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Houben F, den Heijer CDJ, Dukers-Muijrers NHTM, de Bont EGPM, Volbeda HT, Hoebe CJPA. Infection prevention and control in Dutch general practices before and during the COVID-19 pandemic and its implications for pandemic preparedness and seasonal respiratory epidemics: a qualitative study on lessons learned. BMC PRIMARY CARE 2024; 25:222. [PMID: 38902628 PMCID: PMC11191277 DOI: 10.1186/s12875-024-02451-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The COVID-19 pandemic has prompted a re-evaluation of infection prevention and control (IPC) in general practices, highlighting the need for comprehensive IPC implementation. This study aimed to evaluate healthcare workers' (HCWs) experiences and perspectives regarding IPC in general practices before and during the COVID-19 pandemic, and its implications for post-pandemic IPC implementation. METHODS This qualitative study involved semi-structured, in-depth interviews during two time periods: (1) prior to the COVID-19 pandemic (July 2019-February 2020), involving 14 general practitioners (GPs) and medical assistants; and (2) during the COVID-19 pandemic (July 2022-February 2023), including 22 GPs and medical assistants. Data analysis included thematic analysis that addressed multiple system levels. RESULTS Findings indicated a shift towards comprehensive IPC implementation and organisation during the pandemic compared to the pre-pandemic period. Since the Omicron variant, some general practices maintained a broad set of IPC measures, while others released most measures. HCWs' future expectations on post-pandemic IPC implementation varied: some anticipated reduced implementation due to the desire to return to the pre-pandemic standard, while others expected IPC to be structurally scaled up during seasonal respiratory epidemics. Main contextual challenges included patient cooperation, staff shortages (due to infection), shortages of IPC materials/equipment, and frequently changing and ambiguous guidelines. Key lessons learned were enhanced preparedness (e.g., personal protective equipment supply), and a new perspective on care organisation (e.g., digital care). Main recommendations reported by HCWs were to strengthen regional collaboration within primary care, and between primary care, public health, and secondary care. CONCLUSION HCWs' experiences, perspectives and recommendations provide insights to enhance preparedness for future epidemics and pandemics, and sustain IPC in general practices. For IPC improvement strategies, adopting an integrated system-based approach that encompasses actions across multiple levels and engages multiple stakeholders is recommended.
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Affiliation(s)
- Famke Houben
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health MOSA, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands.
| | - Casper D J den Heijer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health MOSA, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health MOSA, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Eefje G P M de Bont
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Hanneke T Volbeda
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health MOSA, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Christian J P A Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health MOSA, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
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Mahyuddin AP, Swa HLF, Weng R, Zhang J, Dhanaraj JP, Sesurajan BP, Rauff M, Dashraath P, Kanneganti A, Lee R, Wang LF, Young BE, Tambyah PA, Lye DC, Chai LYA, Yee S, Choolani M, Mattar CNZ. COVID-19 vaccination before or during pregnancy results in high, sustained maternal neutralizing activity to SARS-CoV-2 wild-type and Delta/Omicron variants of concern, particularly following a booster dose or infection. Int J Infect Dis 2024; 146:107121. [PMID: 38823622 DOI: 10.1016/j.ijid.2024.107121] [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: 02/16/2024] [Revised: 05/21/2024] [Accepted: 05/26/2024] [Indexed: 06/03/2024] Open
Abstract
OBJECTIVES To investigate multi-dose and timings of COVID-19 vaccines in preventing antenatal infection. DESIGN Prospective observational study investigating primary vaccinations, boosters, antenatal COVID-19 infections, neutralizing antibody (Nab) durability, and cross-reactivity to Delta and Omicron variants of concern (VOCs). RESULTS Ninety-eight patients completed primary vaccination prepregnancy (29.6%) and antenatally (63.3%), 24.2% of whom had antenatal COVID-19, while 7.1% were unvaccinated (28.6% had antenatal COVID-19). None had severe COVID-19. Prepregnancy vaccination resulted in vaccination-to-infection delay of 23.3 weeks, which extended to 45.2 weeks with a booster, compared to 16.9 weeks following antenatal vaccination (P < 0.001). Infections occurred at 26.2 weeks gestation in women vaccinated prepregnancy compared to 36.2 weeks gestation in those vaccinated during pregnancy (P < 0.007). The risk of COVID-19 infection was higher without antenatal vaccination (hazard ratio [HR] 14.6, P = 0.05) and after prepregnancy vaccination without a booster (HR 10.4, P = 0.002). Antenatal vaccinations initially led to high Nab levels, with mild waning but subsequent rebound. Significant Nab enhancement occurred with a third-trimester booster. Maternal-neonatal Nab transfer was efficient (transfer ratio >1), and cross-reactivity to VOCs was observed. CONCLUSION Completing vaccination during any trimester delays COVID-19 infection and maintains effective neutralizing activity throughout pregnancy, with robust cross-reactivity to VOCs and efficient maternal-neonatal transfer.
