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Ma Y, Deng J, Liu Q, Du M, Liu M, Liu J. Long-Term Consequences of Asymptomatic SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20021613. [PMID: 36674367 PMCID: PMC9863678 DOI: 10.3390/ijerph20021613] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/06/2023] [Accepted: 01/14/2023] [Indexed: 05/12/2023]
Abstract
Little is known about the long-term consequences of asymptomatic infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to review the data available to explore the long-term consequences of asymptomatic SARS-CoV-2 infection in the real world. We searched observational cohort studies that described the long-term health effects of asymptomatic SARS-CoV-2 infections. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of long-term symptoms. Random effects were used to estimate the pooled odds ratios (OR) and its 95%CI of different long-term symptoms between symptomatic and asymptomatic infections. Five studies involving a total of 1643 cases, including 597 cases of asymptomatic and 1043 cases of symptomatic SARS-CoV-2 infection were included in this meta-analysis. The PPs of long-term consequences after asymptomatic SARS-CoV-2 infections were 17.13% (95%CI, 7.55−26.71%) for at least one symptom, 15.09% (95%CI, 5.46−24.73%) for loss of taste, 14.14% (95%CI, −1.32−29.61%) for loss of smell, and 9.33% (95%CI, 3.07−15.60) for fatigue. Compared with symptomatic SARS-CoV-2 infection, asymptomatic infection was associated with a significantly lower risk of developing COVID-19-related sequelae (p < 0.05), with 80% lower risk of developing at least one symptom (OR = 0.20, 95%CI, 0.09−0.45), 81% lower risk of fatigue (OR = 0.19, 95%CI, 0.08−0.49), 90% lower risk of loss of taste/smell (OR = 0.10, 95%CI, 0.02−0.58). Our results suggested that there were long-term effects of asymptomatic SARS-CoV-2 infection, such as loss of taste or smell, fatigue, cough and so on. However, the risk of developing long-term symptoms in asymptomatic SARS-CoV-2 infected persons was significantly lower than those in symptomatic SARS-CoV-2 infection cases.
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Affiliation(s)
- Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (M.L.); (J.L.); Tel.: +86-10-8-2805146 (M.L.); +86-10-8-2801528-316 (J.L.); Fax: +86-10-8-2805146 (M.L. & J.L.)
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Institute for Global Health and Development, Peking University, Beijing 100871, China
- Correspondence: (M.L.); (J.L.); Tel.: +86-10-8-2805146 (M.L.); +86-10-8-2801528-316 (J.L.); Fax: +86-10-8-2805146 (M.L. & J.L.)
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Vicenti I, Basso M, Gatti F, Scaggiante R, Boccuto A, Zago D, Modolo E, Dragoni F, Parisi SG, Zazzi M. Faster decay of neutralizing antibodies in never infected than previously infected healthcare workers three months after the second BNT162b2 mRNA COVID-19 vaccine dose. Int J Infect Dis 2021; 112:40-44. [PMID: 34481967 PMCID: PMC8410637 DOI: 10.1016/j.ijid.2021.08.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to describe the longitudinal evolution of neutralizing antibody titres (NtAb) in three different cohorts of healthcare workers (HCWs), including vaccinated HCWs with and without a previous SARS-CoV-2 infection and previously infected unvaccinated HCWs. COVID-19 was mild or asymptomatic in those experiencing infection. METHODS NtAb was tested before BNT162b2 mRNA COVID-19 vaccine (V0), 20±2 days after the first dose (V1_20), 20±3 days (V2_20) and 90±2 days (V2_90) after the second dose in vaccinated HCWs and after about 2 months (N_60), 10 months (N_300) and 13 months (N_390) from natural infection in unvaccinated HCWs. NtAb were measured by authentic virus neutralization with a SARS-CoV-2 B.1 isolate circulating in Italy at HCW enrolment. RESULTS Sixty-two HCWs were enrolled. NtAb were comparable in infected HCWs with no or mild disease at all the study points. NtAb of uninfected HCWs were significantly lower with respect to those of previously infected HCWs at V1_20, V2_20 and V2_90. The median NtAb fold decrease from V2_20 to V2_90 was higher in the uninfected HCWs with respect to those with mild infection (6.26 vs 2.58, p=0.03) and to asymptomatic HCWs (6.26 vs 3.67, p=0.022). The median Nabt at N_390 was significantly lower than at N_60 (p=0.007). CONCLUSIONS In uninfected HCWs completing the two-dose vaccine schedule, a third mRNA vaccine dose is a reasonable option to counteract the substantial NtAb decline occurring at a significantly higher rate compared with previously infected, vaccinated HCWs. Although low, Nabt were still at a detectable level after 13 months in two-thirds of previously infected and unvaccinated HCWs.
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Affiliation(s)
- Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Monica Basso
- Department of Molecular Medicine University of Padova, Padova, Italy
| | - Francesca Gatti
- Department of Molecular Medicine University of Padova, Padova, Italy
| | | | - Adele Boccuto
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Daniela Zago
- Department of Molecular Medicine University of Padova, Padova, Italy
| | | | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Vicenti I, Gatti F, Scaggiante R, Boccuto A, Zago D, Basso M, Dragoni F, Parisi SG, Zazzi M. BNT162b2 SARS-CoV-2 Vaccination Elicits High Titers of Neutralizing Antibodies to Both B.1 and P.1 Variants in Previously Infected and Uninfected Subjects. Life (Basel) 2021; 11:896. [PMID: 34575045 PMCID: PMC8470771 DOI: 10.3390/life11090896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate neutralizing antibody titers (NtAbT) to the P.1 and B.1 SARS-CoV-2 variants in a cohort of healthy health care workers (HCW), including 20 previously infected individuals tested at baseline (BLinf, after a median of 298 days from diagnosis) and 21 days after receiving one vaccine dose (D1inf) and 15 uninfected subjects tested 21 days after the second-dose vaccination (D2uninf). All the subjects received BNT162b2 vaccination. D1inf NtAbT increased significantly with respect to BLinf against both B.1 and P.1 variants, with a fold-change significantly higher for P.1. D1inf NtAbT were significantly higher than D2uninf NtAbT, against B.1 and P.1. NtAbT against the two strains were highly correlated. P.1 NtAbT were significantly higher than B.1 NtAbT. This difference was significant for post-vaccination sera in infected and uninfected subjects. A single-dose BNT162b2 vaccination substantially boosted the NtAb response to both variants in the previously infected subjects. NtAb titers to B.1 and P.1 lineages were highly correlated, suggesting substantial cross-neutralization. Higher titers to the P.1 than to the B.1 strain were driven by the post-vaccination titers, highlighting that cross-neutralization can be enhanced by vaccination.
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Affiliation(s)
- Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100 Siena, Italy; (I.V.); (A.B.); (F.D.); (M.Z.)
| | - Francesca Gatti
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy; (F.G.); (D.Z.); (M.B.)
| | | | - Adele Boccuto
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100 Siena, Italy; (I.V.); (A.B.); (F.D.); (M.Z.)
| | - Daniela Zago
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy; (F.G.); (D.Z.); (M.B.)
| | - Monica Basso
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy; (F.G.); (D.Z.); (M.B.)
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100 Siena, Italy; (I.V.); (A.B.); (F.D.); (M.Z.)
| | - Saverio Giuseppe Parisi
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy; (F.G.); (D.Z.); (M.B.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100 Siena, Italy; (I.V.); (A.B.); (F.D.); (M.Z.)
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Coppeta L, Somma G, Ferrari C, Mazza A, Rizza S, Trabucco Aurilio M, Perrone S, Magrini A, Pietroiusti A. Persistence of Anti-S Titre among Healthcare Workers Vaccinated with BNT162b2 mRNA COVID-19. Vaccines (Basel) 2021; 9:vaccines9090947. [PMID: 34579184 PMCID: PMC8472926 DOI: 10.3390/vaccines9090947] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 01/28/2023] Open
Abstract
The COVID-19 pandemic has led to health, social and economic consequences for public health systems. As a result, the development of safe and effective vaccines, in order to contain the infection quickly became a priority. The first vaccine approved by the Italian Agency for Drugs Authorization (AIFA) was the BNT162b2 mRNA vaccine, developed by BioNTech and Pfizer (Comirnaty). Comirnaty contains a molecule called messenger RNA (mRNA), which is a nucleoside-modified RNA that encodes the SARS-CoV-2 spike glycoprotein. Even if data from phase I suggest that vaccine induced antibodies can persist for up to six months following the second shot of BNT vaccine, data regarding the real duration of immunological protection are lacking. In this study, we aimed to evaluate the duration of serological protection by detecting the presence of anti-S-RBD (receptor-binding domain) antibodies for SARS-CoV-2 among a large group of healthcare workers (HCWs) three months after vaccination. 99% of HCWs had a detectable titre of anti-S SARS-CoV-2 antibodies 90 days after the second vaccine shot. Elderly operators showed significantly lower levels of protective antibodies when compared to the younger ones, thus they could become unprotected earlier than other operators.
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Affiliation(s)
- Luca Coppeta
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Giuseppina Somma
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Cristiana Ferrari
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
- Correspondence:
| | - Andrea Mazza
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Stefano Rizza
- Department of Traslational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy;
| | - Marco Trabucco Aurilio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Stefano Perrone
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Andrea Magrini
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
| | - Antonio Pietroiusti
- Department of Occupational Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Roma, Italy; (L.C.); (G.S.); (A.M.); (S.P.); (A.M.); (A.P.)
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