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Martín-Sánchez M, Wu P, Adam DC, Yang B, Lim WW, Lin Y, Lau EH, Sullivan SG, Leung GM, Cowling BJ. An observational study on imported COVID-19 cases in Hong Kong during mandatory on-arrival hotel quarantine. PUBLIC HEALTH IN PRACTICE 2024; 8:100525. [PMID: 39050010 PMCID: PMC11267049 DOI: 10.1016/j.puhip.2024.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 07/27/2024] Open
Abstract
Background Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures. Methods Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented. Findings A total of 2269 imported COVID-19 cases aged 0-85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p < 0.001). Lower Ct values at isolation were observed in Omicron cases than in ancestral strain or other variants cases. No Omicron cases were detected beyond 14 days after arrival. Cases detected after 14 days of quarantine (n=58, 2.6 %) were more likely asymptomatic at isolation and had higher Ct value during isolation, some of them indicating re-positivity or post-arrival infections. Conclusions Testing inbound travellers at arrival and during quarantine can detect imported cases early, but may not prevent all COVID-19 introductions into the community. Public health measures should be adapted in response to the emergence of SARS-CoV-2 variants based on evidence from ongoing surveillance.
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Affiliation(s)
- Mario Martín-Sánchez
- 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, China
| | - Peng Wu
- 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, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Dillon C. Adam
- 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, China
| | - Bingyi Yang
- 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, China
| | - Wey Wen Lim
- 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, China
| | - Yun Lin
- 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, China
| | - Eric H.Y. Lau
- 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, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Epidemiology, University of California, Los Angeles, USA
| | - Gabriel M. Leung
- 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, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- 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, China
- Laboratory of Data Discovery for Health Limited (D4H), Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
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Kumari P, Singh HP, Singh S. Mathematical model for understanding the relationship between diabetes and novel coronavirus. Gene 2024:148970. [PMID: 39357581 DOI: 10.1016/j.gene.2024.148970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 09/15/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024]
Abstract
A new model is proposed to explore interactions between diabetes and novel coronavirus. The model accounted for both the omicron variant and variants varying from omicron. The model investigated compartments such as hospitalization, diabetes, co-infection, omicron variant, and quarantine. Additionally, the impact of different vaccination doses is assessed. Sensitivity analysis is carried out to determine disease prevalence and control options, emphasizing the significance of knowing epidemics and their characteristics. The model is validated using actual data from Japan. The parameters are fitted with the help of "Least Square Curve Fitting" method to describe the dynamic behavior of the proposed model. Simulation results and theoretical findings demonstrate the dynamic behavior of novel coronavirus and diabetes mellitus (DM). Biological illustrations that illustrate impact of model parameters are evaluated. Furthermore, effect of vaccine efficacy and vaccination rates for the vaccine's first, second, and booster doses is conducted. The impact of various preventive measures, such as hospitalization rate, quarantine or self-isolation rate, vaccine dose-1, dose-2, and booster dose, is considered for diabetic individuals in contact with symptomatic or asymptomatic COVID-19 infectious people in the proposed model. The findings demonstrate the significance of vaccine doses on people with diabetes and individuals infectious with omicron variant. The proposed work helps with subsequent prevention efforts and the design of a vaccination policy to mitigate the effect of the novel coronavirus.
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Affiliation(s)
- Preety Kumari
- Faculty of Mathematical Science, University of Delhi, Delhi 110007, India; School of Engineering & Technology, Central University of Haryana, Mahendergarh 123031, India.
| | | | - Swarn Singh
- Sri Venkateswara College, University of Delhi, Delhi 110021, India.
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Leung JTC, Li YY, Kong CW, To WWK. Impact of COVID-19 pandemic on specialty training in obstetrics and gynaecology in Hong Kong: is there a concern about the future prospect? BMC MEDICAL EDUCATION 2024; 24:893. [PMID: 39160533 PMCID: PMC11334357 DOI: 10.1186/s12909-024-05727-1] [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: 03/12/2024] [Accepted: 07/01/2024] [Indexed: 08/21/2024]
Abstract
INTRODUCTION The COVID-19 pandemic in the past few years led to major adjustments in the provision of healthcare. This study aimed to investigate trainees' perception of impact of the pandemic on specialty training in Obstetrics & Gynaecology (O&G) in Hong Kong. METHODS A cross-sectional questionnaire survey was performed on all the O&G trainees and the young fellows of the Hong Kong College of Obstetricians and Gynaecologists (HKCOG). The questionnaires included 5 parts: demographic data, impact on clinical activities, redeployment, educational activities and career progression. RESULTS A total of 104 questionnaires (92.9%) were received for final analysis. The majority of the participants had reductions in elective and emergency operations, as well as exposure to in-patient admissions and out-patient clinics in both obstetrics and gynaecology. The reduction was most significant in elective gynaecology operations. One-third (34.6%) of the participants had been redeployed to other departments, and educational activities were reduced during the pandemic. Around 58% of the trainees were concerned with the reduction in clinical exposure, and 78% worried they would not be able to log sufficient number of surgical procedures. Basic trainees were significantly more worried than higher trainees. Around half of the trainees had doubts or regrets about choosing to undergo O&G specialty training. CONCLUSION The O&G trainees in Hong Kong perceived that the COVID-19 pandemic had significant negative impacts on their training. Many trainees were worried they would not be able to attain the required level of competence when they complete their specialist training.
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Affiliation(s)
| | - Yan Yu Li
- Department of Obstetrics & Gynaecology, United Christian Hospital, Kowloon, Hong Kong.
| | - Choi Wah Kong
- Department of Obstetrics & Gynaecology, United Christian Hospital, Kowloon, Hong Kong
| | - William Wing Kee To
- Department of Obstetrics & Gynaecology, United Christian Hospital, Kowloon, Hong Kong
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Leung CCD, Yu ELM, Chan YH, Ho MY, Kwok CT, Chan HCC, Yeung YC. Chronic Obstructive Pulmonary Disease and the Omicron Variant of COVID-19 Prognosis: A Retrospective Cohort Study. Cureus 2024; 16:e65713. [PMID: 39211713 PMCID: PMC11358666 DOI: 10.7759/cureus.65713] [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: 07/24/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND AIM This retrospective cohort study aimed to investigate the association between chronic obstructive pulmonary disease (COPD) and the prognosis of COVID-19 patients infected with the Omicron variant. The primary objective was to determine if COVID-19 patients with COPD had higher mortality rates compared to those without COPD. Secondary objectives included assessing the risk of respiratory failure, hospital stay length, intensive care unit (ICU) admission, and oxygen requirements in COPD patients with COVID-19. MATERIALS AND METHODS The study included 2761 COVID-19 patients admitted to the Princess Margaret Hospital, Hong Kong, between January 1 and June 30, 2022. Among them, 7.4% (n = 205) had COPD. Demographic and clinical data, including vaccination status and comorbidities, were collected. The primary outcome was 30-day mortality, and secondary outcomes included respiratory support requirement, hospital stay length, and ICU admission. Logistic regression analyses were conducted, adjusting for potential confounders. RESULTS COPD did not independently increase the risk of COVID-19 mortality after adjusting for confounders. Instead, older age, male sex, incomplete vaccination, long-term oxygen therapy use, and specific comorbidities were identified as significant predictors of 30-day mortality. COPD patients were more likely to require oxygen and noninvasive ventilation, but there were no significant differences in other secondary outcomes compared to non-COPD patients. CONCLUSION COPD itself was not an independent risk factor for COVID-19 mortality. Age, sex, vaccination status, comorbidities, and long-term oxygen therapy use were important predictors of mortality. These findings underscore the importance of considering multiple factors when assessing the impact of COPD on COVID-19 prognosis, particularly with the Omicron variant.
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Affiliation(s)
| | | | - Yu Hong Chan
- Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, HKG
| | - Man Ying Ho
- Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, HKG
| | | | | | - Yiu Cheong Yeung
- Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, HKG
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Wen Q, Guo Z, Zhang XH, Xu LP, Wang Y, Yan CH, Chen H, Chen YH, Han W, Wang FR, Sun YQ, Huang XJ, Mo XD. COVID-19 was associated with the complications after allogeneic hematopoietic stem cell transplantation. Sci Rep 2024; 14:11778. [PMID: 38782966 PMCID: PMC11116404 DOI: 10.1038/s41598-024-62731-7] [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: 11/13/2023] [Accepted: 05/21/2024] [Indexed: 05/25/2024] Open
Abstract
We aimed to identify the severity and duration of COVID-19 infection on complications after allo-HSCT. Enrolled 179 hospitalized patients with COVID-19 were categorized into long-term infection (> 18 days, n = 90) or short-term infection group (≤ 18 days, n = 89) according to the median duration of COVID-19. The severity of COVID-19 was categorized as asymptomatic infection, mild, moderate, severe, and critical illness according to guidelines of National Institutes of Health. Particularly, severe illness and critical illness were classified as serious infection. Asymptomatic infection, mild illness and moderate illness were classified as non-serious infection. The 150-day probabilities of poor graft function (PGF), cytomegalovirus (CMV) pneumonia and non-relapse mortality (NRM) were significantly higher in long-term infection group. The 150-day probabilities of CMV pneumonia and NRM after COVID-19 were higher in serious infection group. The 150-day probabilities of overall survival (OS) was significantly lower in long-term and serious infection group. In multivariable analysis, the severity of COVID-19 was associated with NRM and OS, and the duration of COVID-19 was associated with PGF. In summary, our data reported that the severity and duration of COVID-19 were associated with several complications and contribute to poor outcomes after allo-HSCT.
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Affiliation(s)
- Qi Wen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ze Guo
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Hui Zhang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Lan-Ping Xu
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yu Wang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Chen-Hua Yan
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Huan Chen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yu-Hong Chen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Wei Han
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Feng-Rong Wang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Yu-Qian Sun
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Jun Huang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China
| | - Xiao-Dong Mo
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China.
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Gao Y, Lau JTF, Zhang Q, Ming WK, Shen F, Huang YHC, Jiang LC. The Impact of Expert Opinions in COVID-19 News Coverage on Vaccination During the Fifth Outbreak in Hong Kong: A Time Series Analysis. HEALTH COMMUNICATION 2024:1-16. [PMID: 38655579 DOI: 10.1080/10410236.2024.2344283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The role of experts in news coverage has become increasingly prominent, but the evidence regarding the effectiveness of expert opinions in affecting public behavior remains mixed. This study seeks to examine the influence of expert opinions covered in the news on the public's response to public health crises. By adopting a macro-level framing perspective, we investigated how framing consistency, a macro-level concept indicating the agreement between expert opinions in news coverage and government policies or among peer experts, evolves over time and its temporal causal relationship with public behavior. Specifically, this study collected all press news coverage in Hong Kong over four months during the fifth outbreak, including 1,416 articles with 650 expert opinions, as well as the vaccination data that paralleled with this period. We constructed time series of expert opinions and vaccination behavior, and then conducted Vector Autoregressive (VAR) models with Granger causality analysis to examine how framing consistency of expert opinions in news coverage influenced vaccination. The results indicate that the consistent framing between expert opinions and government policies increased COVID-19 vaccination during the fifth outbreak in Hong Kong, while conflicting opinions responding to government policies had no significant effect on vaccination. Opinions among medical experts on COVID-19 issues also did not significantly impact vaccination. The implications for designing communication strategies and enhancing public behavioral support during public health crises are discussed.
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Affiliation(s)
- Yiqian Gao
- Department of Media and Communication, City University of Hong Kong
| | - Joseph Tak-Fai Lau
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - Qingpeng Zhang
- Musketeers Foundation Institute of Data Science and Department of Pharmacology and Pharmacy, The University of Hong Kong
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, City University of Hong Kong
| | - Fei Shen
- Department of Media and Communication, City University of Hong Kong
| | | | - Li Crystal Jiang
- Department of Media and Communication, City University of Hong Kong
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Liao Q, Yuan J, Wong IOL, Ni MY, Cowling BJ, Lam WWT. Motivators and Demotivators for COVID-19 Vaccination Based on Co-Occurrence Networks of Verbal Reasons for Vaccination Acceptance and Resistance: Repetitive Cross-Sectional Surveys and Network Analysis. JMIR Public Health Surveill 2024; 10:e50958. [PMID: 38648099 DOI: 10.2196/50958] [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: 07/18/2023] [Revised: 10/21/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is complex and multifaced. People may accept or reject a vaccine due to multiple and interconnected reasons, with some reasons being more salient in influencing vaccine acceptance or resistance and hence the most important intervention targets for addressing vaccine hesitancy. OBJECTIVE This study was aimed at assessing the connections and relative importance of motivators and demotivators for COVID-19 vaccination in Hong Kong based on co-occurrence networks of verbal reasons for vaccination acceptance and resistance from repetitive cross-sectional surveys. METHODS We conducted a series of random digit dialing telephone surveys to examine COVID-19 vaccine hesitancy among general Hong Kong adults between March 2021 and July 2022. A total of 5559 and 982 participants provided verbal reasons for accepting and resisting (rejecting or hesitating) a COVID-19 vaccine, respectively. The verbal reasons were initially coded to generate categories of motivators and demotivators for COVID-19 vaccination using a bottom-up approach. Then, all the generated codes were mapped onto the 5C model of vaccine hesitancy. On the basis of the identified reasons, we conducted a co-occurrence network analysis to understand how motivating or demotivating reasons were comentioned to shape people's vaccination decisions. Each reason's eigenvector centrality was calculated to quantify their relative importance in the network. Analyses were also stratified by age group. RESULTS The co-occurrence network analysis found that the perception of personal risk to the disease (egicentrality=0.80) and the social responsibility to protect others (egicentrality=0.58) were the most important comentioned reasons that motivate COVID-19 vaccination, while lack of vaccine confidence (egicentrality=0.89) and complacency (perceived low disease risk and low importance of vaccination; egicentrality=0.45) were the most important comentioned reasons that demotivate COVID-19 vaccination. For older people aged ≥65 years, protecting others was a more important motivator (egicentrality=0.57), while the concern about poor health status was a more important demotivator (egicentrality=0.42); for young people aged 18 to 24 years, recovering life normalcy (egicentrality=0.20) and vaccine mandates (egicentrality=0.26) were the more important motivators, while complacency (egicentrality=0.77) was a more important demotivator for COVID-19 vaccination uptake. CONCLUSIONS When disease risk is perceived to be high, promoting social responsibility to protect others is more important for boosting vaccination acceptance. However, when disease risk is perceived to be low and complacency exists, fostering confidence in vaccines to address vaccine hesitancy becomes more important. Interventions for promoting vaccination acceptance and reducing vaccine hesitancy should be tailored by age.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Jiehu Yuan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Irene Oi Ling Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Michael Yuxuan Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China (Hong Kong)
- Urban Systems Institute, University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Benjamin John Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, Hong Kong, China (Hong Kong)
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China (Hong Kong)
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8
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Zhou Y, Dong J, Lu H. Predictors and Clinical Significance of Myocardial Injury in Elderly Patients Under the COVID-19 Pandemic. Int J Gen Med 2024; 17:1369-1379. [PMID: 38601195 PMCID: PMC11005849 DOI: 10.2147/ijgm.s458365] [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: 01/06/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024] Open
Abstract
Background The elderly patients are at increased high risk of myocardial injury and mortality after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to investigate the prevalence, predictors and prognostic implications of myocardial injury in the elderly patients with SARS-CoV-2 infection. Methods Patients aged over 65 years were consecutively recruited between April to May, 2022. Myocardial injury was assessed using the high-sensitivity cardiac troponin T (hs-cTnT) assay. The primary endpoint was in-hospital mortality. Results A total of 347 patients were recruited with a median age of 81 years. 45.8% were male and 18 (5.2%) deceased before discharge. Myocardial injury (hs-cTnT over 99% upper reference limit [URL]) was detected in 202 (58.2%) of patients. Predictors of myocardial injury included age (per 5-year increase), hypertension, vaccination, creatine, and neutrophil-to-lymphocyte ratio. hs-cTnT over 3 × URL was independently correlated with in-hospital mortality (adjusted odds ratio [adOR], 13.21; 95% confidence interval [CI], 2.11-87.1; p = 0.005) in comparison to hs-cTnT > URL (adOR, 0.66; 95% CI, 0.09-5.92; p = 0.680). Conclusion Myocardial injury was a common phenomenon and prognostic predictor in elder patients after SARS-CoV-2 infection. Higher threshold of myocardial injury may be considered to improve risk stratification.
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Affiliation(s)
- You Zhou
- Department of Cardiology, Shanghai Geriatric Medical Center, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine; Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, People’s Republic of China
| | - Jing Dong
- Department of Cardiology, Shanghai Geriatric Medical Center, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine; Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, People’s Republic of China
| | - Hao Lu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine; Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, People’s Republic of China
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Fan S, Mo X, Zhang X, Xu L, Wang Y, Yan C, Chen H, Zhang Y, Cheng Y, Sun Y, Chen Y, Chen Y, Han W, Wang J, Wang F, Xu Z, Huang X. Clinical characteristics and outcomes of allogeneic hematopoietic stem cell transplantation recipients with coronavirus disease 2019 caused by the Omicron variant: a prospective, observational cohort study. Ann Hematol 2024; 103:1333-1344. [PMID: 38381172 DOI: 10.1007/s00277-024-05653-8] [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: 09/25/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
We aimed to describe the clinical characteristics, particularly the occurrence and risk factors of severe/critical illness, in allogeneic hematopoietic stem cell (allo-HSCT) recipients infected with coronavirus disease 2019 (COVID-19) caused by Omicron variant in an observational prospective study (n = 311). The median time from allo-HSCT to COVID-19 diagnosis was 8.5 months (range 0.8-106.1) months. Four patients (1.3%) were reported to be asymptomatic during Omicron variant infection, and 135 (43.4%) patients showed lower respiratory tract disease. Thirty-four (10.9%) patients were categorized into serious infection (severe illness n = 25; critical illness n = 9) and the median duration from COVID-19 diagnosis to serious infections was 6 days (range, 0-29) days. Thirteen (4.2%) and 6 (1.9%) patients required intensive care unit care and invasive mechanical ventilation, respectively. Receiving more than 1 type of immunosuppressive therapies at COVID-19 diagnosis was associated with severity and persistence of infection. Six patients (1.9%) died after diagnosis of COVID-19 infection. The 4-week probability of overall survival after COVID-19 diagnosis was 98.7%, which was 100% and 88.2% for non-serious and serious infection group (P < 0.001), respectively. Thus, we observed a relatively low serious infection and mortality rate in allo-HSCT recipients infected with COVID-19 caused by Omicron variant.
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Affiliation(s)
- Shuang Fan
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiaodong Mo
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China
| | - Xiaohui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - LanPing Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yu Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Chenhua Yan
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Huan Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuanyuan Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yifei Cheng
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuqian Sun
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuhong Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yao Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Wei Han
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Jingzhi Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Fengrong Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Zhengli Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiaojun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China.
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
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Wang C, Yang M, Zhu G, Hu Y, Shen L, Qiu J, Huang Y, Wang L. Vaccination Shortens the Negative Nucleic Acid Conversion Time of the Older Population: A Retrospective Cohort Study of 73,456 Asymptomatic and Mild Patients with COVID-19 in Shanghai. Int J Gen Med 2024; 17:763-773. [PMID: 38463436 PMCID: PMC10922007 DOI: 10.2147/ijgm.s451393] [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: 11/23/2023] [Accepted: 02/20/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose To explore the influencing factors to predict the negative nucleic acid conversion time and ORF1ab gene CT value changes in patients with asymptomatic and mild COVID-19. Patients and Methods A total of 73,456 patients with asymptomatic and mild COVID-19 admitted to the Mobile Cabin Hospital in Shanghai from April 3 to April 23, 2022 were selected as the research objects. Epidemiological, clinical, and laboratory data were collected. Correlation analysis was performed. Results In patients <18 years old and ≥65 years old, COVID-19 vaccine can shorten the negative nucleic acid conversion time, which is reflected in the lower median or 75% quantile (P<0.001, P<0.05). In patients with underlying diseases, the negative nucleic acid conversion time of booster vaccination and complete vaccination was lower than that of non-vaccinated group (P<0.001, P<0.05). In patients ≤18 years of age or >65 years of age, patients with comorbidity and patients with symptoms, compared with patients 18-65 years of age, patients without comorbidity and patients without symptoms, there was a greater difference in the rate of rise of CT values between vaccinated and unvaccinated patients (P<0.05). Conclusion The time of nucleic acid conversion to negative in patients with asymptomatic and mild COVID-19 is affected by age, comorbidity, and first nucleic acid CT value. Vaccination could shorten the negative nucleic acid conversion time of the older population, those with complications or symptoms. The vaccination of older patients does not increase the risk of symptoms.
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Affiliation(s)
- Chaoqun Wang
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Meng Yang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Guanglin Zhu
- Department of Respiratory and Critical Care Medicine, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of China
| | - Yanyan Hu
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Le Shen
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Jiaona Qiu
- Department of Endocrinology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Yi Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Libing Wang
- Department of Hematology, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, People’s Republic of China
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11
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Datta S, Vattiato G, Maclaren OJ, Hua N, Sporle A, Plank MJ. The impact of Covid-19 vaccination in Aotearoa New Zealand: A modelling study. Vaccine 2024; 42:1383-1391. [PMID: 38307744 DOI: 10.1016/j.vaccine.2024.01.101] [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: 12/07/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/04/2024]
Abstract
Aotearoa New Zealand implemented a Covid-19 elimination strategy in 2020 and 2021, which enabled a large majority of the population to be vaccinated before being exposed to the virus. This strategy delivered one of the lowest pandemic mortality rates in the world. However, quantitative estimates of the population-level health benefits of vaccination are lacking. Here, we use a validated mathematical model of Covid-19 in New Zealand to investigate counterfactual scenarios with differing levels of vaccine coverage in different age and ethnicity groups. The model builds on earlier research by adding age- and time-dependent case ascertainment, the effect of antiviral medications, improved hospitalisation rate estimates, and the impact of relaxing control measures. The model was used for scenario analysis and policy advice for the New Zealand Government in 2022 and 2023. We compare the number of Covid-19 hospitalisations, deaths, and years of life lost in each counterfactual scenario to a baseline scenario that is fitted to epidemiological data between January 2022 and June 2023. Our results estimate that vaccines saved 6650 (95% credible interval [4424, 10180]) lives, and prevented 74500 [51000, 115400] years of life lost and 45100 [34400, 55600] hospitalisations during this 18-month period. Making the same comparison before the benefit of antiviral medications is accounted for, the estimated number of lives saved by vaccines increases to 7604 [5080, 11942]. Due to inequities in the vaccine rollout, vaccination rates among Māori were lower than in people of European ethnicity. Our results show that, if vaccination rates had been equitable, an estimated 11%-26% of the 292 Māori Covid-19 deaths that were recorded in this time period could have been prevented. We conclude that Covid-19 vaccination greatly reduced health burden in New Zealand and that equity needs to be a key focus of future vaccination programmes.
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Affiliation(s)
- Samik Datta
- Population Modelling group, National Institute of Water and Atmospheric Research, Wellington, New Zealand
| | - Giorgia Vattiato
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand; Manaaki Whenua, Lincoln, New Zealand
| | - Oliver J Maclaren
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Ning Hua
- Precision Driven Health, Auckland, New Zealand
| | - Andrew Sporle
- Department of Statistics, University of Auckland, Auckland, New Zealand; iNZight Analytics Ltd., Auckland, New Zealand
| | - Michael J Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand.
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12
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Liu S, Jiang C, Liu Y, Qiu X, Luo J, Wang J, Xu Y. Covid-19 vaccination coverage and associated factors among older hypertensive patients in Hangzhou, China. Int Health 2024:ihae019. [PMID: 38365904 DOI: 10.1093/inthealth/ihae019] [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: 07/24/2023] [Revised: 12/03/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients. METHODS Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage. RESULTS As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with ≥4 risk factors were 2.55 (2.12∼3.07) and 2.60 (2.16∼3.13), compared to individuals without risk factors. CONCLUSION The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.
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Affiliation(s)
- Shijun Liu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Caixia Jiang
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Yan Liu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Xin Qiu
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Jun Luo
- Department of Non-communicable and Chronic Diseases, Hangzhou Center for Disease Control and prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Jing Wang
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
| | - Yuyang Xu
- Department of Expanded Program on Immunization, Hangzhou Center for Disease Control and Prevention, Mingshi Road No. 568, Hangzhou, Zhejiang 310021, China
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13
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Lee CKK, Chan KNJ, Wong SMC, Wong HSG, Lei HCJ, So YK, Fung SCV, Chu STR, Chung KKA, Cheng PWC, Lo KYH, Chan WC, Chang WC. Relationships between psychopathological symptoms, pandemic-related stress, perceived social support, and COVID-19 infection history: a network analysis in Chinese college students. Front Psychiatry 2024; 15:1340101. [PMID: 38370557 PMCID: PMC10873916 DOI: 10.3389/fpsyt.2024.1340101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction Previous coronavirus, 2019 (COVID-19) research has applied network analysis to examine relationships between psychopathological symptoms but rarely extended to potential risk and protective factors or the influence of COVID-19 infection history. This study examined complex inter-relationships between psychopathological symptoms, COVID-19-related stressors, perceived social support, and COVID-19 infection history among Chinese university/college students during the peak of fifth pandemic wave using a network analysis approach. Methods A Least Absolute Shrinkage and Selection Operator-regularized partial correlation network using Gaussian graphical model was constructed in 1,395 Chinese university/college students in Hong Kong who completed a survey between 15 March and 3 April, 2022. Depressive, anxiety, and acute/traumatic stress symptoms were measured by Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Impact of Event Scale-6, respectively. COVID-19-related stressors and perceived social support were measured. Network differences by COVID-19 infection history (COVID-network vs. no_COVID-network) and network communities were examined. Results Our results showed that the most influential nodes were depressed mood, uncontrollable worries, and uncontrollable thoughts about COVID-19. The main bridging symptoms were concentration problems and psychomotor problems. The COVID-network, comprising participants with a history of COVID-19 infection only, was significantly stronger than the no_COVID-network. Perceived social support and stress from conflicts with family/friends formed a unique community with negative cognition and suicidal idea in the COVID-network only. Conclusion Our findings indicate that specific interventions targeting interpersonal conflicts and concentration problems as well as facilitating stress buffering effects of social support may represent effective strategies to reduce psychological distress in university/college students during COVID-19 and should be considered for future pandemic preparedness.
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Affiliation(s)
- Chi Kei Krystal Lee
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kwun Nam Joe Chan
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sau Man Corine Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hou Sem Gabbie Wong
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hiu Ching Janet Lei
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yuen Kiu So
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shi Cheng Vivian Fung
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sai Ting Ryan Chu
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kar Kin Albert Chung
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pak Wing Calvin Cheng
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ka Ying Heidi Lo
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Kwok KO, Wei WI, Mcneil EB, Tang A, Tang JWT, Wong SYS, Yeoh EK. Comparative analysis of symptom profile and risk of death associated with infection by SARS-CoV-2 and its variants in Hong Kong. J Med Virol 2024; 96:e29326. [PMID: 38345166 DOI: 10.1002/jmv.29326] [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: 06/14/2023] [Revised: 11/19/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024]
Abstract
The recurrent multiwave nature of coronavirus disease 2019 (COVID-19) necessitates updating its symptomatology. We characterize the effect of variants on symptom presentation, identify the symptoms predictive and protective of death, and quantify the effect of vaccination on symptom development. With the COVID-19 cases reported up to August 25, 2022 in Hong Kong, an iterative multitier text-matching algorithm was developed to identify symptoms from free text. Multivariate regression was used to measure associations between variants, symptom development, death, and vaccination status. A least absolute shrinkage and selection operator technique was used to identify a parsimonious set of symptoms jointly associated with death. Overall, 70.9% (54 450/76 762) of cases were symptomatic with 102 symptoms identified. Intrinsically, the wild-type and delta variant caused similar symptoms among unvaccinated symptomatic cases, whereas the wild-type and omicron BA.2 subvariant had heterogeneous patterns, with seven symptoms (fatigue, fever, chest pain, runny nose, sputum production, nausea/vomiting, and sore throat) more frequent in the BA.2 cohort. With ≥2 vaccine doses, BA.2 was more likely than delta to cause fever among symptomatic cases. Fever, blocked nose, pneumonia, and shortness of breath remained jointly predictive of death among unvaccinated symptomatic elderly in the wild-type-to-omicron transition. Number of vaccine doses required for reducing occurrence varied by symptoms. We substantiate that omicron has a different clinical presentation compared to previous variants. Syndromic surveillance can be bettered with reduced reliance on symptom-based case identification, increased weighing on symptoms predictive of death in outcome prediction, individual-based risk assessment in care homes, and incorporating free-text symptom reporting.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Edward B Mcneil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Arthur Tang
- School of Science, Engineering and Technology, RMIT University, Ho Chi Minh City, Vietnam
| | - Julian W-T Tang
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Clinical Microbiology, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Samuel Y S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eng Kiong Yeoh
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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15
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Tabatabaei SR, Babaie D, Hoseini-Alfatemi SM, Shamshiri A, Karimi A. Determining the coverage and efficacy of the COVID-19 vaccination program at the community level in children aged 12 to 17 in Tehran. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc04. [PMID: 38404412 PMCID: PMC10884833 DOI: 10.3205/dgkh000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background The vaccination is one of the acceptable and recomended solution to prevent and control of COVID-19. The aim of this study was to determine the efficacy of sinopharm vaccination in children aged 12-17 in Tehran. Methods The case population study was performed from October 2021 to March 2022 among 1,500 children with positive PCR test reffered in Mofid Children's Hospital in Tehran. 64 children aged 12-17 years were included. The data were collected by the hospital information system (HIS), vaccination information registration systems and questionnaire with their families. The coverage and efficacy of vaccination determined with equels commented by WHO. Results Out of 64 children, 52 children were 12 to 15 years old (13.35±1.08), 12 children were 16 to 17 years old (16.55±0.52). 48.4% had received two doses of vaccine. The highest rate of positive PCR was observed in February 2022. Sinopharm vaccine coverage in this age group was 93.6% for the first dose and 81.1% for the second dose. Based on this information, 48.4% children in this study have received two complete doses of the COVID-19 vaccine. The efficacy of the vaccine was estimated as 94.4% (95% CI 90.2 to 97.7). Conclusion It seems the coverage of Sinopharm vaccination in the age group of 12-17 years in Tehran is favorable and has high efficacy in this age group. In order to obtain more accurate and comprehensive estimation, it is recommended to take a sample on a wider level of the community.
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Affiliation(s)
- Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delara Babaie
- Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gu X, Guo Y, Shi Y, Lu Y, Yang S, Jiang Y, Jin Q, Li QY. Poor nutritional status is associated with the severity of omicron infection in the older adults. BMC Infect Dis 2024; 24:88. [PMID: 38225630 PMCID: PMC10789013 DOI: 10.1186/s12879-023-08959-6] [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: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients. METHODS This is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0-11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups. RESULTS Total of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P < 0.001) and less vaccinated (P < 0.001), with a longer virus shedding duration (P = 0.022), more comorbidities (≥ 2) (P = 0.004) and higher value of NLR (P < 0.001), PLR (P < 0.001) and SII (P = 0.012). Vaccination, cycle threshold value in ORF1ab gene (OR CT value) and female, higher MNA-SF score was negatively connected with probability of moderate to severe infection. For every 1 score increase in MNA-SF, the odds ratio of moderate to severe infection decreased by 14.8% [adjusted odds ratio (aOR), 0.852; 95% confidence interval (CI): 0.734-0.988; P = 0.034]. CONCLUSIONS Older patients with poor nutritional status are more likely to develop moderate to severe Omicron infection.
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Affiliation(s)
- Xiaohan Gu
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yongchao Guo
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yongmei Shi
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Yaxiong Lu
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shihan Yang
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yongmei Jiang
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qianwen Jin
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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17
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Xin S, Chen W, Yu Q, Gao L, Lu G. Effect of the number of coronavirus disease 2019 (COVID-19) vaccination shots on the occurrence of pneumonia, severe pneumonia, and death in SARS-CoV-2-infected patients. Front Public Health 2024; 11:1330106. [PMID: 38259762 PMCID: PMC10800481 DOI: 10.3389/fpubh.2023.1330106] [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: 10/30/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background Coronavirus disease (COVID-19) has posed a significant threat to the lives and health of people worldwide since its onset in 2019. However, the relationship between the number of vaccination shots and the severity of SARS-CoV-2 infection in Chinese patients remains unclear. Methods We retrospectively collected information from 829 patients infected with SARS-CoV-2 in Ningbo Medical Center Lihuili Hospital from December 05, 2022 to March 31, 2023, then divided them into four groups based on the severity of pneumonia. Last, we compared the difference in the number of shots of COVID-19 vaccine between the four groups, considering potential confounding factors using univariate and multivariate logistic regression. Results Vaccination with two and three doses was positively associated with low prevalence of pneumonia and severe pneumonia both in crude and optimal models, while only three doses of the vaccine was correlated with low prevalence of death in SARS-CoV-2-infected patients. In optimal models, male SARS-CoV-2-infected individuals with advanced age were positively associated with high prevalence of pneumonia, severe pneumonia, and death; comorbidity with hypertension (OR = 2.532, p < 0.001) was positively associated with high prevalence of pneumonia (OR = 2.532, p < 0.001); and comorbidity with diabetes was positively associated with high prevalence of death (OR = 1.856, p = 0.011). However, this is a cross-sectional study and the causal relationships need to be further studied. Conclusion One dose of vaccine may not have a protective effect against pneumonia, severe pneumonia, and death; more than one dose of vaccine is an independent protective factor for pneumonia and severe pneumonia; and three doses of vaccine is an independent protective factor for death.
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Affiliation(s)
| | | | | | | | - Genjie Lu
- Department of Blood Transfusion, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
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18
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Martins C, Silveira VNDC, da Silva FN, Dias JDJ, Branco MDRFC, dos Santos AM, de Oliveira BLCA. Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2023128. [PMID: 38126542 PMCID: PMC10727126 DOI: 10.1590/s2237-96222023000400003.en] [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: 03/07/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. METHODS This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. RESULTS Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). CONCLUSION Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well. MAIN RESULTS Prevalence was found to be high among unvaccinated individuals. Risk of death was lower among those vaccinated with a booster dose, compared to those not vaccinated, in all age groups analyzed. IMPLICATIONS FOR SERVICES The number of hospitalizations of unvaccinated individuals with severe acute respiratory syndrome was high, which increases the demand for health services to care for these individuals. PERSPECTIVES It is necessary to promote widespread vaccination of the entire population of Brazil, in addition to the regular provision of booster doses for the different population groups.
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Affiliation(s)
- Carlos Martins
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | | | - Fábio Nogueira da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
| | - José de Jesus Dias
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís, MA, Brazil
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Liu W, Gong F, Zheng X, Pei L, Wang X, Yang S, Zhao S, Yang Z, Lin J, Jing F, Shang H, Bi Y, Wei D, Chen E, Chen Y. Factors associated with prolonged viral shedding of SARS-CoV-2 Omicron variant infection in Shanghai: A multicenter, retrospective, observational study. J Med Virol 2023; 95:e29342. [PMID: 38130170 DOI: 10.1002/jmv.29342] [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: 08/24/2023] [Revised: 11/06/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
Shanghai has faced an unprecedented COVID-19 pandemic with the BA.2.2 strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron infection. Comprehensive insights into its epidemiology, clinical manifestations, and viral shedding dynamics are currently limited. This study encompasses 208373 COVID-19 patients that were infected with the Omicron BA.2.2 sub-lineage in Shanghai, China. Demographic information, clinical symptoms, vaccination status, isolation status, as well as viral shedding time (VST) were recorded. Among the COVID-19 patients included in this study, 187124 were asymptomatic and 21249 exhibited mild symptoms. The median VST was 8.3 days. The common clinical symptoms included fever, persistent cough, phlegm, sore throat, and gastrointestinal symptoms. Factors such as advanced age, presence of comorbidities, mild symptomatology, and delayed isolation correlated with extended VST. Conversely, female gender and administration of two or three vaccine doses correlated with a reduction in VST. This investigation offers an in-depth characterization and analytical perspective on Shanghai's recent COVID-19 surge. Prolonged viral shedding of SARS-CoV-2 was observed in elderly, male, symptomatic patients, and those with comorbidity. Female, individuals with two or three vaccine doses, as well as those isolated early, shows an effective reduced VST.
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Affiliation(s)
- Wenbin Liu
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fangchen Gong
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangtao Zheng
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Pei
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaofeng Wang
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Song Yang
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanzhi Zhao
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhitao Yang
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingsheng Lin
- Department of Disciplinary Development and Planning, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Jing
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanbing Shang
- Department of Neurosurgery, Center of Pituitary Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Wei
- Research Laboratory of Clinical Virology, Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Erzhen Chen
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Chen
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Leung CLK, Wei WI, Li KK, McNeil EB, Tang A, Wong SYS, Kwok KO. Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19. Vaccines (Basel) 2023; 11:1700. [PMID: 38006032 PMCID: PMC10675220 DOI: 10.3390/vaccines11111700] [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: 09/29/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July-November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks.
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Affiliation(s)
- Cyrus Lap Kwan Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin-Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China;
| | - Edward B. McNeil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Arthur Tang
- School of Science, Engineering and Technology, RMIT University, Ho Chi Minh City 700000, Vietnam;
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong, China
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Tsui KHM, Chau WW, Liu WH, Tam CY, Yee DKH, Tso CY, Zhang N, Cheung WH, Tang N, Wong RMY. COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels? J Orthop Translat 2023; 43:14-20. [PMID: 37920546 PMCID: PMC10618614 DOI: 10.1016/j.jot.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/11/2023] [Accepted: 09/24/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction The COVID-19 pandemic has caused high mortality rates in hip fracture patients, but data for Asian patients are lacking. Whilst Cycle threshold (Ct) values and D-dimer have been reported as predictors of mortality in COVID-19 patients, their prognostic roles in those with concomitant hip fracture remain unknown. The objectives of this study were to i) assess the clinical outcomes of COVID-19 hip fractures patients in the Chinese population, ii) identify risk factors of mortality and complications, and iii) determine the prognostic roles of Ct values and D-dimer levels. Methodology This cohort study was conducted during the 5th wave of the COVID-19 pandemic. Inclusion criteria were 1) hip fracture 2) ≥ 60 years old 3) low-energy trauma. Outcomes were 90-day all-cause mortality, complications, length of stay, discharge destination and mobility status. Logistic regression analysis was performed to identify risk factors for mortality and complications. Subgroup analysis was performed for patients with Ct < 30 and Ct > 30, comparing their outcomes of operations performed within 48 h vs beyond 48 h. Results 159 hip fracture patients were included, 42 patients were COVID-19 positive. COVID-19 group had significantly higher 90-day mortality rates (21.4% vs 9.4%), complication rates (45.2% vs 28.2%) and longer length of stay (17.06 vs 10.84 nights). COVID-19 was an independent risk factor for mortality and complications. Amongst the COVID-19 group, risk factors for poor outcomes were advanced age, steroids use, conservative treatment and American Society of Anaesthesiologists (ASA) score ≥ 3. Conservative treatment was associated with higher mortality (OR = 16.00; p = 0.025) in COVID-19 hip fracture patients. There was no significant difference between Ct values < 30 and >30 regarding mortality and complication rate. D-dimer and timing to operation did not affect outcomes. Conclusions Patients with concomitant COVID-19 and hip fracture are at high risk of mortality and complications. Ct values and D-dimer levels have no prognostic roles for hip fracture outcomes. Early operative treatment is recommended as soon as patients are medically fit.
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Affiliation(s)
- Kwan Hung Moya Tsui
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China
| | - Wai Wang Chau
- Department of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Hong Kong SAR, China
| | - Wing Hong Liu
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China
| | - Cheuk Yin Tam
- Department of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Hong Kong SAR, China
| | - Dennis King Hang Yee
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Yin Tso
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China
| | - Ning Zhang
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ning Tang
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hospital Authority, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
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Guo W, Zheng Y, Feng S. Omicron related COVID-19 prevention and treatment measures for patients with hematological malignancy and strategies for modifying hematologic treatment regimes. Front Cell Infect Microbiol 2023; 13:1207225. [PMID: 37928188 PMCID: PMC10622671 DOI: 10.3389/fcimb.2023.1207225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023] Open
Abstract
The Omicron variant of SARS-CoV-2 has rapidly become the dominant strain worldwide due to its high transmissibility, although it appears to be less pathogenic than previous strains. However, individuals with hematological malignancy (HM) and COVID-19 remain susceptible to severe infection and mortality, especially those with chronic lymphocytic leukemia (CLL) and those undergoing chimeric antigen receptor T-cell (CAR-T) treatment. Hematologists should thoroughly assess the severity of the patient's hematological disease and the potential risk of SARS-CoV-2 infection before initiating chemotherapy or immunosuppressive treatment. Vaccination and booster doses are strongly recommended and patients with a poor vaccine response may benefit from long-acting COVID-19 neutralizing monoclonal antibodies (such as Evusheld). Early use of small molecule antiviral drugs is recommended for managing mild COVID-19 in HM patients and those with severe immunodeficiency may benefit from SARS-CoV-2 neutralizing monoclonal antibody therapy and high-titer COVID-19 convalescent plasma (CCP). For moderate to severe cases, low-dose glucocorticoids in combination with early antiviral treatment can be administered, with cytokine receptor antagonists or JAK inhibitors added if the condition persists or worsens. In the treatment of hematological malignancies, delaying chemotherapy is preferable for CLL, acute leukemia (AL), and low-risk myelodysplastic syndrome (MDS), but if the disease progresses, appropriate adjustments in dosage and frequency of treatment are required, with the avoidance of anti-CD20 monoclonal antibody, CAR-T and hematopoietic stem cell transplantation (HSCT). Patients with chronic myelocytic leukemia (CML) and myeloproliferative neoplasms (MPNs) can continue current treatment. What's more, non-drug protective measures, the development of new vaccines and antiviral drugs, and monitoring of mutations in immunocompromised populations are particularly important.
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Affiliation(s)
- Wenjing Guo
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yizhou Zheng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Sizhou Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
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Lun P, Ning K, Wang Y, Ma TSW, Flores FP, Xiao X, Subramaniam M, Abdin E, Tian L, Tsang TK, Leung K, Wu JT, Cowling BJ, Leung GM, Ni MY. COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. JAMA Netw Open 2023; 6:e2337909. [PMID: 37856125 PMCID: PMC10587797 DOI: 10.1001/jamanetworkopen.2023.37909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/22/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Hong Kong was held as an exemplar for pandemic response until it recorded the world's highest daily COVID-19 mortality, which was likely due to vaccine refusal. To prevent this high mortality in future pandemics, information on underlying reasons for vaccine refusal is necessary. Objectives To track the evolution of COVID-19 vaccination willingness and uptake from before vaccine rollout to mass vaccination, to examine factors associated with COVID-19 vaccine refusal and compare with data from Singapore, and to assess the population attributable fraction for vaccine refusal. Design, Setting, and Participants This cohort study used data from randomly sampled participants from 14 waves of population-based studies in Hong Kong (February 2020 to May 2022) and 2 waves of population-based studies in Singapore (May 2020 to June 2021 and October 2021 to January 2022), and a population-wide registry of COVID-19 vaccination appointments. Data were analyzed from February 23, 2021, to May 30, 2022. Exposures Trust in COVID-19 vaccine information sources (ie, health authorities, physicians, traditional media, and social media); COVID-19 vaccine confidence on effectiveness, safety, and importance; COVID-19 vaccine misconceptions on safety and high-risk groups; political views; and COVID-19 policies (ie, workplace vaccine mandates and vaccine pass). Main Outcomes and Measures Primary outcomes were the weighted prevalence of COVID-19 vaccination willingness over the pandemic, adjusted incidence rate ratios, and population attributable fractions of COVID-19 vaccine refusal. A secondary outcome was change in daily COVID-19 vaccination appointments. Results The study included 28 007 interviews from 20 waves of longitudinal data, with 1114 participants in the most recent wave (median [range] age, 54.2 years [20-92] years; 571 [51.3%] female). Four factors-mistrust in health authorities, low vaccine confidence, vaccine misconceptions, and political views-could jointly account for 82.2% (95% CI, 62.3%-100.0%) of vaccine refusal in adults aged 18 to 59 years and 69.3% (95% CI, 47.2%-91.4%) of vaccine refusal in adults aged 60 years and older. Workplace vaccine mandates were associated with 62.2% (95% CI, 9.9%-139.2%) increases in daily COVID-19 vaccination appointments, and the Hong Kong vaccine pass was associated with 124.8% (95% CI, 65.9%-204.6%) increases in daily COVID-19 vaccination appointments. Conclusions and Relevance These findings suggest that trust in health authorities was fundamental to overcoming vaccine hesitancy. As such, engendering trust in health care professionals, experts, and public health agencies should be incorporated into pandemic preparedness and response.
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Affiliation(s)
- Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yishan Wang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiffany S. W. Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Francis P. Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Xiao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Linwei Tian
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tim K. Tsang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Kathy Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Joseph T. Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Benjamin J. Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Urban System Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Du Z, Wang Y, Bai Y, Wang L, Cowling BJ, Meyers LA. Estimate of COVID-19 Deaths, China, December 2022-February 2023. Emerg Infect Dis 2023; 29:2121-2124. [PMID: 37640373 PMCID: PMC10521589 DOI: 10.3201/eid2910.230585] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
China announced a slight easing of its zero-COVID rules on November 11, 2022, and then a major relaxation on December 7, 2022. We estimate that the ensuing wave of SARS-CoV-2 infections caused 1.41 million deaths in China during December 2022-February 2023, substantially higher than that reported through official channels.
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Thakkar K, Spinardi JR, Yang J, Kyaw MH, Ozbilgili E, Mendoza CF, Oh HML. Impact of vaccination and non-pharmacological interventions on COVID-19: a review of simulation modeling studies in Asia. Front Public Health 2023; 11:1252719. [PMID: 37818298 PMCID: PMC10560858 DOI: 10.3389/fpubh.2023.1252719] [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: 07/04/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Epidemiological modeling is widely used to offer insights into the COVID-19 pandemic situation in Asia. We reviewed published computational (mathematical/simulation) models conducted in Asia that assessed impacts of pharmacological and non-pharmacological interventions against COVID-19 and their implications for vaccination strategy. Methods A search of the PubMed database for peer-reviewed, published, and accessible articles in English was performed up to November 2022 to capture studies in Asian populations based on computational modeling of outcomes in the COVID-19 pandemic. Extracted data included model type (mechanistic compartmental/agent-based, statistical, both), intervention type (pharmacological, non-pharmacological), and procedures for parameterizing age. Findings are summarized with descriptive statistics and discussed in terms of the evolving COVID-19 situation. Results The literature search identified 378 results, of which 59 met criteria for data extraction. China, Japan, and South Korea accounted for approximately half of studies, with fewer from South and South-East Asia. Mechanistic models were most common, either compartmental (61.0%), agent-based (1.7%), or combination (18.6%) models. Statistical modeling was applied less frequently (11.9%). Pharmacological interventions were examined in 59.3% of studies, and most considered vaccination, except one study of an antiviral treatment. Non-pharmacological interventions were also considered in 84.7% of studies. Infection, hospitalization, and mortality were outcomes in 91.5%, 30.5%, and 30.5% of studies, respectively. Approximately a third of studies accounted for age, including 10 that also examined mortality. Four of these studies emphasized benefits in terms of mortality from prioritizing older adults for vaccination under conditions of a limited supply; however, one study noted potential benefits to infection rates from early vaccination of younger adults. Few studies (5.1%) considered the impact of vaccination among children. Conclusion Early in the COVID-19 pandemic, non-pharmacological interventions helped to mitigate the health burden of COVID-19; however, modeling indicates that high population coverage of effective vaccines will complement and reduce reliance on such interventions. Thus, increasing and maintaining immunity levels in populations through regular booster shots, particularly among at-risk and vulnerable groups, including older adults, might help to protect public health. Future modeling efforts should consider new vaccines and alternative therapies alongside an evolving virus in populations with varied vaccination histories.
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Affiliation(s)
- Karan Thakkar
- Vaccine Medical Affairs, Emerging Markets, Pfizer Inc., Singapore, Singapore
| | | | - Jingyan Yang
- Vaccine Global Value and Access, Pfizer Inc., New York, NY, United States
| | - Moe H. Kyaw
- Vaccine Medical Affairs, Emerging Markets, Pfizer Inc., Reston, VA, United States
| | - Egemen Ozbilgili
- Asia Cluster Medical Affairs, Emerging Markets, Pfizer Inc., Singapore, Singapore
| | | | - Helen May Lin Oh
- Department of Infectious Diseases, Changi General Hospital, Singapore, Singapore
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Osarenkhoe JO, Agbon GO, Esene H, Ohenhen V, Bassey AS. A Comparison of the Awareness, Attitude, and Uptake of COVID-19, Hepatitis B Virus, and Yellow Fever Vaccines Between Rural and Urban Respondents in Edo State, Nigeria. Cureus 2023; 15:e44352. [PMID: 37779750 PMCID: PMC10539674 DOI: 10.7759/cureus.44352] [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: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
INTRODUCTION Despite the target set by WHO, Africa still falls short when it comes to individuals' use of COVID-19 vaccines. There is a similar pattern of low vaccine usage for the hepatitis B virus (HBV) and yellow fever (YF). AIM AND OBJECTIVE The objective of our study is to compare the awareness, attitude, and uptake of vaccine-preventable diseases (VPD), COVID-19, HBV, and YF, between a rural and an urban community in Nigeria. METHODOLOGY The study was a descriptive cross-sectional study carried out between January 2022 and December 2022 in a rural community, Okada, and an urban community, Benin, in Edo State, Nigeria. A total of 283 rural participants and 483 urban participants were interviewed. SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.) was used for data collection and analysis. The significant value was set at P<0.05. RESULTS A major percentage of both populations, 98.3% urban and 90.1% rural, reported being aware of COVID-19 vaccines (indicated by P<0.001). There was a similar pattern with HBV vaccine awareness. However, awareness of YF vaccines was more common in the rural (63.3%) community than in the urban (55.0%) community. A complete dose uptake of COVID-19 vaccines was reported by 7.7% of the rural and 2.2% of the urban respondents. The major reason for the refusal of vaccine uptake was the fear of possible side effects. CONCLUSION The study showed that vaccine uptake for COVID-19, HBV, and YF is low despite seemingly good awareness of these vaccines. The number one reason for any vaccine refusal is the possibility of experiencing side effects.
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Affiliation(s)
- John O Osarenkhoe
- Internal Medicine and Cardiology, Igbinedion University Teaching Hospital, Okada, NGA
| | - Godwin O Agbon
- Obstetrics and Gynecology, Igbinedion University Teaching Hospital, Okada, NGA
| | - Hendrith Esene
- Community Medicine, Igbinedion University Teaching Hospital, Okada, NGA
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Tong CK, Chan YH, Leung CCD, Kwok CT, Ng LW, Wong OF, Yeung YC, Tsang TY, Chan NY, Law CB. Use of high flow nasal cannula oxygen therapy for patients infected with SARS-CoV-2 outside intensive care setting. J Thorac Dis 2023; 15:3699-3707. [PMID: 37559646 PMCID: PMC10407535 DOI: 10.21037/jtd-22-1507] [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: 10/22/2022] [Accepted: 06/09/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND In early 2022, there was a sudden surge of patients infected by the Omicron variant of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Hong Kong (HK), resulting in 9,163 deaths as of 29 May 2022. Many of the local population had not been vaccinated before this wave. The number of patients who developed coronavirus disease 2019 (COVID-19) related respiratory failure outnumbered the capacity of intensive care unit (ICU) beds. Some of these patients had to be supported with high flow nasal cannula (HFNC) therapy outside ICU setting. HK was in crisis situation. The primary objective of this study is to assess the 28-day mortality of this group of patients. The secondary objective is to explore any predictors of non-survivors to help clinical decision-making in future crisis. METHODS This is a retrospective observational study of patients suffering from COVID-19 related respiratory failure who received HFNC therapy in general medical wards of two hospitals during the period of 17 Mar to 30 Apr 2022. Survival and risk factors were reviewed. RESULTS Forty-nine patients were recruited. Twenty-six patients (53%) survived at 28-day after initiation of HFNC support. Three clinical parameters were found to be significantly associated with mortality at 28-day: (I) SpO2/FiO2 (SF) ratio <160 at 48 hours; (II) SF ratio <191 at 72 hours; (III) serial SF ratio at 48 or 72 hours showing no improvement over that at the time of initiation of HFNC therapy. CONCLUSIONS Use of HFNC outside ICU setting showed benefit to patients suffering from COVID-19 related acute hypoxemic respiratory failure (AHRF). Serial SF ratio monitoring at 48 and 72 hours after therapy initiation might serve as predictors of outcome and thus guide clinical decision-making for medical resource allocation in outbreak situation.
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Affiliation(s)
- Chak Kwan Tong
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Yu Hong Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | | | - Chin Tong Kwok
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Lo Wa Ng
- Department of Accident and Emergency, North Lantau Hospital, Hong Kong, China
| | - Oi Fung Wong
- Department of Accident and Emergency, North Lantau Hospital, Hong Kong, China
| | - Yiu Cheong Yeung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Tak Yin Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Ngai Yin Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Chun Bon Law
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
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Wu Y, Huang P, Xu M, Zhao Q, Xu Y, Han S, Li H, Wang Y. Immunogenicity and reactogenicity of inactivated SARS-CoV-2 vaccines in healthy adults. Front Immunol 2023; 14:1152899. [PMID: 37559719 PMCID: PMC10407550 DOI: 10.3389/fimmu.2023.1152899] [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: 01/28/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly pathogenic to humans and has caused the ongoing coronavirus disease 2019 (COVID-19) pandemic. Vaccines are one of the efficient ways to prevent the viral infection. After COVID-19 vaccination, the monitoring of the dynamic change in neutralizing antibodies is necessary to determine booster requirements. Methods We estimated the effectiveness of the inactivated vaccines by monitoring dynamic SARS-CoV-2 neutralizing antibodies for over 2 years. Additionally, we also investigated the activation of T lymphocytes (CD3+ T cells) after three doses of the inactivated vaccine. Result The results showed that the rate of reduction of SARS-CoV-2 neutralizing antibody levels gradually showed after each booster dose. The IgG/IgM level at 9 months after the third vaccination were significantly higher than those at 6 months after the second dose (p<0.0001). The expression of CD25+T cell in 18-35 age group was significantly higher than that in the other groups. Nine months after the third dose (the time of last blood sample collection), the expression of CD25+T cell in the 18-35 age group was significantly higher than that at 6 months after the second dose. CD25+T cell in the 18-35 years old group was significantly higher than 6 months after the second vaccination. Conclusion CD25, a late activation marker of lymphocytes and high-activity memory T cell subgroup, exhibited higher levels at the later stages after vaccination. COVID-19 booster vaccination in older adults and regular testing of SARS-CoV-2 neutralizing antibodies are recommended. Booster doses should be administered if the antibody level falls below the 30% inhibition rate.
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Affiliation(s)
- Yufei Wu
- Institute of Medical Sciences, the Second Hospital of Shandong University, Jinan, Shandong, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Ping Huang
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Mingjie Xu
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Qianqian Zhao
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Yihui Xu
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Shuyi Han
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Huanjie Li
- Institute of Medical Sciences, the Second Hospital of Shandong University, Jinan, Shandong, China
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yunshan Wang
- Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Research Center of Basic Medicine, Jinan Central Hospital, Shandong University, Jinan, Shandong, China
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Shi HJ, Yang J, Eom JS, Ko JH, Peck KR, Kim UJ, Jung SI, Kim S, Seok H, Hyun M, Kim HA, Kim B, Joo EJ, Cheong HS, Jun CH, Wi YM, Kim J, Kym S, Lim S, Park Y. Clinical Characteristics and Risk Factors for Mortality in Critical COVID-19 Patients Aged 50 Years or Younger During Omicron Wave in Korea: Comparison With Patients Older Than 50 Years of Age. J Korean Med Sci 2023; 38:e217. [PMID: 37463688 DOI: 10.3346/jkms.2023.38.e217] [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: 12/01/2022] [Accepted: 03/22/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused the death of thousands of patients worldwide. Although age is known to be a risk factor for morbidity and mortality in COVID-19 patients, critical illness or death is occurring even in the younger age group as the epidemic spreads. In early 2022, omicron became the dominant variant of the COVID-19 virus in South Korea, and the epidemic proceeded on a large scale. Accordingly, this study aimed to determine whether young adults (aged ≤ 50 years) with critical COVID-19 infection during the omicron period had different characteristics from older patients and to determine the risk factors for mortality in this specific age group. METHODS We evaluated 213 critical adult patients (high flow nasal cannula or higher respiratory support) hospitalized for polymerase chain reaction-confirmed COVID-19 in nine hospitals in South Korea between February 1, 2022 and April 30, 2022. Demographic characteristics, including body mass index (BMI) and vaccination status; underlying diseases; clinical features and laboratory findings; clinical course; treatment received; and outcomes were collected from electronic medical records (EMRs) and analyzed according to age and mortality. RESULTS Overall, 71 critically ill patients aged ≤ 50 years were enrolled, and 142 critically ill patients aged over 50 years were selected through 1:2 matching based on the date of diagnosis. The most frequent underlying diseases among those aged ≤ 50 years were diabetes and hypertension, and all 14 patients who died had either a BMI ≥ 25 kg/m² or an underlying disease. The total case fatality rate among severe patients (S-CFR) was 31.0%, and the S-CFR differed according to age and was higher than that during the delta period. The S-CFR was 19.7% for those aged ≤ 50 years, 36.6% for those aged > 50 years, and 38.1% for those aged ≥ 65 years. In multivariate analysis, age (odds ratio [OR], 1.084; 95% confidence interval [CI], 1.043-1.127), initial low-density lipoprotein > 600 IU/L (OR, 4.782; 95% CI, 1.584-14.434), initial C-reactive protein > 8 mg/dL (OR, 2.940; 95% CI, 1.042-8.293), highest aspartate aminotransferase > 200 IU/L (OR, 12.931; 95% CI, 1.691-98.908), and mechanical ventilation implementation (OR, 3.671; 95% CI, 1.294-10.420) were significant independent predictors of mortality in critical COVID-19 patients during the omicron wave. A similar pattern was shown when analyzing the data by age group, but most had no statistical significance owing to the small number of deaths in the young critical group. Although the vaccination completion rate of all the patients (31.0%) was higher than that in the delta wave period (13.6%), it was still lower than that of the general population. Further, only 15 (21.1%) critically ill patients aged ≤ 50 years were fully vaccinated. Overall, the severity of hospitalized critical patients was significantly higher than that in the delta period, indicating that it was difficult to find common risk factors in the two periods only with a simple comparison. CONCLUSION Overall, the S-CFR of critically ill COVID-19 patients in the omicron period was higher than that in the delta period, especially in those aged ≤ 50 years. All of the patients who died had an underlying disease or obesity. In the same population, the vaccination rate was very low compared to that in the delta wave, indicating that non-vaccination significantly affected the progression to critical illness. Notably, there was a lack of prescription for Paxlovid for these patients although they satisfied the prescription criteria. Early diagnosis and active initial treatment was necessary, along with the proven methods of vaccination and personal hygiene. Further studies are needed to determine how each variant affects critically ill patients.
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Affiliation(s)
- Hye Jin Shi
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jinyoung Yang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joong Sik Eom
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Uh Jin Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Sook In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Seulki Kim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyeri Seok
- Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Miri Hyun
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Hyun Ah Kim
- Department of Infectious Diseases, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Bomi Kim
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Jeong Joo
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hae Suk Cheong
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheon Hoo Jun
- Division of Infectious Diseases, Department of Medicine, Changwon Samsung Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yu Mi Wi
- Division of Infectious Diseases, Department of Medicine, Changwon Samsung Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Jungok Kim
- Division of Infectious Diseases, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Sungmin Kym
- Division of Infectious Diseases, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Seungjin Lim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea.
| | - Yoonseon Park
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
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Zhang J, Tang W, Gao H, Lavine CL, Shi W, Peng H, Zhu H, Anand K, Kosikova M, Kwon HJ, Tong P, Gautam A, Rits-Volloch S, Wang S, Mayer ML, Wesemann DR, Seaman MS, Lu J, Xiao T, Xie H, Chen B. Structural and functional characteristics of the SARS-CoV-2 Omicron subvariant BA.2 spike protein. Nat Struct Mol Biol 2023; 30:980-990. [PMID: 37430064 DOI: 10.1038/s41594-023-01023-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/17/2023] [Indexed: 07/12/2023]
Abstract
The Omicron subvariant BA.2 has become the dominant circulating strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in many countries. Here, we have characterized structural, functional and antigenic properties of the full-length BA.2 spike (S) protein and compared replication of the authentic virus in cell culture and an animal model with previously prevalent variants. BA.2 S can fuse membranes slightly more efficiently than Omicron BA.1, but still less efficiently than other previous variants. Both BA.1 and BA.2 viruses replicated substantially faster in animal lungs than the early G614 (B.1) strain in the absence of pre-existing immunity, possibly explaining the increased transmissibility despite their functionally compromised spikes. As in BA.1, mutations in the BA.2 S remodel its antigenic surfaces, leading to strong resistance to neutralizing antibodies. These results suggest that both immune evasion and replicative advantage may contribute to the heightened transmissibility of the Omicron subvariants.
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Affiliation(s)
- Jun Zhang
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Weichun Tang
- Laboratory of Pediatric and Respiratory Viral Diseases, Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Hailong Gao
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Christy L Lavine
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Wei Shi
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Hanqin Peng
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Haisun Zhu
- Institute for Protein Innovation, Harvard Institutes of Medicine, Boston, MA, USA
| | - Krishna Anand
- Institute for Protein Innovation, Harvard Institutes of Medicine, Boston, MA, USA
| | - Matina Kosikova
- Laboratory of Pediatric and Respiratory Viral Diseases, Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Hyung Joon Kwon
- Laboratory of Pediatric and Respiratory Viral Diseases, Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA
| | - Pei Tong
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital; Ragon Institute of MGH, MIT and Harvard, Boston, MA, USA
| | - Avneesh Gautam
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital; Ragon Institute of MGH, MIT and Harvard, Boston, MA, USA
| | | | | | - Megan L Mayer
- The Harvard Cryo-EM Center for Structural Biology, Boston, MA, USA
| | - Duane R Wesemann
- Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital; Ragon Institute of MGH, MIT and Harvard, Boston, MA, USA
| | - Michael S Seaman
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jianming Lu
- Codex BioSolutions, Inc., Rockville, MD, USA
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington, DC, USA
| | - Tianshu Xiao
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Hang Xie
- Laboratory of Pediatric and Respiratory Viral Diseases, Division of Viral Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD, USA.
| | - Bing Chen
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Cheong HH, Sio FI, Chan CC, Neng SI, Sam IP, Cheang T, Tou WI, Lei HS, Cheong TF, Lao EPL, Cheong TH, Kuok CU, Lo IL. Clinical characteristics of COVID-19 patients infected by the Omicron variants in Macao, China: A cross-sectional study. Health Sci Rep 2023; 6:e1361. [PMID: 37404450 PMCID: PMC10316466 DOI: 10.1002/hsr2.1361] [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: 01/28/2023] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
Background and Aims The evolving mutants of SARS-CoV-2 have made the COVID-19 pandemic sustained for over 3 years. In 2022, BA.4 and BA.5 were the Omicron variants dominating the spread globally. Although COVID-19 was no longer a Public Health Emergency of International Concern (PHEIC) as announced by WHO, the SARS-CoV-2 variants remain a challenge to global healthcare under the circumstances of withdrawal and loosening of personal protective behavior in the post-quarantine era. This study aims to acknowledge the clinical characteristics caused by Omicron BA.4/BA.5 in COVID-19 naive people and analyze possible factors affecting disease severities. Methods In this retrospective study, we report and analyze the clinical features of 1820 COVID-19 patients infected with the BA.4/BA.5 Omicron variants of SARS-CoV-2 during a local outbreak that occurred in Macao SAR, China, from June to July 2022. Results A total of 83.5% of patients were symptomatic eventually. The most common symptoms were fever, cough, and sore throat. Hypertension, dyslipidemia, and diabetes mellitus were the leading comorbidities. There were significantly more elderly patients (p < 0.001), more patients with comorbidity (p < 0.001) and more patients without vaccination or not completing the series (p < 0.001) in the "Severe to Critical" group. All deceased patients were elderly with at least three comorbidities and were partial to totally dependent in their daily lives. Conclusion Our data are consistent with a milder disease caused by BA.4/5 Omicron variants in the general population, while patients with old age and comorbidities have developed severe to critical diseases. Complete vaccination series and booster doses are effective strategies to reinforce protection against severe diseases and avoid mortality.
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Wang RC, Gottlieb M, Montoy JCC, Rodriguez RM, Yu H, Spatz ES, Chandler CW, Elmore JG, Hannikainen PA, Chang AM, Hill M, Huebinger RM, Idris AH, Koo K, Li SX, McDonald S, Nichol G, O’Laughlin KN, Plumb ID, Santangelo M, Saydah S, Stephens KA, Venkatesh AK, Weinstein RA. Association Between SARS-CoV-2 Variants and Frequency of Acute Symptoms: Analysis of a Multi-institutional Prospective Cohort Study-December 20, 2020-June 20, 2022. Open Forum Infect Dis 2023; 10:ofad275. [PMID: 37426947 PMCID: PMC10327880 DOI: 10.1093/ofid/ofad275] [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: 04/05/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Background While prior work examining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern focused on hospitalization and death, less is known about differences in clinical presentation. We compared the prevalence of acute symptoms across pre-Delta, Delta, and Omicron. Methods We conducted an analysis of the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a cohort study enrolling symptomatic SARS-CoV-2-positive participants. We determined the association between the pre-Delta, Delta, and Omicron time periods and the prevalence of 21 coronavirus disease 2019 (COVID-19) acute symptoms. Results We enrolled 4113 participants from December 2020 to June 2022. Pre-Delta vs Delta vs Omicron participants had increasing sore throat (40.9%, 54.6%, 70.6%; P < .001), cough (50.9%, 63.3%, 66.7%; P < .001), and runny noses (48.9%, 71.3%, 72.9%; P < .001). We observed reductions during Omicron in chest pain (31.1%, 24.2%, 20.9%; P < .001), shortness of breath (42.7%, 29.5%, 27.5%; P < .001), loss of taste (47.1%, 61.8%, 19.2%; P < .001), and loss of smell (47.5%, 55.6%, 20.0%; P < .001). After adjustment, those infected during Omicron had significantly higher odds of sore throat vs pre-Delta (odds ratio [OR], 2.76; 95% CI, 2.26-3.35) and Delta (OR, 1.96; 95% CI, 1.69-2.28). Conclusions Participants infected during Omicron were more likely to report symptoms of common respiratory viruses, such as sore throat, and less likely to report loss of smell and taste. Trial registration NCT04610515.
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Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Juan Carlos C Montoy
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Robert M Rodriguez
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Huihui Yu
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Christopher W Chandler
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Joann G Elmore
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Paavali A Hannikainen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anna Marie Chang
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mandy Hill
- Department of Emergency Medicine, UTHealth Houston, Houston, Texas, USA
| | - Ryan M Huebinger
- Department of Emergency Medicine, UTHealth Houston, Houston, Texas, USA
| | - Ahamed H Idris
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Katherine Koo
- Department of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Samuel McDonald
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Graham Nichol
- Departments of Medicine and Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Kelli N O’Laughlin
- Departments of Emergency Medicine and Global Health, University of Washington, Seattle, Washington, USA
| | - Ian D Plumb
- Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia, USA
| | - Michelle Santangelo
- Division of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Sharon Saydah
- Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia, USA
| | - Kari A Stephens
- Departments of Family Medicine and Biomedical Informatics & Medical Education, University of Washington, Seattle, Washington, USA
| | - Arjun K Venkatesh
- Center for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Robert A Weinstein
- Department of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
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Luo Y, Zhou Q, Huang X, Ding Y, Ye X, Ding J, Kuang Y, Liu Y, Peng S, Zhu Q, Wang H, Xiao H. Effect of inactivated COVID-19 vaccine on the negative conversion of nucleic acid in asymptomatic or mild patients with COVID-19. BMC Infect Dis 2023; 23:443. [PMID: 37391716 DOI: 10.1186/s12879-023-08315-8] [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: 01/29/2023] [Accepted: 05/09/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Negative conversion of nucleic acid was a key factor in deciding discharge or the end of isolation of asymptomatic or mild COVID-19 patients. We aimed to explore the effect of vaccination on the time to negative conversion after Omicron infection. METHODS This retrospective cohort study included asymptomatic or mild patients with COVID-19 admitted to Fangcang shelter Hospital from November 10, 2022 to December 2, 2022. The relationship between vaccination status and the time to negative conversion was analyzed by multiple linear regression. RESULTS A total of 2,104 asymptomatic or mild COVID-19 patients were included in the analysis, of whom 1,963 were vaccinated. The mean time to negative conversion of no vaccination, one dose, two doses, and three doses were 12.57 (5.05), 12.18 (3.46), 11.67 (4.86) and 11.22 (4.02) days, respectively (p = 0.002). Compared with no vaccination, two doses (β=-0.88, 95% CI: -1.74, -0.02, p = 0.045), and three doses (β=-1.51, 95% CI: -2.33, -0.70, p < 0.001) were both associated with shorter time to negative conversion. Comparing with two doses, booster dose was associated significantly with shorter time to negative conversion (β=-0.63, 95% CI: -1.07, -0.20, p = 0.004). Age was positively correlated with the time to negative conversion (β = 0.04, 95% CI: 0.02, 0.05, p < 0.001). CONCLUSION Vaccination with inactivated vaccine and booster dose can shorten the time to negative conversion of asymptomatic or mild COVID-19 patients. The significant prolongation of time to negative conversion with increasing age suggests the promotion of vaccination, especially booster dose, particularly in the elderly.
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Affiliation(s)
- Yifeng Luo
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Institute of Respiratory Diseases, Sun Yat-sen University, Guangzhou, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xinyan Huang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Institute of Respiratory Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yuqi Ding
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiangrong Ye
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Institute of Respiratory Diseases, Sun Yat-sen University, Guangzhou, China
| | - Jie Ding
- Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yukun Kuang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Institute of Respiratory Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Haibo Wang
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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Wong SM, Chen EY, Suen YN, Ho W, Chan SK, Lee EH, Chan KT, Lui SS, Wong MT, Hui CL. Increased psychological distress among young people before and during the fifth wave of COVID-19 after two years of pandemic in Hong Kong: a 6-month longitudinal study. BMC Psychiatry 2023; 23:433. [PMID: 37322448 PMCID: PMC10267546 DOI: 10.1186/s12888-023-04933-3] [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: 08/08/2022] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Despite over two years of COVID-19 worldwide, the outbreak of the Omicron variant has given rise to an unprecedented surge of infection with diverse lockdown measures implemented globally. Whether the emergence of a new wave of COVID-19 could further affect mental health in the population after nearly two years of the pandemic remains to be addressed. Furthermore, whether changes in smartphone overuse behaviours and physical activity - both of which are particularly relevant to young people - would together contribute to changes in distress symptoms during this wave of COVID-19 was also examined. METHODS A total of 248 young people from an ongoing household-based epidemiological study in Hong Kong who completed their baseline assessments prior to the Omicron variant outbreak, i.e., fifth wave of COVID-19 (July-November 2021), were invited for a 6-month follow-up study during this wave of infection (January-April 2022) (mean age = 19.7 years, SD = 2.7; 58.9% females). At both time points, levels of global distress symptoms, perceived stress, smartphone overuse, frequency of engagement in vigorous physical activity, and other potential risk and protective factors were assessed. RESULTS The proportion of young people presenting moderate-to-severe distress (6-item Kessler Psychological Distress Scale ≥ 5) significantly increased from 45.6 to 54.4% during the fifth wave of COVID-19 (p < 0.010). Significantly increased levels of smartphone overuse and reduced days of vigorous physical activity were also observed during the fifth wave. Notably, increased smartphone overuse and reduced physical activity both additively and interactively contributed to elevated distress at 6 months, even after accounting for demographic characteristics, psychiatric history, childhood adversity, as well as baseline distress symptoms, resilience, and recent personal stressors. CONCLUSIONS The findings suggest that the emergence of a new wave of COVID-19, specifically the Omicron outbreak, can further aggravate mental distress even after a protracted period of the pandemic. Awareness of the dynamic nature of COVID-19 is necessitated to address the pressing mental health needs of populations. Supporting young people in healthier patterns of smartphone use and physical activity can be helpful.
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Affiliation(s)
- Stephanie My Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Eric Yh Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong.
| | - Y N Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Winky Ho
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Sherry Kw Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Edwin Hm Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - K T Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Simon Sy Lui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Michael Th Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
| | - Christy Lm Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong, Hong Kong
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Cao Y, Zhang J, Zhao Y, Hui F, Hu Z, Shen X. Severity and Vaccine Effectiveness in Patients With the Omicron Variant of COVID-19 in Suzhou: A Retrospective Single-Center Study. Cureus 2023; 15:e41200. [PMID: 37525812 PMCID: PMC10387285 DOI: 10.7759/cureus.41200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/02/2023] Open
Abstract
Background The Omicron variant of the coronavirus disease 2019 (COVID-19) virus has spread rapidly worldwide, even in areas with high vaccination rates. Consequently, it has further exacerbated the current global pandemic. In this study, we aimed to characterize the clinical severity of patients with the COVID-19 variant Omicron and analyze vaccine effectiveness in predicting clinical severity. Methodology A total of 142 patients who contracted the COVID-19 virus in the Omicron era were retrospectively studied, and differences in their clinical severity were analyzed. They were stratified as follows: unvaccinated vs. vaccinated, unvaccinated vs. one to two vaccine doses vs. three vaccine doses, and cycle threshold (CT) values ≤ 28 vs. CT > 28. Results Of the 142 patients, 27 were asymptomatic, 83 had mild disease, and 32 had moderate disease. The median age was 32 years for asymptomatic patients vs. 31 years for those with mild disease vs. 59 years for those with moderate disease (P<0.05), and the direct medical hospitalization costs were ¥4901 for asymptomatic patients vs. ¥5259 for those with mild disease vs. ¥8378 for those with moderate disease (P<0.05). Of the 142 patients, 112 (78.8%) were vaccinated, 11 (7.7%) had one vaccine dose, 63 (44.4%) had two vaccine doses, and 38 (26.7%) received three vaccine doses. The median direct medical cost in the vaccinated group was significantly lower than that in the unvaccinated group (¥5470.5 vs. ¥7535.5, P<0.05). For ORF1ab and N genes, hospital stay length and direct medical cost significantly decreased in the group with CT values > 28 compared with those in the group with CT values ≤ 28 (P<0.05). Multiple regression analysis showed that being ≥ 60 years old could be a predictor of moderate disease severity in patients, and three vaccine doses could be effective against moderate COVID-19. Conclusion Mild infection is the main clinical manifestation of the Omicron variant. Vaccination can significantly decrease direct Omicron-associated medical costs. Although vaccination cannot provide protection against severe disease caused by this variant, three vaccine doses are highly effective in preventing moderate COVID-19.
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Affiliation(s)
- Yanmei Cao
- Department of Occupational Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
| | - Jianping Zhang
- Department of Tuberculosis Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
| | - Yiming Zhao
- Department of Occupational Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
| | - Fen Hui
- Department of Medical Section, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
| | - Zhijie Hu
- Department of Medical Section, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
| | - Xinhua Shen
- Department of Tuberculosis Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN
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Li H, Ping F, Li X, Wang Z, Xiao J, Jiang H, Xue Y, Quan J, Yao H, Zheng X, Chen Y, Li Y, Yu X, Xu L, Feng X, Wang S, Li Y, Xiao X. COVID-19 vaccine coverage, safety, and perceptions among patients with diabetes mellitus in China: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1172089. [PMID: 37334292 PMCID: PMC10270113 DOI: 10.3389/fendo.2023.1172089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Aims Diabetes mellitus (DM), one of the most common chronic diseases in China, is a risk factor for SARS-COV-2 infection and poor prognosis of COVID-19. The COVID-19 vaccine is one of the key measures to control the pandemic. However, the actual coverage of COVID-19 vaccination and associated factors remain unclear among DM patients in China. We conducted this study to investigate the COVID-19 vaccine coverage, safety, and perceptions among patients with DM in China. Methods A cross-sectional study of a sample of 2200 DM patients from 180 tertiary hospitals in China was performed using a questionnaire developed through the Wen Juan Xing survey platform to collect information regarding their coverage, safety, and perceptions of COVID-19 vaccination. A multinomial logistic regression analysis model was performed to determine any independent relationships with COVID-19 vaccination behavior among DM patients. Results In total, 1929 (87.7%) DM patients have received at least one dose COVID-19 vaccine, and 271 (12.3%) DM patients were unvaccinated. In addition, 65.2% (n = 1434) were booster vaccinated against COVID-19, while 16.2% (n = 357) were only fully vaccinated and 6.3% (n = 138) were only partially vaccinated. The prevalence of adverse effects after the first dose of vaccine, the second dose of vaccine, and the third dose of vaccine were 6.0%, 6.0%, and 4.3% respectively. Multinomial logistic regression analysis showed that DM patients complicated with immune and inflammatory diseases (partially vaccinated: OR = 0.12; fully vaccinated: OR = 0.11; booster vaccinated: OR = 0.28), diabetic nephropathy (partially vaccinated: OR = 0.23; fully vaccinated: OR = 0.50; booster vaccinated: OR = 0.30), and perceptions on the safety of COVID-19 vaccine (partially vaccinated: OR = 0.44; fully vaccinated: OR = 0.48; booster vaccinated: OR = 0.45) were all associated with the three of vaccination status. Conclusion This study showed that higher proportion of COVID-19 vaccine coverage among patients with DM in China. The concern about the safety of the COVID-19 vaccine affected the vaccine behavior in patients with DM. The COVID-19 vaccine was relatively safe for DM patients due to all side effects were self-limiting.
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Affiliation(s)
- Haolong Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Fan Ping
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Xiaomeng Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhihong Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianzhong Xiao
- Department of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hongwei Jiang
- The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinxing Quan
- Department of Endocrinology, Gansu Provincial People’s Hospital, Lanzhou, Gansu, China
| | - Hebin Yao
- Department of Endocrinology, Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Xianling Zheng
- Department of Endocrinology, Handan Central Hospital, Handan, China
| | - Yanming Chen
- Department of Endocrinology & Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yufeng Li
- Department of Endocrinology, Capital Medical University, Beijing, China
| | - Xiaohua Yu
- Department of Endocrinology, Liaoyang Central Hospital, Liaoyang, Liaoning, China
| | - Lingling Xu
- Department of Endocrinology, ShenZhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Xinxin Feng
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Siyu Wang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yongzhe Li
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xinhua Xiao
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
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Yu Y, Yen SHY, Jiang LC, Ming WK, Lau MMC, Lau JTF. Levels and Determinants of COVID-19 Vaccination at a Later Phase among Chinese Older People Aged 60 Years or Older: A Population-Based Survey. Vaccines (Basel) 2023; 11:1029. [PMID: 37376418 DOI: 10.3390/vaccines11061029] [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: 05/05/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The early attainment of high COVID-19 vaccination rates can minimize avoidable hospitalizations/deaths. The fifth wave COVID-19 outbreak in Hong Kong caused >9000 deaths, and most of them were unvaccinated older people. This study hence investigated determinants of taking the first dose vaccination at a later phase (Phase 3: during the fifth wave outbreak, i.e., February-July 2022) versus two earlier phases (Phase 1: first six months since vaccine rollout, i.e., February-July 2021; Phase 2: six months prior to the outbreak, i.e., August 2021-January 2022) via a random telephone survey among 386 ever-vaccinated Hong Kong older people aged ≥60 (June/July 2022). A total of 27.7%, 51.1%, and 21.3% took the first dose at Phase 1, Phase 2, and Phase 3, respectively. Unfavorable perceptions related to COVID-19/vaccination, exposure to conflicting/counter-information about the suitability of older people's vaccination from various sources, unsupportive family influences prior to the outbreak, and depressive symptoms were significantly associated with taking the first dose at Phase 3 instead of Phase 1 and Phase 2. To speed up COVID-19 vaccination and avoid unnecessary deaths, the government and health professionals should rectify misinformation, provide clear/consistent information for older people and their family members, and focus on those having depressive symptoms at an earlier stage of the pandemic.
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Affiliation(s)
- Yanqiu Yu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
- Health Communication Institute, Fudan University, Shanghai 200032, China
| | - Stefanie Hoi Ying Yen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Crystal Jiang
- Department of Media and Communication, City University of Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Ming
- Department of Infectious Disease and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Mason M C Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph T F Lau
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325000, China
- School of Public Health, Zhejiang University, Hangzhou 310058, China
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Cuypers L, Keyaerts E, Hong SL, Gorissen S, Menezes SM, Starick M, Van Elslande J, Weemaes M, Wawina-Bokalanga T, Marti-Carreras J, Vanmechelen B, Van Holm B, Bloemen M, Dogne JM, Dufrasne F, Durkin K, Ruelle J, De Mendonca R, Wollants E, Vermeersch P, Boulouffe C, Djiena A, Broucke C, Catry B, Lagrou K, Van Ranst M, Neyts J, Baele G, Maes P, André E, Dellicour S, Van Weyenbergh J. Immunovirological and environmental screening reveals actionable risk factors for fatal COVID-19 during post-vaccination nursing home outbreaks. NATURE AGING 2023:10.1038/s43587-023-00421-1. [PMID: 37217661 DOI: 10.1038/s43587-023-00421-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/13/2023] [Indexed: 05/24/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) vaccination has resulted in excellent protection against fatal disease, including in older adults. However, risk factors for post-vaccination fatal COVID-19 are largely unknown. We comprehensively studied three large nursing home outbreaks (20-35% fatal cases among residents) by combining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) aerosol monitoring, whole-genome phylogenetic analysis and immunovirological profiling of nasal mucosa by digital nCounter transcriptomics. Phylogenetic investigations indicated that each outbreak stemmed from a single introduction event, although with different variants (Delta, Gamma and Mu). SARS-CoV-2 was detected in aerosol samples up to 52 d after the initial infection. Combining demographic, immune and viral parameters, the best predictive models for mortality comprised IFNB1 or age, viral ORF7a and ACE2 receptor transcripts. Comparison with published pre-vaccine fatal COVID-19 transcriptomic and genomic signatures uncovered a unique IRF3 low/IRF7 high immune signature in post-vaccine fatal COVID-19 outbreaks. A multi-layered strategy, including environmental sampling, immunomonitoring and early antiviral therapy, should be considered to prevent post-vaccination COVID-19 mortality in nursing homes.
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Affiliation(s)
- Lize Cuypers
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Els Keyaerts
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Samuel Leandro Hong
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Sarah Gorissen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Soraya Maria Menezes
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Marick Starick
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Jan Van Elslande
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Matthias Weemaes
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Tony Wawina-Bokalanga
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Joan Marti-Carreras
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Bert Vanmechelen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Bram Van Holm
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Mandy Bloemen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Jean-Michel Dogne
- Department of Pharmacy, Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - François Dufrasne
- Laboratory of Proteomics and Microbiology, University of Mons, Mons, Belgium
- Department of Infectious Diseases, Laboratory of Viral Diseases, National Institute for Public Health (Sciensano), Brussels, Belgium
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA Research Institute, Liège, Belgium
| | - Jean Ruelle
- Medical Microbiology Unit (MBLG), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| | | | - Elke Wollants
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Pieter Vermeersch
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Caroline Boulouffe
- Infectious Disease Surveillance Unit, Agence pour une vie de qualité (AVIQ), Wallonia, Belgium
| | - Achille Djiena
- Infectious Disease Surveillance Unit, Agence pour une vie de qualité (AVIQ), Wallonia, Belgium
| | - Caroline Broucke
- Outbreak Investigation Team, Agentschap zorg en gezondheid, Flanders, Belgium
| | - Boudewijn Catry
- Unit Healthcare-Associated Infections and Antimicrobial Resistance, Sciensano, Brussels, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Marc Van Ranst
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Johan Neyts
- Department of Microbiology, Immunology and Transplantation, Laboratory Virology and Chemotherapy, Rega Institute, KU Leuven, Leuven, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
| | - Emmanuel André
- Department of Laboratory Medicine, National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Bruxelles, Belgium
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU Leuven, Leuven, Belgium.
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Baum SD, Adams VM. Pandemic refuges: Lessons from 2 years of COVID-19. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:875-883. [PMID: 35648882 PMCID: PMC9347849 DOI: 10.1111/risa.13953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This paper relates evidence from the COVID-19 pandemic to the concept of pandemic refuges, as developed in literature on global catastrophic risk. In this literature, a refuge is a place or facility designed to keep a portion of the population alive during extreme global catastrophes. COVID-19 is not the most extreme pandemic scenario, but it is nonetheless a very severe global event, and it therefore provides an important source of evidence. Through the first 2 years of the COVID-19 pandemic, several political jurisdictions have achieved low spread of COVID-19 via isolation from the rest of the world and can therefore classify as pandemic refuges. Their suppression and elimination of COVID-19 demonstrates the viability of pandemic refuges as a risk management measure. Whereas prior research emphasizes island nations as pandemic refuges, this paper uses case studies of China and Western Australia to show that other types of jurisdictions can also successfully function as pandemic refuges. The paper also refines the concept of pandemic refuges and discusses implications for future pandemics.
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Affiliation(s)
- Seth D. Baum
- Global Catastrophic Risk InstituteWashingtonDistrict of ColumbiaUSA
| | - Vanessa M. Adams
- School of Geography, Planning, and Spatial SciencesUniversity of TasmaniaHobartTasmaniaAustralia
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Clinical progression, disease severity, and mortality among adults hospitalized with COVID-19 caused by the Omicron and Delta SARS-CoV-2 variants: A population-based, matched cohort study. PLoS One 2023; 18:e0282806. [PMID: 37104488 PMCID: PMC10138229 DOI: 10.1371/journal.pone.0282806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/23/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND To compare the intrinsic virulence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant with the delta variant in hospitalized adults with coronavirus disease 2019 (COVID-19). METHODS All adults hospitalized in the Capital Region of Copenhagen with a positive reverse transcription polymerase chain reaction test for SARS-CoV-2 and an available variant determination from 1 September 2021 to 11 February 2022. Data from health registries and patient files were used. Omicron and Delta patients were matched (1:1) by age, sex, comorbidities, and vaccination status. We calculated crude and adjusted hazard ratios (aHRs) for severe hypoxemia and mortality at 30 and 60 days. RESULTS 1,043 patients were included. Patients with Omicron were older, had more comorbidities, were frailer, and more often had three vaccine doses than those with Delta. Fewer patients with Omicron developed severe hypoxemia than those with Delta (aHR, 0.55; 95% confidence interval, 0.38-0.78). Omicron patients exhibited decreased aHR for 30-day mortality compared to Delta (aHR, 0.61; 0.39-0.95). Omicron patients who had received three vaccine doses had lower mortality compared to Delta patients who received three doses (aHR, 0.31;0.16-0.59), but not among those who received two or 0-1 doses (aHR, 0.86; 0.41-1.84 and 0.94; 0.49-1.81 respectively). Similar findings were observed for mortality at 60 days. Similar outcomes were obtained in the analyses of 316 individually matched patients. CONCLUSIONS Among adults hospitalized with COVID-19, those with Omicron had less severe hypoxemia and nearly 40% higher 30- and 60-day survival, as compared with those with Delta, mainly driven by a larger proportion of Omicron patients vaccinated with three doses of an mRNA vaccine.
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Xie R, Edwards KM, Adam DC, Leung KSM, Tsang TK, Gurung S, Xiong W, Wei X, Ng DYM, Liu GYZ, Krishnan P, Chang LDJ, Cheng SMS, Gu H, Siu GKH, Wu JT, Leung GM, Peiris M, Cowling BJ, Poon LLM, Dhanasekaran V. Resurgence of Omicron BA.2 in SARS-CoV-2 infection-naive Hong Kong. Nat Commun 2023; 14:2422. [PMID: 37105966 PMCID: PMC10134727 DOI: 10.1038/s41467-023-38201-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/20/2023] [Indexed: 04/29/2023] Open
Abstract
Hong Kong experienced a surge of Omicron BA.2 infections in early 2022, resulting in one of the highest per-capita death rates of COVID-19. The outbreak occurred in a dense population with low immunity towards natural SARS-CoV-2 infection, high vaccine hesitancy in vulnerable populations, comprehensive disease surveillance and the capacity for stringent public health and social measures (PHSMs). By analyzing genome sequences and epidemiological data, we reconstructed the epidemic trajectory of BA.2 wave and found that the initial BA.2 community transmission emerged from cross-infection within hotel quarantine. The rapid implementation of PHSMs suppressed early epidemic growth but the effective reproduction number (Re) increased again during the Spring festival in early February and remained around 1 until early April. Independent estimates of point prevalence and incidence using phylodynamics also showed extensive superspreading at this time, which likely contributed to the rapid expansion of the epidemic. Discordant inferences based on genomic and epidemiological data underscore the need for research to improve near real-time epidemic growth estimates by combining multiple disparate data sources to better inform outbreak response policy.
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Affiliation(s)
- Ruopeng Xie
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kimberly M Edwards
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dillon C Adam
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kathy S M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tim K Tsang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Shreya Gurung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Weijia Xiong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoman Wei
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Daisy Y M Ng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gigi Y Z Liu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Pavithra Krishnan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lydia D J Chang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Samuel M S Cheng
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Haogao Gu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gilman K H Siu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joseph T Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong SAR, China
| | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong SAR, China
| | - Malik Peiris
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Immunology & Infection, Hong Kong Science and Technology Park, New Territories, Hong Kong SAR, China
| | - Benjamin J Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong SAR, China
| | - Leo L M Poon
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Immunology & Infection, Hong Kong Science and Technology Park, New Territories, Hong Kong SAR, China
| | - Vijaykrishna Dhanasekaran
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Qin C, Du M, Wang Y, Li M, Wu H, Li S, Liu J. COVID-19 Vaccination Coverage among 42,565 Adults Amid the Spread of Omicron Variant in Beijing, China. Vaccines (Basel) 2023; 11:vaccines11040739. [PMID: 37112651 PMCID: PMC10146383 DOI: 10.3390/vaccines11040739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Vaccines against coronavirus disease 2019 (COVID-19) have been in use for over two years, but studies that reflect real-world vaccination coverage and demographic determinants are lacking. Using a multistage stratified random cluster sampling method, we planned to directly explore vaccination coverage and the demographic determinants of different doses of COVID-19 vaccines in Beijing, especially in older populations. All 348 community health service centers in 16 districts were involved. We performed multivariable logistic regression analyses to identify demographic determinants of different coverage rates via adjusted odds ratios (aORs) and 95% CIs. Of the 42,565 eligible participants, the total vaccination coverage rates for ≥1 dose, ≥2 doses, ≥3 doses, and 4 doses were 93.3%, 91.6%, 84.9%, and 13.0%, respectively, but decreased to 88.1%, 85.1%, 76.2%, and 3.8% in the older population. Among all participants, younger (aOR = 1.77, 95% CI: 1.60–1.95), male (aOR = 1.15, 95% CI: 1.06–1.23), and better-educated residents (high school and technical secondary school aOR = 1.58, 95% CI: 1.43–1.74; bachelor’s degree aOR = 1.53, 95% CI: 1.37–1.70) were more likely to be fully vaccinated. People who lived in rural areas (aOR = 1.45, 95% CI: 1.31–1.60) and held the new rural cooperative health insurance (aOR = 1.37, 95% CI: 1.20–1.57) established a higher rate of full vaccination coverage. No history of chronic disease was positively associated with a higher coverage rate (aOR = 1.81, 95% CI: 1.66–1.97). Occupation also affected vaccination coverage. Demographic factors influencing the rate of vaccination with at least one or three doses were consistent with the results above. Results remained robust in a sensitivity analysis. Given the highly transmissible variants and declining antibody titers, accelerating the promotion of booster vaccination coverage, especially in high-risk groups such as the elderly, is a top priority. For all vaccine-preventable diseases, rapidly clarifying vaccine-hesitant populations, clearing barriers, and establishing a better immune barrier can effectively safeguard people’s lives and property and coordinate economic development with epidemic prevention and control.
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Cao X, Li Y, Zi Y, Zhu Y. The shift of percent excess mortality from zero-COVID policy to living-with-COVID policy in Singapore, South Korea, Australia, New Zealand and Hong Kong SAR. Front Public Health 2023; 11:1085451. [PMID: 37020822 PMCID: PMC10067885 DOI: 10.3389/fpubh.2023.1085451] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/28/2023] [Indexed: 03/22/2023] Open
Abstract
Introduction With the economic recession and pandemic fatigue, milder viral variants and higher vaccine coverage along the time lay the basis for lifting anti-COVID policies to restore COVID-19 normalcy. However, when and how to adjust the anti-COVID policies remain under debate in many countries. Methods In this study, four countries (Singapore, South Korea, Australia, and New Zealand) and one region (Hong Kong SAR), that have shifted from the zero-COVID (ZC) policy to or close to the living-with-COVID (LWC) during or after the Omicron outbreak, were selected as research objects. All-cause mortality data were collected for these objects from 2009 to 2019. The expected mortality was estimated by a simple linear regression method. Excess mortality over time was calculated as the difference between the expected mortality and the observed mortality. Finally, percent excess mortality (PEM) was calculated as the excess mortality divided by the expected mortality. Results In the examined four countries, PEM fluctuated around 0% and was lower than 10% most of the time under the ZC policy before 2022. After shifting to the LWC policy, all the examined countries increased the PEM. Briefly, countries with high population density (Singapore and South Korea) experienced an average PEM of 20-40% during the first half of 2022, and followed by a lower average PEM of 15-18% during the second half of 2022. For countries with low population density under the LWC policy, Australia experienced an average PEM of 39.85% during the first half of 2022, while New Zealand was the only country in our analysis that achieved no more than 10% in average PEM all the time. On the contrary, Hong Kong SAR under their ZC policy attained an average PEM of 71.14% during the first half of 2022, while its average PEM decreased to 9.19% in the second half of 2022 with LWC-like policy. Conclusion PEM under different policies within each country/region overtime demonstrated that the mortality burden caused by COVID-19 had been reduced overtime. Moreover, anti-COVID policies are suggested to control the excess mortality to achieve as low as 10% in PEM.
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Affiliation(s)
- Xiaohan Cao
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yunlong Zi
- Thrust of Sustainable Energy and Environment, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China
| | - Yuyan Zhu
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
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Wang M, Mi H, Li N, Shi Q, Sun W, He T, Lin J, Jin W, Gao X, Hu B, Su C, Pan J. Association between the overall burden of comorbidity and Ct values among the older patients with Omicron infection: Mediated by inflammation. Front Immunol 2023; 14:1145044. [PMID: 36999038 PMCID: PMC10043200 DOI: 10.3389/fimmu.2023.1145044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023] Open
Abstract
ObjectivesTo investigate the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly with COVID-19.MethodsWe conducted a retrospective observational study. The results of each nucleic acid test of during hospitalization were obtained. Linear regression models assessed the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly. A causal mediation analysis was performed to assess the mediation effects of inflammatory indicators on the association between the overall burden of comorbidity and Ct values.ResultsA total of 767 COVID-19 patients aged ≥ 60 years were included between April 2022 and May 2022. Patients with a high burden of comorbidity had significantly lower Ct values of the ORF gene than subjects with a low burden of comorbidity (median, 24.81 VS 26.58, P < 0.05). Linear regression models showed that a high burden of comorbidity was significantly associated with higher inflammatory responses, including white blood cell count, neutrophil count and C-reactive protein. Also, white blood cell count, neutrophil count, C-reactive protein and the overall burden of comorbidity assessed by age-adjusted Charlson comorbidity index were independent risk factors for the Ct values. A mediation analysis detected the mediation effect of white blood cells on the association between the burden of comorbidity and Ct values, with the indirect effect estimates of 0.381 (95% CI: 0.166, 0.632, P < 0.001). Similarly, the indirect effect of C-reactive protein was -0.307 (95% CI: -0.645, -0.064, P = 0.034). White blood cells and C-reactive protein significantly mediated the relationship between the burden of comorbidity and Ct values by 29.56% and 18.13% of the total effect size, respectively.ConclusionsInflammation mediated the association between the overall burden of comorbidity and Ct values among elderly with COVID-19, which suggests that combined immunomodulatory therapies could reduce the Ct values for such patients with a high burden of comorbidity.
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Affiliation(s)
- Meixia Wang
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, Fujian, China
| | - Hongfei Mi
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, Fujian, China
| | - Na Li
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qingfeng Shi
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Sun
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tingjuan He
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, Fujian, China
| | - Jiabing Lin
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenting Jin
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodong Gao
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bijie Hu
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenghao Su
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, Fujian, China
| | - Jue Pan
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, Fujian, China
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
- *Correspondence: Jue Pan,
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Yu B, Li Q, Chen J, He D. The impact of COVID-19 vaccination campaign in Hong Kong SAR China and Singapore. Infect Dis Model 2023; 8:101-106. [PMID: 36569521 PMCID: PMC9763205 DOI: 10.1016/j.idm.2022.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 12/27/2022] Open
Abstract
Background Vaccination has been the most important measure to mitigate the COVID-19 pandemic. The vaccination coverage was relatively low in Hong Kong Special Administrative Region China, compared to Singapore, in early 2022. Hypothetically, if the two regions, Hong Kong (HK) and Singapore (SG), swap their vaccination coverage rate, what outcome would occur? Method We adopt the Susceptible - Vaccinated - Exposed - Infectious - Hospitalized - Death - Recovered model with a time-varying transmission rate and fit the model to weekly reported COVID-19 deaths (the data up to 2022 Nov 4) in HK and SG using R package POMP. After we obtain a reasonable fitting, we rerun our model with the estimated parameter values and swap the vaccination rates between HK and SG to explore what would happen. Results Our model fits the data well. The reconstructed transmission rate was higher in HK than in SG in 2022. With a higher vaccination rate as in SG, the death total reported in HK would decrease by 37.5% and the timing of the peak would delay by 3 weeks. With a lower vaccination rate as in HK, the death total reported in SG would increase to 5.5-fold high with a peak 6 weeks earlier than the actual during the Delta variant period. Conclusions Vaccination rate changes in HK and SG may lead to very different outcomes. This is likely due that the estimated transmission rates were very different in HK and SG which reflect the different control policies and dominant variants. Because of strong control measures, HK avoided large-scale community transmission of the Delta variant. Given the high breakthrough infection rate and transmission rate of the Omicron variant, increasing the vaccination rate in HK will likely yield a mild (but significant) contribution in terms of lives saved. While in SG, lower vaccination coverage to the level of HK will be disastrous.
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Affiliation(s)
- Boyu Yu
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Qiong Li
- BNU-HKBU United International College, Zhuhai, China
| | - Jing Chen
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
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Takahashi Y, Tanaka H, Koga Y, Takiguchi S, Ogimoto S, Inaba S, Matsuoka H, Miyajima Y, Takagi T, Irie F, Bamba Y, Yoshimi F, Suzuki T, Araki I, Shirai C, Matsumoto S, Shimizu M, Shibata T, Nagai H, Kinoshita M, Fujita R, Ogata T. Change over Time in the Risk of Death among Japanese COVID-19 Cases Caused by the Omicron Variant Depending on Prevalence of Sublineages. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2779. [PMID: 36833477 PMCID: PMC9957287 DOI: 10.3390/ijerph20042779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
To assess temporal changes to the risk of death in COVID-19 cases caused by the Omicron variant, we calculated age-standardized case fatality rates (CFR) in patients aged ≥40 years over nine diagnostic periods (3 January to 28 August 2022) in ten Japanese prefectures (14.8 million residents). Among 552,581 study subjects, we found that there were 1836 fatalities during the isolation period (up to 28 days from date of onset). The highest age-standardized CFR (0.85%, 95% confidence interval (CI):0.78-0.92) was observed in cases diagnosed in the second 4-week period (January 31 to February 27), after which it declined significantly up to the 6th 4-week period (0.23%, 95% CI: 0.13-0.33, May 23 to June 19). The CFR then increased again but remained at 0.39% in the eighth period (July 18 to August 28). The CFR in cases with the BA.2 or BA.5 sublineages in the age range 60-80 years was significantly lower than that with BA.1 infections (60 years: 0.19%, 0.02%, 0.053%, respectively; 70 years: 0.91%, 0.33%, 0.39%; ≥80 years: 3.78%, 1.96%, 1.81%, respectively). We conclude that the risk of death in Japanese COVID-19 patients infected with Omicron variants declined through February to mid-June 2022.
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Affiliation(s)
- Yuki Takahashi
- Fujiidera Public Health Center of Osaka Prefectural Government, Fujiidera 583-0024, Japan
| | - Hideo Tanaka
- Neyagawa City Public Health Center, Neyagawa 572-0838, Japan
| | - Yoshitaka Koga
- Tosu Public Health and Welfare Office of Saga Prefectural Government, Tosu 841-0051, Japan
| | - Shunichi Takiguchi
- Central Public Health Center of Miyazaki Prefectural Government, Kirishima 880-0032, Japan
| | - Shigeru Ogimoto
- Miyoshi Public Health Center of Tokushima Prefectural Government, Mima 778-0002, Japan
| | - Shizuyo Inaba
- Gifu Public Health Center of Gifu Prefectural Government, Gifu 504-0838, Japan
| | - Hiroyuki Matsuoka
- Iida Public Health Center of Nagano Prefectural Government, Iida 395-0034, Japan
| | - Yuka Miyajima
- Matsumoto Public Health Center of Nagano Prefectural Government, Matsumoto 390-0852, Japan
| | - Takeshi Takagi
- Isesaki Public Health Center of Gunma Prefectural Government, Isesaki 372-0024, Japan
| | - Fujiko Irie
- Tsuchiura Public Health Center of Ibaraki Prefectural Government, Tsuchiura 300-0812, Japan
| | - Yoshihito Bamba
- Ibaraki Prefectual Department of Public Health and Welfare, Mito 310-8555, Japan
| | - Fuyo Yoshimi
- Central Public Health Center of Ibaraki Prefectural Government, Mito 310-0852, Japan
| | - Tomoyuki Suzuki
- Shiga Prefectural Department of Public Health Care and Welfare, Otsu 520-8577, Japan
| | - Isao Araki
- Shiga Prefectural Health, Medical and Welfare Department, Otsu 520-8577, Japan
| | - Chika Shirai
- Hirakata City Public Health Center, Hirakata 573-0027, Japan
| | - Sayuri Matsumoto
- Higashiosaka City Public Health Center, Higashiosaka 578-0941, Japan
| | - Motoyuki Shimizu
- Higashiosaka City Public Health Center, Higashiosaka 578-0941, Japan
| | | | - Hitomi Nagai
- Ibaraki Public Health Center of Osaka Prefectural Government, Ibaraki 567-8585, Japan
| | - Masaru Kinoshita
- Fujiidera Public Health Center of Osaka Prefectural Government, Fujiidera 583-0024, Japan
| | - Rie Fujita
- Kenou Public Health Center of Nagasaki Prefectural Government, Isahaya 854-0081, Japan
| | - Tsuyoshi Ogata
- Itako Public Health Center of Ibaraki Prefectural Government, Itako 311-2422, Japan
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Pei L, Chen Y, Zheng X, Gong F, Liu W, Lin J, Zheng R, Yang Z, Bi Y, Chen E. Comorbidities prolonged viral shedding of patients infected with SARS-CoV-2 omicron variant in Shanghai: A multi-center, retrospective, observational study. J Infect Public Health 2023; 16:182-189. [PMID: 36566602 PMCID: PMC9724554 DOI: 10.1016/j.jiph.2022.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/15/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND As the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surges amid the coronavirus disease 2019 (COVID-19) pandemic, there is limited comorbidities data associated with viral shedding time (VST). We aimed to investigate the effect of comorbidities on VST in asymptomatic and mild patients with omicron. METHODS A multi-center, retrospective, observational study was conducted from March 12, 2022 to May 24, 2022 in Shanghai. The analysis was adjusted for patients' baseline demographic, using log-rank test and logistic regression model. RESULTS The study enrolled 198,262 subjects. The median duration of viral shedding time (VST) was 8.29 days. The number of cumulative viral shedding events was significantly lower in the chronic obstructive pulmonary disease (COPD), hyperlipidemia, diabetes, urinary system disease, and cardiocerebrovascular disease than in the no corresponding comorbidities group. Patients with comorbidities had a lower incidence of viral shedding, and the most significant independent risk factor is COPD (aOR 1.78, 95% CI: 1.53-2.08, p < 0.001). Across different age ranges, the comorbidities affecting viral shedding also differ, with the greatest risk factors for viral shedding being hyperlipidemia (aOR 2.23, 95% CI: 1.50-3.31, p < 0.001) and COPD (aOR 1.85, 95% CI: 1.50-2.28, p < 0.001) between ages of 18-39 and 40-64, and thyroid dysfunction (aOR 2.36, 95% CI: 1.60-3.47, p < 0.001) above age 64. CONCLUSIONS Omicron-infected patients with comorbidities might prolong the VST. The independent risk factors also differ across age ranges, suggesting that providing targeted effective prevention and control guidance and allocating appropriate resources to different populations should be a crucial strategy.
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Affiliation(s)
- Lei Pei
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Chen
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangtao Zheng
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fangchen Gong
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbin Liu
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingsheng Lin
- Department of Disciplinary Development and Planning, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhitao Yang
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Correspondence to: Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin No. 2 Road, Huangpu District, Shanghai 200025, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Erzhen Chen
- Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Correspondence to: Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Ruijin No. 2 Road, Huangpu District, Shanghai 200025, China
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Aita A, Navaglia F, Moz S, Contran N, Barbaro F, Cattelan AM, Padoan A, Cosma C, Faggian D, Plebani M, Basso D. New insights into SARS-CoV-2 Lumipulse G salivary antigen testing: accuracy, safety and short TAT enhance surveillance. Clin Chem Lab Med 2023; 61:323-331. [PMID: 36282616 DOI: 10.1515/cclm-2022-0849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The rapid, accurate and safe detection of SARS-CoV-2 is the key to improving surveillance and infection containment. The aim of the present study was to ascertain whether, after heat/chemical inactivation, SARS-CoV-2 N antigen chemiluminescence (CLEIA) assay in saliva remains a valid alternative to molecular testing. METHODS In 2022, 139 COVID-19 inpatients and 467 healthcare workers were enrolled. In 606 self-collected saliva samples (Salivette), SARS-CoV-2 was detected by molecular (TaqPath rRT-PCR) and chemiluminescent Ag assays (Lumipulse G). The effect of sample pre-treatment (extraction solution-ES or heating) on antigen recovery was verified. RESULTS Salivary SARS-CoV-2 antigen assay was highly accurate (AUC=0.959, 95% CI: 0.943-0.974), with 90% sensitivity and 92% specificity. Of the 254 antigen positive samples, 29 were false positives. We demonstrated that heterophilic antibodies could be a cause of false positive results. A significant antigen concentration decrease was observed after ES treatment (p=0.0026), with misclassification of 43 samples. Heat had a minimal impact, after treatment the correct classification of cases was maintained. CONCLUSIONS CLEIA SARS-CoV-2 salivary antigen provides accurate, timely and high-throughput results that remain accurate also after heat inactivation, thus ensuring a safer work environment. This supports the use of salivary antigen detection by CLEIA in surveillance programs.
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Affiliation(s)
- Ada Aita
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Filippo Navaglia
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Stefania Moz
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Nicole Contran
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Francesco Barbaro
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | - Anna Maria Cattelan
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | - Andrea Padoan
- Department of Medicine - DIMED, University of Padova, Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Chiara Cosma
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Diego Faggian
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Mario Plebani
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Daniela Basso
- Department of Medicine - DIMED, University of Padova, Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
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Yin Y, Liu Y, Duan M, Xie X, Hong J, Huang J, Li K, Shi J, Chen X, Guo H, Zhou X, Liu R, Zhou C, Wang X, Kong L, Zhang Z. Optimizing the nucleic acid screening strategy to mitigate regional outbreaks of SARS-CoV-2 Omicron variant in China: a modeling study. Infect Dis Poverty 2023; 12:1. [PMID: 36642738 PMCID: PMC9841147 DOI: 10.1186/s40249-022-01049-w] [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: 08/26/2022] [Accepted: 12/11/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads rapidly and insidiously. Coronavirus disease 2019 (COVID-19) screening is an important means of blocking community transmission in China, but the costs associated with testing are high. Quarantine capacity and medical resources are also threatened. Therefore, we aimed to evaluate different screening strategies to balance outbreak control and consumption of resources. METHODS A community network of 2000 people, considering the heterogeneities of household size and age structure, was generated to reflect real contact networks, and a stochastic individual-based dynamic model was used to simulate SARS-CoV-2 transmission and assess different whole-area nucleic acid screening strategies. We designed a total of 87 screening strategies with different sampling methods, frequencies of screening, and timings of screening. The performance of these strategies was comprehensively evaluated by comparing the cumulative infection rates, the number of tests, and the quarantine capacity and consumption of medical resource, which were expressed as medians (95% uncertainty intervals, 95% UIs). RESULTS To implement COVID-19 nucleic acid testing for all people (Full Screening), if the screening frequency was four times/week, the cumulative infection rate could be reduced to 13% (95% UI: 1%, 51%), the miss rate decreased to 2% (95% UI: 0%, 22%), and the quarantine and medical resource consumption was lower than higher-frequency Full Screening or sampling screening. When the frequency of Full Screening increased from five to seven times/week (which resulted in a 2581 increase in the number of tests per positive case), the cumulative infection rate was only reduced by 2%. Screening all people weekly by splitting them equally into seven batches could reduce infection rates by 73% compared to once per week, which was similar to Full Screening four times/week. Full Screening had the highest number of tests per positive case, while the miss rate, number of tests per positive case, and hotel quarantine resource consumption in Household-based Sampling Screening scenarios were lower than Random Sampling Screening. The cumulative infection rate of Household-based Sampling Screening or Random Sampling Screening seven times/week was similar to that of Full Screening four times/week. CONCLUSIONS If hotel quarantine, hospital and shelter hospital capacity are seriously insufficient, to stop the spread of the virus as early as possible, high-frequency Full Screening would be necessary, but intermediate testing frequency may be more cost-effective in non-extreme situations. Screening in batches is recommended if the testing capacity is low. Household-based Sampling Screening is potentially a promising strategy to implement.
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Affiliation(s)
- Yun Yin
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yuanhua Liu
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Mengwei Duan
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Xiyang Xie
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Jie Hong
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaqi Huang
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Ke Li
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jin Shi
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xi Chen
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hongyan Guo
- Department of Blood Transfusion, Changchun People’s Hospital, Changchun, China
| | - Xuan Zhou
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Rui Liu
- grid.412508.a0000 0004 1799 3811Department of Geomatics and Spatial Information, Shandong University of Science and Technology, Qingdao, China
| | - Caifeng Zhou
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Xiaozhe Wang
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Lingcai Kong
- grid.261049.80000 0004 0645 4572Department of Mathematics and Physics, North China Electric Power University, Baoding, China
| | - Zhijie Zhang
- grid.8547.e0000 0001 0125 2443Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, No.130, Dong’An Road, Xuhui District, Shanghai, 200032 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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张 苡, 梁 世, 吴 沛, 蔡 燕, 林 跃, 王 晴, 庄 锡, 陈 素. [Clinical features of severe acute respiratory syndrome coronavirus 2 Omicron variant infection in children: an analysis of 201 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:5-10. [PMID: 36655657 PMCID: PMC9893821 DOI: 10.7499/j.issn.1008-8830.2207052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/18/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection. METHODS A retrospective analysis was performed on the medical data of 201 children with coronavirus disease 2019 (COVID-19) who were hospitalized and diagnosed with SARS-CoV-2 Omicron variant infection in Quanzhou First Hospital from March 14 to April 7, 2022. Among the 201 children, there were 34 children with asymptomatic infection and 167 with symptomatic infection. The two groups were compared in terms of clinical features, results of experimental examinations, and outcome. RESULTS Of all the 201 children, 161 (80.1%) had a history of exposure to COVID-19 patients and 132 (65.7%) had a history of COVID-19 vaccination. Among the 167 children with symptomatic infections, 151 had mild COVID-19 and 16 had common COVID-19, with no severe infection or death. Among the 101 children who underwent chest CT examination, 16 had ground glass changes and 20 had nodular or linear opacities. The mean time to nucleic acid clearance was (14±4) days for the 201 children with Omicron variant infection, and the symptomatic infection group had a significantly longer time than the asymptomatic infection group [(15±4) days vs (11±4) days, P<0.05]. The group vaccinated with one or two doses of COVID-19 vaccine had a significantly higher positive rate of IgG than the group without vaccination (P<0.05). The proportions of children with increased blood lymphocyte count in the symptomatic infection group was significantly lower than that in the asymptomatic infection group (P<0.05). Compared with the asymptomatic infection group, the symptomatic infection group had significantly higher proportions of children with increased interleukin-6, increased fibrinogen, and increased D-dimer (P<0.05). CONCLUSIONS Most of the children with Omicron variant infection have clinical symptoms, which are generally mild. The children with symptomatic infection are often accompanied by decreased or normal blood lymphocyte count and increased levels of interleukin-6, fibrinogen, and D-dimer, with a relatively long time to nucleic acid clearance. Some of them had ground glass changes on chest CT.
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