVID-19 serum samples were evaluated in SARS-CoV-2 plaque reduction neutralization titer (PRNT) assays, a SARS-CoV-2 specific 8-plex microsphere immunoassay, a cell-based pseudovirus assay, and two different spike-ACE2 inhibition assays, an in-house Luminex-based RBD-ACE2 inhibition assay and a commercial real-time PCR-based inhibition assay (NAB-Sure™). Results DBS eluates from convalescent individuals were compatible with the spike-ACE2 inhibition assays, but not cell-based pseudovirus assays or PRNT. However, the insensitivity of cell-based pseudovirus assays was overcome with DBS eluates from vaccinated individuals with high SARS-CoV-2 antibody titers. Conclusion SARS-CoV-2 neutralizing titers can be derived with confidence from DBS eluates, thereby opening the door to the use of these biospecimens for the analysis of vulnerable populations and normally hard to reach communities.
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Affiliation(s)
- Katherine Berman
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Greta Van Slyke
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Hayley Novak
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Jean M. Rock
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Rachel Bievenue
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Amanda K. Damjanovic
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Kate L. DeRosa
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Gianna Mirabile
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Roxie C. Girardin
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Alan P. Dupuis
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Kathleen A. McDonough
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Monica M. Parker
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Linda M. Styer
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
| | - Nicholas J. Mantis
- Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, NY 12208
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Kim JS, Sun Y, Balte P, Cushman M, Boyle R, Tracy RP, Styer LM, Bell TD, Anderson MR, Allen NB, Schreiner PJ, Bowler RP, Schwartz DA, Lee JS, Xanthakis V, Doyle MF, Regan EA, Make BJ, Kanaya AM, Wenzel SE, Coresh J, Isasi CR, Raffield LM, Elkind MSV, Howard VJ, Ortega VE, Woodruff P, Cole SA, Henderson JM, Mantis NJ, Parker MM, Demmer RT, Oelsner EC. Demographic and Clinical Factors Associated With SARS-CoV-2 Spike 1 Antibody Response Among Vaccinated US Adults: the C4R Study. Nat Commun 2024; 15:1492. [PMID: 38374032 PMCID: PMC10876680 DOI: 10.1038/s41467-024-45468-9] [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: 05/05/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024] Open
Abstract
This study investigates correlates of anti-S1 antibody response following COVID-19 vaccination in a U.S. population-based meta-cohort of adults participating in longstanding NIH-funded cohort studies. Anti-S1 antibodies were measured from dried blood spots collected between February 2021-August 2022 using Luminex-based microsphere immunoassays. Of 6245 participants, mean age was 73 years (range, 21-100), 58% were female, and 76% were non-Hispanic White. Nearly 52% of participants received the BNT162b2 vaccine and 48% received the mRNA-1273 vaccine. Lower anti-S1 antibody levels are associated with age of 65 years or older, male sex, higher body mass index, smoking, diabetes, COPD and receipt of BNT16b2 vaccine (vs mRNA-1273). Participants with a prior infection, particularly those with a history of hospitalized illness, have higher anti-S1 antibody levels. These results suggest that adults with certain socio-demographic and clinical characteristics may have less robust antibody responses to COVID-19 vaccination and could be prioritized for more frequent re-vaccination.
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Affiliation(s)
- John S Kim
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Yifei Sun
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Pallavi Balte
- Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Rebekah Boyle
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Russell P Tracy
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Linda M Styer
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Taison D Bell
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - David A Schwartz
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joyce S Lee
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Vanessa Xanthakis
- Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Margaret F Doyle
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | | | - Barry J Make
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | - Alka M Kanaya
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sally E Wenzel
- Department of Medicine, Department of Immunology, and Department of Environmental Medicine and Occupational Health, University of Pittsburgh School of Medicine, School of Public Health, Pittsburgh, PA, USA
| | - Josef Coresh
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
- Department of Medicine, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Laura M Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Mitchell S V Elkind
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor E Ortega
- Division of Respiratory Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Prescott Woodruff
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Shelley A Cole
- Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Joel M Henderson
- Department of Pathology and Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Nicholas J Mantis
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY, USA
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, NY, USA
| | - Monica M Parker
- Division of Infectious Diseases, Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
- Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.