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Affiliation(s)
- Aniza P Mahyuddin
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hannah L F Swa
- Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore
| | - Ruifen Weng
- Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jingxian Zhang
- Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore
| | - Janice P Dhanaraj
- Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore
| | - Binny P Sesurajan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary Rauff
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Pradip Dashraath
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Rachel Lee
- Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Lin-Fa Wang
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore; The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore
| | - Barnaby E Young
- The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore; National Centre for Infectious Diseases, Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Paul A Tambyah
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - David C Lye
- The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore; National Centre for Infectious Diseases, Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Louis Y A Chai
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Sidney Yee
- Innovation and Enterprise, Agency for Science, Technology and Research, Connexis North Tower, Singapore, Singapore
| | - Mahesh Choolani
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Citra N Z Mattar
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore.
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Sánchez-Simarro Á, Fernández-Soto D, Grau B, Albert E, Giménez E, Avilés-Alía AI, Gozalbo-Rovira R, Rusu L, Olea B, Geller R, Reyburn HT, Navarro D. Functional antibody responses targeting the Spike protein of SARS-CoV-2 Omicron XBB.1.5 in elderly nursing home residents following Wuhan-Hu-1-based mRNA booster vaccination. Sci Rep 2024; 14:11896. [PMID: 38789475 PMCID: PMC11126592 DOI: 10.1038/s41598-024-62874-7] [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: 02/15/2024] [Accepted: 05/22/2024] [Indexed: 05/26/2024] Open
Abstract
The immune effector mechanisms involved in protecting against severe COVID-19 infection in elderly nursing home residents following vaccination or natural infection are not well understood. Here, we measured SARS-CoV-2 Spike (S)-directed functional antibody responses, including neutralizing antibodies (NtAb) and antibody Fc-mediated NK cell activity (degranulation and IFNγ production), against the Wuhan-Hu-1, BA.4/5 (for NtAb), and Omicron XBB.1.5 variants in elderly nursing home residents (n = 39; median age, 91 years) before and following a third (pre- and post-3D) and a fourth (pre- and post-4D) mRNA COVID-19 vaccine dose. Both 3D and 4D boosted NtAb levels against both (sub)variants. Likewise, 3D and 4D increased the ability of sera to trigger both LAMP1- and IFNγ-producing NK cells, in particular against XBB.1.5. In contrast to NtAb titres, the frequencies of LAMP1- and IFNγ-producing NK cells activated by antibodies binding to Wuhan-Hu-1 and Omicron XBB.1.5 S were comparable at all testing times. Stronger functional antibody responses were observed in vaccine-experienced participants compared to vaccine-naïve at some testing times. These findings can contribute to identifying a reliable correlate of protection in elderly nursing home residents against severe COVID-19 and inform future vaccine strategies in this population group.
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Grants
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- FIS, PI21/00563 Instituto de Salud Carlos III
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- 202020E079 y CSIC-COVID19-028 Fundación General CSIC
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
- PID2020-115506RB-I00 (HTR) Ministerio de Ciencia e Innovación
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Affiliation(s)
- Ángela Sánchez-Simarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
| | - Daniel Fernández-Soto
- Department of Immunology and Oncology, National Centre for Biotechnology, CNB-CSIC, Madrid, Spain
| | - Brayan Grau
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, 46980, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Isabel Avilés-Alía
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, 46980, Valencia, Spain
| | | | - Luciana Rusu
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, 46980, Valencia, Spain
| | - Beatriz Olea
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
| | - Ron Geller
- Institute for Integrative Systems Biology (I2SysBio), Universitat de Valencia-CSIC, 46980, Valencia, Spain
| | - Hugh T Reyburn
- Department of Immunology and Oncology, National Centre for Biotechnology, CNB-CSIC, Madrid, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.
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Horváth JK, Túri G, Krisztalovics K, Kristóf K, Oroszi B. Vaccine Effectiveness against GP-Attended Symptomatic COVID-19 and Hybrid Immunity among Adults in Hungary during the 2022-2023 Respiratory Season Dominated by Different SARS-CoV-2 Omicron Subvariants. Vaccines (Basel) 2024; 12:496. [PMID: 38793747 PMCID: PMC11125656 DOI: 10.3390/vaccines12050496] [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: 03/11/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Hungary provides the opportunity to evaluate the effectiveness of COVID-19 vaccination in a setting where naturally acquired immunity and hybrid immunity are likely to play a greater role due to suboptimal vaccination coverage. METHODS A test-negative study was conducted during the 2022-2023 respiratory season at the primary care level to determine the effectiveness of at least one COVID-19 booster dose in preventing medically attended symptomatic RT-PCR-confirmed SARS-CoV-2 infection in adults. Unvaccinated patients were used as a reference group. RESULTS A total of 247 cases and 1073 controls were included in the analysis. CVE was 56.8% (95% CI: 11.9-78.8%) in the population aged 60 years and older and 2.3% (95% CI: -50.0-36.3%) in the younger adults against COVID-19 caused by Omicron subvariants, mainly BA.5, BQ.1, and XBB.1. Self-reported COVID-19 in the 60-365 days prior to the current illness did not confer protection against reinfection without vaccination, but together with booster vaccination, it reduced the risk of COVID-19 by 63.0% (95% CI: -28.0-89.3%) and 87.6% (95% CI: 26.4-97.9%) among the 18-59 and 60+ age groups, respectively. CONCLUSIONS CVE against COVID-19 was moderately high in the 60+ age groups. Because of the benefit of hybrid immunity, persons with previous SARS-CoV-2 infection should still be considered for vaccination campaigns.
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Affiliation(s)
- Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary; (J.K.H.); (G.T.); (K.K.)
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary; (J.K.H.); (G.T.); (K.K.)
| | - Katalin Krisztalovics
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary; (J.K.H.); (G.T.); (K.K.)
| | - Katalin Kristóf
- Institute of Laboratory Medicine, Clinical Microbiology Laboratory, Semmelweis University, 1085 Budapest, Hungary;
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, 1085 Budapest, Hungary; (J.K.H.); (G.T.); (K.K.)
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Razonable RR. Protecting the vulnerable: addressing the COVID-19 care needs of people with compromised immunity. Front Immunol 2024; 15:1397040. [PMID: 38756784 PMCID: PMC11096526 DOI: 10.3389/fimmu.2024.1397040] [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: 03/06/2024] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
While the general population regained a certain level of normalcy with the end of the global health emergency, the risk of contracting COVID-19 with a severe outcome is still a major concern for people with compromised immunity. This paper reviews the impact of COVID-19 on people with immunocompromised status, identifies the gaps in the current management landscape, and proposes actions to address this unmet need. Observational studies have demonstrated that people with immune dysfunction have a higher risk of COVID-19-related hospitalization and death, despite vaccination, than the general population. More research is needed to define the optimal prevention and treatment strategies that are specific to people with immunocompromised status, including novel vaccination strategies, monoclonal antibodies that provide passive immunity and complement suboptimal vaccination responses, and improved and safer antiviral treatment for COVID-19. Preventive measures beyond vaccination alone are urgently needed to protect this vulnerable population.
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Affiliation(s)
- Raymund R. Razonable
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States
- William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, United States
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Yin Q, Liu W, Jiang Y, Feng Q, Wang X, Dou H, Liu Z, He F, Fan Y, Jiao B, Jiao B. Comprehensive genomic analysis of the SARS-CoV-2 Omicron variant BA.2.76 in Jining City, China, 2022. BMC Genomics 2024; 25:378. [PMID: 38632523 PMCID: PMC11022347 DOI: 10.1186/s12864-024-10246-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE This study aims to analyze the molecular characteristics of the novel coronavirus (SARS-CoV-2) Omicron variant BA.2.76 in Jining City, China. METHODS Whole-genome sequencing was performed on 87 cases of SARS-CoV-2 infection. Evolutionary trees were constructed using bioinformatics software to analyze sequence homology, variant sites, N-glycosylation sites, and phosphorylation sites. RESULTS All 87 SARS-CoV-2 whole-genome sequences were classified under the evolutionary branch of the Omicron variant BA.2.76. Their similarity to the reference strain Wuhan-Hu-1 ranged from 99.72 to 99.74%. In comparison to the reference strain Wuhan-Hu-1, the 87 sequences exhibited 77-84 nucleotide differences and 27 nucleotide deletions. A total of 69 amino acid variant sites, 9 amino acid deletions, and 1 stop codon mutation were identified across 18 proteins. Among them, the spike (S) protein exhibited the highest number of variant sites, and the ORF8 protein showed a Q27 stop mutation. Multiple proteins displayed variations in glycosylation and phosphorylation sites. CONCLUSION SARS-CoV-2 continues to evolve, giving rise to new strains with enhanced transmission, stronger immune evasion capabilities, and reduced pathogenicity. The application of high-throughput sequencing technologies in the epidemic prevention and control of COVID-19 provides crucial insights into the evolutionary and variant characteristics of the virus at the genomic level, thereby holding significant implications for the prevention and control of the COVID-19 pandemic.
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Affiliation(s)
- Qiang Yin
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Wei Liu
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Yajuan Jiang
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Qiang Feng
- Department of Laboratory, Rencheng Center for Disease Control and Prevention, Jining, China
| | - Xiaoyu Wang
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Huixin Dou
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Zanzan Liu
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China
| | - Feifei He
- Computer Information Technology, Northern Arizona University, Arizona, USA
| | - Yingying Fan
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China.
| | - Baihai Jiao
- Department of Medicine, School of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
| | - Boyan Jiao
- Department of Laboratory, Jining Center for Disease Control and Prevention, Jining, China.
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Qian J, Zhang S, Wang F, Li J, Zhang J. What makes SARS-CoV-2 unique? Focusing on the spike protein. Cell Biol Int 2024; 48:404-430. [PMID: 38263600 DOI: 10.1002/cbin.12130] [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: 10/09/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) seriously threatens public health and safety. Genetic variants determine the expression of SARS-CoV-2 structural proteins, which are associated with enhanced transmissibility, enhanced virulence, and immune escape. Vaccination is encouraged as a public health intervention, and different types of vaccines are used worldwide. However, new variants continue to emerge, especially the Omicron complex, and the neutralizing antibody responses are diminished significantly. In this review, we outlined the uniqueness of SARS-CoV-2 from three perspectives. First, we described the detailed structure of the spike (S) protein, which is highly susceptible to mutations and contributes to the distinct infection cycle of the virus. Second, we systematically summarized the immunoglobulin G epitopes of SARS-CoV-2 and highlighted the central role of the nonconserved regions of the S protein in adaptive immune escape. Third, we provided an overview of the vaccines targeting the S protein and discussed the impact of the nonconserved regions on vaccine effectiveness. The characterization and identification of the structure and genomic organization of SARS-CoV-2 will help elucidate its mechanisms of viral mutation and infection and provide a basis for the selection of optimal treatments. The leaps in advancements regarding improved diagnosis, targeted vaccines and therapeutic remedies provide sound evidence showing that scientific understanding, research, and technology evolved at the pace of the pandemic.
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Affiliation(s)
- Jingbo Qian
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Shichang Zhang
- Department of Clinical Laboratory Medicine, Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Fang Wang
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Jinming Li
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, China
- National Center for Clinical Laboratories, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Jiexin Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
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Al Qurashi YMA, Abdulhakim JA, Alkhalil SS, Alansari M, Almutiri R, Alabbasi R, Fawzy MS. Molecular Epidemiology of Omicron CH.1.1 Lineage: Genomic and Phenotypic Data Perspective. Cureus 2024; 16:e53496. [PMID: 38440013 PMCID: PMC10910519 DOI: 10.7759/cureus.53496] [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: 01/31/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The Omicron variant (B.1.1.529 lineage) of SARS-CoV-2 represents a substantial global health challenge due to its high transmissibility and potential resistance to immunity from vaccines or previous infections. Among the rapidly evolving Omicron lineages, the BA.2.75 and the emerging CH.1.1 have garnered attention. While BA.2.75 is marked by mutations that may enhance immune evasion, CH.1.1 is distinguished by the S: L452R mutation, linked to increased pathogenicity and transmission. Initially identified in India by the end of 2021, these variants have exhibited global dissemination, signaling an urgent need to track and analyze their progression. METHODS In this study, the genomic and geographical distribution data of CH.1.1 were collected from the Global Initiative on Sharing Avian Influenza Data (GISAID), PANGOLIN, CoV-Spectrum, and NextStrain databases. Due to the unavailability of epidemiological and genomic data of the CH.1.1 lineage, PubMed and ScienceDirect were used as sources of the phenotypic data of the lineage variations. Amino acid variations utilized in the data mining included S: R346T, S: K444T, S: L452R, and S: F486S. RESULTS The current epidemiological data indicate that CH.1.1 is more likely to become one of the dominant spreading lineages in the United Kingdom, New Zealand, Australia, and the United States based on a 32% growth advantage, present CH.1.1 lineage cases number, and the amino acid variation's impact. CONCLUSION A significant increase in the newly detected lineage CH.1.1 is highly anticipated. The rise in the detected sequences number from 13,231 on January 21, 2023, to 23,181 on February 6, 2023, supports the prediction and growth advantage of the lineage detected cases. Increases in viral transmissibility caused by higher affinity to ACE2 receptors and immune evasion are deduced from amino acid variations analyzed in the study.
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Affiliation(s)
| | - Jawaher A Abdulhakim
- Department of Medical Laboratory, College of Applied Medical Sciences, Taibah University, Yanbu, SAU
| | - Samia S Alkhalil
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Alquwayiyah, SAU
| | - Maymuna Alansari
- Department of Medical Laboratory, College of Applied Medical Sciences, Taibah University, Yanbu, SAU
| | - Renad Almutiri
- Department of Medical Laboratory, College of Applied Medical Sciences, Taibah University, Yanbu, SAU
| | - Rageed Alabbasi
- Department of Medical Laboratory, College of Applied Medical Sciences, Taibah University, Yanbu, SAU
| | - Manal S Fawzy
- Department of Biochemistry, Unit of Medical Research and Postgraduate Studies, Faculty of Medicine, Northern Border University, Arar, SAU
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9
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Laquintana V, Mottini C, Marchesi F, Marcozzi B, Terrenato I, Sperandio E, de Latouliere L, Carrieri F, Pimpinelli F, Pontone M, Pellini R, Campo F, Conti L, Accetta C, Mandoj C, Petrone F, Di Bella O, Vujovic B, Morrone A, Compagnone M, Principato E, Pinto E, Papa E, Falcucci P, La Malfa A, Pallocca M, De Marco F, Piaggio G, Ciliberto G, Mengarelli A, di Martino S. Dynamics of humoral and cellular response to three doses of anti-SARS-CoV-2 BNT162b2 vaccine in patients with hematological malignancies and older subjects. Front Immunol 2024; 14:1221587. [PMID: 38343436 PMCID: PMC10853639 DOI: 10.3389/fimmu.2023.1221587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Background Few data are available about the durability of the response, the induction of neutralizing antibodies, and the cellular response upon the third dose of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in hemato-oncological patients. Objective To investigate the antibody and cellular response to the BNT162b2 vaccine in patients with hematological malignancy. Methods We measured SARS-CoV-2 anti-spike antibodies, anti-Omicron neutralizing antibodies, and T-cell responses 1 month after the third dose of vaccine in 93 fragile patients with hematological malignancy (FHM), 51 fragile not oncological subjects (FNO) aged 80-92, and 47 employees of the hospital (healthcare workers, (HW), aged 23-66 years. Blood samples were collected at day 0 (T0), 21 (T1), 35 (T2), 84 (T3), 168 (T4), 351 (T pre-3D), and 381 (T post-3D) after the first dose of vaccine. Serum IgG antibodies against S1/S2 antigens of SARS-CoV-2 spike protein were measured at every time point. Neutralizing antibodies were measured at T2, T3 (anti-Alpha), T4 (anti-Delta), and T post-3D (anti-Omicron). T cell response was assessed at T post-3D. Results An increase in anti-S1/S2 antigen antibodies compared to T0 was observed in the three groups at T post-3D. After the third vaccine dose, the median antibody level of FHM subjects was higher than after the second dose and above the putative protection threshold, although lower than in the other groups. The neutralizing activity of antibodies against the Omicron variant of the virus was tested at T2 and T post-3D. 42.3% of FHM, 80,0% of FNO, and 90,0% of HW had anti-Omicron neutralizing antibodies at T post-3D. To get more insight into the breadth of antibody responses, we analyzed neutralizing capacity against BA.4/BA.5, BF.7, BQ.1, XBB.1.5 since also for the Omicron variants, different mutations have been reported especially for the spike protein. The memory T-cell response was lower in FHM than in FNO and HW cohorts. Data on breakthrough infections and deaths suggested that the positivity threshold of the test is protective after the third dose of the vaccine in all cohorts. Conclusion FHM have a relevant response to the BNT162b2 vaccine, with increasing antibody levels after the third dose coupled with, although low, a T-cell response. FHM need repeated vaccine doses to attain a protective immunological response.
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Affiliation(s)
- Valentina Laquintana
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Carla Mottini
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Francesco Marchesi
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Benedetta Marcozzi
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Irene Terrenato
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Eleonora Sperandio
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Luisa de Latouliere
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Francesca Carrieri
- UOC D.I.T.R.A.R. IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fulvia Pimpinelli
- UOSD of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Martina Pontone
- UOSD of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Raul Pellini
- UOC Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Flaminia Campo
- UOC Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Laura Conti
- UOSD Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Celeste Accetta
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Chiara Mandoj
- UOSD Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fabrizio Petrone
- UOC D.I.T.R.A.R. IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Ornella Di Bella
- Medical Direction, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Branka Vujovic
- Medical Direction, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | | | | | | | - Elena Papa
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Paolo Falcucci
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Matteo Pallocca
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Federico De Marco
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Giulia Piaggio
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Andrea Mengarelli
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Simona di Martino
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
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10
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Gupta DL, Meher J, Giri AK, Shukla AK, Mohapatra E, Ruikar MM, Rao DN. RBD mutations at the residues K417, E484, N501 reduced immunoreactivity with antisera from vaccinated and COVID-19 recovered patients. Drug Target Insights 2024; 18:20-26. [PMID: 38860262 PMCID: PMC11163369 DOI: 10.33393/dti.2024.3059] [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: 03/01/2024] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction It is unclear whether induced spike protein-specific antibodies due to infections with SARS-CoV-2 or to the prototypic Wuhan isolate-based vaccination can immune-react with the emerging variants of SARS-CoV-2. Aim/objectives The main objective of the study was to measure the immunoreactivity of induced antibodies postvaccination with Covishield™ (ChAdOx1 nCoV-19 coronavirus vaccines) or infections with SARS-CoV-2 by using selected peptides of the spike protein of wild type and variants of SARS-CoV-2. Methodology Thirty patients who had recovered from SARS-CoV-2 infections and 30 individuals vaccinated with both doses of Covishield™ were recruited for the study. Venous blood samples (5 mL) were collected at a single time point from patients within 3-4 weeks of recovery from SARS-CoV-2 infections or receiving both doses of Covishield™ vaccines. The serum levels of total immunoglobulin were measured in both study groups. A total of 12 peptides of 10 to 24 amino acids length spanning to the receptor-binding domain (RBD) of wild type of SARS-CoV-2 and their variants were synthesized. The serum levels of immune-reactive antibodies were measured using these peptides. Results The serum levels of total antibodies were found to be significantly (p<0.001) higher in the vaccinated individuals as compared to COVID-19 recovered patients. Our study reported that the mutations in the RBD at the residues K417, E484, and N501 have been associated with reduced immunoreactivity with anti-sera of vaccinated people and COVID-19 recovered patients. Conclusion The amino acid substitutions at the RBD of SARS-CoV-2 have been associated with a higher potential to escape the humoral immune response.
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Affiliation(s)
- Dablu Lal Gupta
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - Jhasketan Meher
- Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - Anjan Kumar Giri
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - Arvind K Shukla
- Department of Community Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - Eli Mohapatra
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - Manisha M Ruikar
- Department of Community Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh - India
| | - DN Rao
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi - India
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11
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Wang Y, Lan X, Qiao Y, Huo Y, Wang L, Liang S, Yu M, Song M, Yan Y, Su B, Xu J. Safety and immunogenicity of homologous prime-boost CoronaVac vaccine in people living with HIV in China: A multicenter prospective cohort study. J Med Virol 2024; 96:e29395. [PMID: 38235782 DOI: 10.1002/jmv.29395] [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: 10/18/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
People living with HIV (PLWH) are particularly vulnerable to SARS-CoV-2. This multicentre prospective cohort study evaluated the long-term immunogenicity and safety of a third homologous dose of Sinovac CoronaVac in PLWH in China. A total of 228 PLWH and 127 HIV-negative controls were finally included and followed up for 6 months. Fewer participants reported mild or moderate adverse reactions, and no serious adverse events were observed. The median levels of neutralizing antibodies (nAbs) and immunoglobulin G against the receptor-binding domain of the spike protein (S-IgG) in PLWH (655.92 IU/mL, IQR: 175.76-1663.55; 206.83 IU/mL, IQR: 85.20-397.82) were comparable to those in control group (1067.16 IU/mL, IQR: 239.85-1670.83; 261.70 IU/mL, IQR: 77.13-400.75), and reached their peak at 4 weeks, exhibiting a delayed peak pattern compared to the 2-week peak in control group. After then, the immune titres gradually decreased over time, but most participants still maintained positive seroconversion at the 6-month mark. Multivariable generalized estimating equation analysis indicated that CD4+T cell count, HIV viral load, and antiretroviral therapy (ART) were independent factors strongly associated with immune response (each p < 0.05). We suggested that PLWH should maintain well-controlled HIV status through ART and receive timely administration of the second booster dose for optimal protection.
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Affiliation(s)
- Yuxiao Wang
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People's Republic of China
| | - Xinquan Lan
- Department of Epidemiology, China Medical University, Shenyang, People's Republic of China
| | - Ying Qiao
- Department of infection, The Second Hospital of Huhhot, Huhhot, People's Republic of China
| | - Yuqi Huo
- Translational Medicine Research Center, The Sixth People's Hospital of Zhengzhou, Zhengzhou, People's Republic of China
| | - Li Wang
- Department of Infection, Heilongjiang Provincial Hospital, Heilongjiang, People's Republic of China
| | - Shijie Liang
- Department of Infectious Disease Prevention, Zhengzhou Centers for Disease Control and Prevention, Zhengzhou, People's Republic of China
| | - Maohe Yu
- Department of HIV Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin, People's Republic of China
| | - Moxin Song
- Department of Epidemiology, China Medical University, Shenyang, People's Republic of China
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital/National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing, People's Republic of China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Junjie Xu
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China
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12
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Yadav S, Zaman K, Bashyal P, Bhatta R, Bhandari S, Mohanty A, Sah R. Newer emerging SARS-COV2 variant: Omicron EG.5. Ann Med Surg (Lond) 2023; 85:5845-5846. [PMID: 38098560 PMCID: PMC10718343 DOI: 10.1097/ms9.0000000000001386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/28/2023] [Indexed: 12/17/2023] Open
Affiliation(s)
- Shailendra Yadav
- Malaria Division, ICMR-Regional Medical Research Centre Dibrugarh (ICMR-RMRC Dibrugarh), Dibrugarh, Assam
| | - Kamran Zaman
- Department of Microbiology and Molecular Biology, Indian Council of Medical Research—National Institute of Traditional Medicine Belagavi (ICMR-NITM Belagavi), Karnataka
| | | | | | | | - Aroop Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur
| | - Ranjit Sah
- Dr. D.Y Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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13
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Okuyama R. mRNA and Adenoviral Vector Vaccine Platforms Utilized in COVID-19 Vaccines: Technologies, Ecosystem, and Future Directions. Vaccines (Basel) 2023; 11:1737. [PMID: 38140142 PMCID: PMC10748114 DOI: 10.3390/vaccines11121737] [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: 10/27/2023] [Revised: 11/12/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
New technological platforms, such as mRNA and adenoviral vector vaccines, have been utilized to develop coronavirus disease 2019 (COVID-19) vaccines. These new modalities enable rapid and flexible vaccine design and cost-effective and swift manufacturing, effectively combating pandemics caused by mutating viruses. Innovation ecosystems, including universities, startups, investors, and governments are crucial for developing these cutting-edge technologies. This review summarizes the research and development trajectory of these vaccine technologies, their investments, and the support surrounding them, in addition to the technological details of each technology. In addition, this study examines the importance of an innovation ecosystem in developing novel technologies, comparing it with the case of Japan, which has lagged behind in COVID-19 vaccine development. It also explores the direction of vaccine development in the post-COVID-19 era.
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Affiliation(s)
- Ryo Okuyama
- College of International Management, Ritsumeikan Asia Pacific University, Beppu 874-8577, Japan
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14
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Katzmarzyk M, Clesle DC, van den Heuvel J, Hoffmann M, Garritsen H, Pöhlmann S, Jacobsen H, Čičin-Šain L. Systematical assessment of the impact of single spike mutations of SARS-CoV-2 Omicron sub-variants on the neutralization capacity of post-vaccination sera. Front Immunol 2023; 14:1288794. [PMID: 38022629 PMCID: PMC10667444 DOI: 10.3389/fimmu.2023.1288794] [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: 09/04/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The evolution of novel SARS-CoV-2 variants significantly affects vaccine effectiveness. While these effects can only be studied retrospectively, neutralizing antibody titers are most used as correlates of protection. However, studies assessing neutralizing antibody titers often show heterogeneous data. Methods To address this, we investigated assay variance and identified virus infection time and dose as factors affecting assay robustness. We next measured neutralization against Omicron sub-variants in cohorts with hybrid or vaccine induced immunity, identifying a gradient of immune escape potential. To evaluate the effect of individual mutations on this immune escape potential of Omicron variants, we systematically assessed the effect of each individual mutation specific to Omicron BA.1, BA.2, BA.2.12.1, and BA.4/5. Results We cloned a library of pseudo-viruses expressing spikes with single point mutations, and subjected it to pooled sera from vaccinated hosts, thereby identifying multiple mutations that independently affect neutralization potency. Discussion These data might help to predict antigenic features of novel viral variants carrying these mutations and support the development of broad monoclonal antibodies.
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Affiliation(s)
- Maeva Katzmarzyk
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Denise Christine Clesle
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Joop van den Heuvel
- Research Group Recombinant Protein Expression, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Markus Hoffmann
- Infection Biology Unit, German Primate Center, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Henk Garritsen
- Institute for Clinical Transfusion Medicine, Klinikum Braunschweig GmbH, Braunschweig, Germany
- Fraunhofer Institute for Surface Engineering and Thin Films IST, Braunschweig, Germany
| | - Stefan Pöhlmann
- Infection Biology Unit, German Primate Center, Göttingen, Germany
- Faculty of Biology and Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Henning Jacobsen
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Luka Čičin-Šain
- Department of Viral Immunology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Centre for Individualized Infection Medicine (CIIM), Joint Venture of Helmholtz Centre for Infection Research and Medical School Hannover, Braunschweig, Germany
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15
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D’Orso S, Pirronello M, Verdiani A, Rossini A, Guerrera G, Picozza M, Sambucci M, Misiti A, De Marco L, Salvia A, Caltagirone C, Giardina E, Battistini L, Borsellino G. Primary and Recall Immune Responses to SARS-CoV-2 in Breakthrough Infection. Vaccines (Basel) 2023; 11:1705. [PMID: 38006037 PMCID: PMC10675240 DOI: 10.3390/vaccines11111705] [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: 10/05/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Breakthrough infections in SARS-CoV-2 vaccinated individuals are an ideal circumstance for the simultaneous exploration of both the vaccine-induced memory reaction to the spike (S) protein and the primary response to the membrane (M) and nucleocapsid (N) proteins generated by natural infection. We monitored 15 healthcare workers who had been vaccinated with two doses of Pfizer BioNTech BNT162b2 and were then later infected with the SARS-CoV-2 B.1.617.2. (Delta) variant, analysing the antiviral humoral and cellular immune responses. Natural infection determined an immediate and sharp rise in anti-RBD antibody titres and in the frequency of both S-specific antibody secreting cells (ASCs) and memory B lymphocytes. T cells responded promptly to infection by activating and expanding already at 2-5 days. S-specific memory and emerging M- and N-specific T cells both expressed high levels of activation markers and showed effector capacity with similar kinetics but with different magnitude. The results show that natural infection with SARS-CoV-2 in vaccinated individuals induces fully functional and rapidly expanding T and B lymphocytes in concert with the emergence of novel virus-specific T cells. This swift and punctual response also covers viral variants and captures a paradigmatic case of a healthy adaptive immune reaction to infection with a mutating virus.
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Affiliation(s)
- Silvia D’Orso
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Marta Pirronello
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Alice Verdiani
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Angelo Rossini
- Medical Services, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (A.R.); (A.S.)
| | - Gisella Guerrera
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Mario Picozza
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Manolo Sambucci
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Andrea Misiti
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Lorenzo De Marco
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Antonino Salvia
- Medical Services, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (A.R.); (A.S.)
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, Santa Lucia Foundation IRCCS, 00179 Rome, Italy;
| | - Emiliano Giardina
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation IRCCS, 00179 Rome, Italy;
- Medical Genetics Laboratory, Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
| | - Luca Battistini
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
| | - Giovanna Borsellino
- Neuroimmunology Unit, Santa Lucia Foundation IRCCS, 00143 Rome, Italy; (S.D.); (M.P.); (A.V.); (G.G.); (M.P.); (M.S.); (A.M.); (L.D.M.); (L.B.)
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16
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Klee B, Diexer S, Sarajan MH, Glaser N, Binder M, Frese T, Girndt M, Sedding D, Hoell JI, Moor I, Gekle M, Mikolajczyk R, Gottschick C. Regional Differences in Uptake of Vaccination against COVID-19 and Influenza in Germany: Results from the DigiHero Cohort. Vaccines (Basel) 2023; 11:1640. [PMID: 38005973 PMCID: PMC10674575 DOI: 10.3390/vaccines11111640] [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: 09/14/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
During the COVID-19 pandemic in Germany, vaccination uptake exhibited considerable regional disparities. To assess the factors contributing to this variation, we examined the association of sociodemographic variables with COVID-19, COVID-19 booster, and influenza vaccination status within a cohort of 37,078 participants from 13 German federal states in the digital health cohort study commonly known as DigiHero. Our findings revealed variations in vaccination rates based on sociodemographic factors. However, these factors had limited explanatory power regarding regional differences in vaccine uptake. In contrast, we found substantial correlations between regional support of specific parties during the last local elections and the vaccination uptake at the level of each administrative district. In conclusion, sociodemographic factors alone did not suffice to explain the regional disparities in vaccine uptake. Political stances can play a major role, although the current investigation did not assess individual political orientations but rather used only an ecological approach.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Myka Harun Sarajan
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Nadine Glaser
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Haematology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany;
| | - Matthias Girndt
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Daniel Sedding
- Mid-German Heart Centre, Department of Cardiology and Intensive Care Medicine, University Hospital, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Jessica I. Hoell
- Paediatric Haematology and Oncology, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
| | - Irene Moor
- Institute for Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany;
| | - Michael Gekle
- Julius-Bernstein-Institute of Physiology, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 6, 06110 Halle (Saale), Germany;
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometry and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany; (B.K.); (S.D.); (M.H.S.); (N.G.)
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17
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Schest S, Langer C, Stiegler Y, Karnuth B, Arends J, Stiegler H, Masetto T, Peter C, Grimmler M. Vaccine-induced SARS-CoV-2 antibody response: the comparability of S1-specific binding assays depends on epitope and isotype discrimination. Front Immunol 2023; 14:1257265. [PMID: 37965324 PMCID: PMC10641008 DOI: 10.3389/fimmu.2023.1257265] [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: 07/12/2023] [Accepted: 09/28/2023] [Indexed: 11/16/2023] Open
Abstract
Background Quantification of the SARS-CoV-2-specific immune response by serological immunoassays is critical for the management of the COVID-19 pandemic. In particular, neutralizing antibody titers to the viral spike (S) protein have been proposed as a correlate of protection (CoP). The WHO established the First International Standard (WHO IS) for anti-SARS-CoV-2 immunoglobulin (Ig) (NIBSC 20/136) to harmonize binding assays with the same antigen specificity by assigning the same unitage in binding antibody units (BAU)/ml. Method In this study, we analyzed the S1-specific antibody response in a cohort of healthcare workers in Germany (n = 76) during a three-dose vaccination course over 8.5 months. Subjects received either heterologous or homologous prime-boost vaccination with ChAdOx1 nCoV-19 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) or three doses of BNT162b2. Antibodies were quantified using three anti-S1 binding assays (ELISA, ECLIA, and PETIA) harmonized to the WHO IS. Serum levels of neutralizing antibodies were determined using a surrogate virus neutralization test (sVNT). Binding assays were compared using Spearman's rank correlation and Passing-Bablok regression. Findings All assays showed good correlation and similar antibody kinetics correlating with neutralizing potential. However, the assays show large proportional differences in BAU/ml. ECLIA and PETIA, which detect total antibodies against the receptor- binding domain (RBD) within the S1 subunit, interact similarly with the convalescent plasma-derived WHO IS but differently with vaccine serum, indicating a high sensitivity to the IgG/IgM/IgA ratio. Conclusion All three binding assays allow monitoring of the antibody response in COVID-19-vaccinated individuals. However, the assay-specific differences hinder the definition of a common protective threshold in BAU/ml. Our results highlight the need for the thoughtful use of conversion factors and consideration of method-specific differences. To improve the management of future pandemics and harmonize total antibody assays, we should strive for reference material with a well-characterized Ig isotype composition.
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Affiliation(s)
- Silvia Schest
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
- Health University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Claus Langer
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Yuriko Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Bianca Karnuth
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Jan Arends
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Hugo Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Thomas Masetto
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
| | - Christoph Peter
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Grimmler
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Idstein, Germany
- DiaServe Laboratories GmbH, Iffeldorf, Germany
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18
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Kilic SS. Editorial: Women in primary immunodeficiencies. Front Immunol 2023; 14:1268595. [PMID: 37901216 PMCID: PMC10602883 DOI: 10.3389/fimmu.2023.1268595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Sara Sebnem Kilic
- Department of Pediatric Immunology-Rheumatology, Faculty of Medicine, Bursa Uludag University, Bursa, Türkiye
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19
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Hollstein MM, Dierks S, Schön MP, Bergmann A, