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Wüsthoff LEC, Lund-Johansen F, Henriksen K, Wildendahl G, Jacobsen JA, Gomes L, Anjum HS, Barlinn R, Kran AMB, Munthe LA, Vaage JT. Seroprevalence of SARS-CoV-2 and humoral immune responses to COVID-19 mRNA vaccines among people who use drugs - in the light of tailored mitigating strategies. Harm Reduct J 2024; 21:120. [PMID: 38890611 PMCID: PMC11186241 DOI: 10.1186/s12954-024-01023-9] [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: 05/16/2023] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND During the initial wave of the COVID-19 pandemic, there was a surprisingly low incidence of SARS-CoV-2 among People Who Use Drugs (PWUD) in Oslo, Norway, despite their heightened vulnerability regarding risk of infection and severe courses of the disease.This study aims to investigate the seroprevalence of SARS-CoV-2 antibodies among PWUD, their antibody responses to relevant virus infections and COVID-19 mRNA vaccines, and their vaccination coverage compared to the general population. METHODS Conducted as a prospective cohort study, data was collected from residents in six institutions for homeless PWUD and users of a low-threshold clinic for opioid agonist treatment. Ninety-seven participants were recruited for SARS-CoV-2 seroprevalence analysis. Additional two participants with known positive SARS-CoV-2 test results were recruited for further analyses. Twenty-five participants completed follow-up. Data included questionnaires, nasal swabs and blood samples. Data on vaccination coverage was obtained from the National Vaccine Register. Serologic methods included detection of antibodies to relevant virus proteins, neutralizing antibodies to SARS-CoV-2, antibodies to the full-length spike protein, and receptor-binding domain from SARS-CoV-2. RESULTS Among PWUD, antibodies to SARS-CoV-2 were detected in 2 out of 97 samples before vaccines against SARS-CoV-2 were available, comparable to a 2.8% frequency in population-based screening. Levels of serum antibodies to seasonal coronaviruses and Epstein-Barr-Virus (EBV) in PWUD were similar to population-based levels. After the second vaccine dose, binding and neutralizing antibody levels to SARS-CoV-2 in PWUD were comparable to controls. Eighty-four of PWUD received at least one dose of COVID-19 mRNA vaccine, compared to 89% in the general population. CONCLUSION Results indicate that PWUD did not exhibit increased SARS-CoV-2 seroprevalence or elevated serum antibodies to seasonal coronaviruses and EBV. Moreover, vaccine responses in PWUD were comparable to controls, suggesting that vaccination is effective in conferring protection against SARS-CoV-2 also in this population.
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Affiliation(s)
- Linda Elise Couëssurel Wüsthoff
- Unit for Clinical Research on Addictions, Oslo University Hospital, PO Box 4959 Nydalen, Oslo, 0424, Norway.
- Norwegian Centre for Addiction Reasearch, Institute of Clinical Medicine, University of Oslo, PO Box 1039 Blindern, Oslo, 0315, Norway.
| | - Fridtjof Lund-Johansen
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- ImmunoLingo Convergence Center, Institute of Clinical Medicine, University of Oslo, Gaustadalleen 21, Oslo, 0349, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, Oslo, 0318, Norway
- Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318, Oslo, Norway
| | - Kathleen Henriksen
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
- Student Health Services, Student Welfare Services in Oslo, Problemveien 9, Oslo, 0313, Norway
| | - Gull Wildendahl
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Jon-Aksel Jacobsen
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Leni Gomes
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Hina Sarwar Anjum
- Agency for Social and Welfare Services, Oslo Municipality, PO Box 30 Sentrum, Oslo, 0101, Norway
| | - Regine Barlinn
- Department of Microbiology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
| | - Anne-Marte Bakken Kran
- Division of Infection Control, Norwegian Institute of Public Health, PO Box 222 Skøyen, Oslo, 0213, Norway
| | - Ludvig Andre Munthe
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- KG Jebsen Centre for B cell Malignancies, and Precision Immunotherapy Alliance, Institute of Clinical Medicine, University of Oslo, PO Box 4950 Nydalen, Oslo, 0424, Norway
| | - John T Vaage
- Department of Immunology, Oslo University Hospital, PO Box 4950 Nydalen, Oslo, 0424, Norway
- Institute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, Oslo, 0318, Norway
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Leonhardt M, Bramness JG, Lien L. Incidence of SARS-CoV-2 and all-cause mortality in persons with co-occurring substance use disorder and mental illness during the pandemic: a Norwegian cohort study. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02599-6. [PMID: 38015236 DOI: 10.1007/s00127-023-02599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE Most people were affected by the COVID-19 pandemic. Persons with co-occurring substance use disorder (SUD) and mental illness (MI) are already a marginalized group, with above average mortality. Thus, the study aim was to investigate SARS-CoV-2 incidence and mortality among persons with SUD/MI during the first two years of the pandemic. METHODS This historical cohort study merged data from the Norwegian Patient Register, the Norwegian Surveillance System for Communicable Diseases and census data from Statistics Norway. We calculated crude mortality rates for persons with SUD and mild/moderate vs. severe MI and compared them to persons with physical illnesses or healthy controls. The incidence rate ratios for SARS-CoV-2 infection and mortality were estimated using Poisson regression models. RESULTS Compared to healthy controls, the SARS-Cov-2-infection rate was marginally lower in persons with SUD and mild/moderate MI (IRR,1.19 [95%CI,1.09-1.30]) as in persons with physical illness (IRR,1.35 [95%CI, 1.23-1.47]), whereas persons with SUD and severe MI showed a lower rate compared to healthy controls. Crude mortality rates for persons with SUD/MI were substantially higher and increased much more during the pandemic than for persons with physical illnesses or healthy controls. The IRR for mortality in persons with SUD and mild/moderate MI was 10.61 (95%CI,7.19-15.67) and 11.44 (95%CI,7.50-17.45) for SUD and severe MI, compared to 5.03 (3.34-7.57]) for persons with physical illnesses only. CONCLUSION The analysis showed excess mortality during COVID-19-pandemic for SUD/MI, but without higher SARS-CoV-2 infection rates in this group. Consequently, excess mortality among persons with SUD/MI was not due to SARS-CoV-2 infection.
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Affiliation(s)
- Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway.
- Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, PB 104, Brumunddal, 2381, Norway
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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ÓhAiseadha C, Quinn GA, Connolly R, Wilson A, Connolly M, Soon W, Hynds P. Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5223. [PMID: 37047846 PMCID: PMC10094123 DOI: 10.3390/ijerph20075223] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19', 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
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Affiliation(s)
- Coilín ÓhAiseadha
- Department of Public Health, Health Service Executive, D08 W2A8 Dublin, Ireland
| | - Gerry A. Quinn
- Centre for Molecular Biosciences, Ulster University, Coleraine BT52 1SA, UK
| | - Ronan Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Awwad Wilson
- National Drug Treatment Centre, Health Service Executive, D02 NY26 Dublin, Ireland
| | - Michael Connolly
- Independent Scientist, D08 Dublin, Ireland
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
| | - Willie Soon
- Center for Environmental Research and Earth Sciences (CERES), Salem, MA 01970, USA
- Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 Sopron, Hungary
| | - Paul Hynds
- SpatioTemporal Environmental Epidemiology Research (STEER) Group, Environmental Sustainability & Health Institute, Technological University, D07 H6K8 Dublin, Ireland
- Irish Centre for Research in Applied Geoscience, University College Dublin, D02 FX65 Dublin, Ireland
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