| | - Elizabeth C Oelsner
- Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 Antibody Levels Associated with COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu VE Network, October 2021-June 2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.21.23295919. [PMID: 37790578 PMCID: PMC10543239 DOI: 10.1101/2023.09.21.23295919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background We assessed the association between antibody concentration ≤5 days of symptom onset and COVID-19 illness among patients enrolled in a test-negative study. Methods From October 2021-June 2022, study sites in seven states enrolled and tested respiratory specimens from patients of all ages presenting with acute respiratory illness for SARS-CoV-2 infection using rRT-PCR. In blood specimens, we measured concentration of anti-SARS-CoV-2 antibodies against the ancestral strain spike protein receptor binding domain (RBD) and nucleocapsid (N) antigens in standardized binding antibody units (BAU/mL). Percent reduction in odds of symptomatic COVID-19 by anti-RBD antibody was estimated using logistic regression modeled as (1-adjusted odds ratio of COVID-19)×100, adjusting for COVID-19 vaccination status, age, site, and high-risk exposure. Results A total of 662 (33%) of 2,018 symptomatic patients tested positive for acute SARS-CoV-2 infection. During the Omicron-predominant period, geometric mean anti-RBD binding antibody concentrations measured 823 BAU/mL (95%CI:690-981) among COVID-19 case-patients versus 1,189 BAU/mL (95%CI:1,050-1,347) among SARS-CoV-2 test-negative patients. In the adjusted logistic regression, increasing levels of anti-RBD antibodies were associated with reduced odds of COVID-19 for both Delta and Omicron infections. Conclusion Higher anti-RBD antibodies in patients were associated with protection against symptomatic COVID-19 during emergence of SARS-CoV-2 Delta and Omicron variants.
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Affiliation(s)
- Kelsey M. Sumner
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruchi Yadav
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma K. Noble
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Ryan Sandford
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Devyani Joshi
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Y. Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Karen J. Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, TX, USA
- Texas A&M University College of Medicine, Temple, TX, USA
| | | | | | | | - Jessie R. Chung
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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6
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Shad N, Colón-López V, Pérez CM, López-Cepero A. Challenges Accessing Food, Water, Healthcare Services, and Medications During the COVID-19 Pandemic Among Adults in Puerto Rico and Their Association with Self-Rated Health: Assessments of PR-CEAL. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01685-4. [PMID: 37405562 DOI: 10.1007/s40615-023-01685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/01/2023] [Accepted: 06/18/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic created challenges in accessing food, water, medications, and healthcare services some of which are linked with lower self-rated health (SRH). These challenges have already been documented in the US, but it remains unknown how the pandemic affected access to food, water, medications and healthcare services, and how these challenges relate to SRH in this group, a population experiencing profound health disparities and limited resources prior to the pandemic. OBJECTIVE To assess associations between challenges accessing food, water, healthcare, and medications during the COVID-19 pandemic and SRH among adults in Puerto Rico. METHODS Cross-sectional analysis of Puerto Rico-CEAL. Adults (>18 years; n=582) completed an online survey (December 30, 2021-February 8, 2022). Presence of each challenge during the past 30 days was measured and analyzed individually and combined (0, 1, >2). SRH (rated from poor-excellent) was measured before and at pandemic. Change in SRH was calculated. Adjusted Poisson models with robust variance errors estimated prevalence ratios (PR). RESULTS Experiencing food, water, medication, and healthcare challenges (vs. not) were associated with pandemic fair-poor SRH (PR=1.44, 95%CI=1.06-1.97; PR=1.59, 95%CI=1.15-2.18; PR=1.38, 95%CI=1.05-1.81; and PR=1.56,9 5%CI=1.15-2.12, respectively). Experiencing 2+ challenges (vs. none) was associated with pandemic fair-poor SRH (PR=1.77, 95%CI=1.22-2.55). Additionally, experiencing food, medication, and healthcare challenges (vs. not) was associated with decreased SRH (PR=1.35, 95%CI=1.08-1.69; PR=1.24, 95%CI=1.01-1.51; and PR=1.25, 95%CI=1.01-1.54, respectively), as well as experiencing 2+ challenges (vs. none; PR =1.49, 95%CI=1.15-1.92). CONCLUSION Challenges accessing food, water, medications, and healthcare services during the pandemic were associated with fair-poor SRH and decreased SRH in Puerto Rico. Public health policy should ensure access to basic needs.
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Affiliation(s)
- Nayeli Shad
- Department of BioSciences, Rice University, Houston, TX, USA
| | - Vivian Colón-López
- University of Puerto Rico Comprehensive Cancer Center, San Juan, PR, USA
| | - Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, PR, USA
| | - Andrea López-Cepero
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
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7
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Isasi CR, Gallo LC, Cai J, Gellman MD, Xie W, Heiss G, Kaplan RC, Talavera GA, Daviglus ML, Pirzada A, Wassertheil-Smoller S, Llabre MM, Youngblood ME, Schneiderman N, Pérez-Stable EJ, Napoles AM, Perreira KM. Economic and Psychosocial Impact of COVID-19 in the Hispanic Community Health Study/Study of Latinos. Health Equity 2023; 7:206-215. [PMID: 37007686 PMCID: PMC10061327 DOI: 10.1089/heq.2022.0211] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives To examine the prevalence and correlates of economic hardship and psychosocial distress experienced during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic in a large cohort of Hispanic/Latino adults. Methods The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an ongoing multicenter study of Hispanic/Latino adults, collected information about COVID-19 illness and psychosocial and economic distress that occurred during the pandemic (N=11,283). We estimated the prevalence of these experiences during the initial phase of the pandemic (May 2020 to May 2021) and examined the prepandemic factors associated with pandemic-related economic hardship and emotional distress using multivariable log linear models with binomial distributions to estimate prevalence ratios. Results Almost half of the households reported job losses and a third reported economic hardship during the first year of the pandemic. Pandemic-related household job losses and economic hardship were more pronounced among noncitizens who are likely to be undocumented. Pandemic-related economic hardship and psychosocial distress varied by age group and sex. Contrary to the economic hardship findings, noncitizens were less likely to report pandemic-related psychosocial distress. Prepandemic social resources were inversely related to psychosocial distress. Conclusions The study findings underscore the economic vulnerability that the pandemic has brought to ethnic minoritized and immigrant populations in the United States, in particular noncitizens. The study also highlights the need to incorporate documentation status as a social determinant of health. Characterizing the initial economic and mental health impact of the pandemic is important for understanding the pandemic consequences on future health. Clinical Trial Registration Number: NCT02060344.
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Affiliation(s)
- Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marc D. Gellman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Wenyi Xie
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Gregory A. Talavera
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maria M. Llabre
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Marston E. Youngblood
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities and Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, Maryland, USA
| | - Anna M. Napoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Krista M. Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
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Hermann EA, Lee B, Balte PP, Xanthakis V, Kirkpatrick BD, Cushman M, Oelsner E. Association of Symptoms After COVID-19 Vaccination With Anti-SARS-CoV-2 Antibody Response in the Framingham Heart Study. JAMA Netw Open 2022; 5:e2237908. [PMID: 36269359 PMCID: PMC9587476 DOI: 10.1001/jamanetworkopen.2022.37908] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/07/2022] [Indexed: 01/21/2023] Open
Abstract
This cohort study examines the association of self-reported postvaccination symptoms with anti–SARS-CoV-2 antibody response among Framingham Heart Study participants contributing to the Collaborative Cohort of Cohorts for COVID-19 Research study.
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Affiliation(s)
- Emilia A. Hermann
- Division of General Medicine, Department of Medicine, Columbia University, New York, New York
| | - Benjamin Lee
- Department of Pediatrics, Larner College of Medicine at the University of Vermont, Burlington
| | - Pallavi P. Balte
- Division of General Medicine, Department of Medicine, Columbia University, New York, New York
| | - Vanessa Xanthakis
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Beth D. Kirkpatrick
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington
- Department of Microbiology and Molecular Genetics, Larner College of Medicine, University of Vermont, Burlington
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington
| | - Elizabeth Oelsner
- Division of General Medicine, Department of Medicine, Columbia University, New York, New York
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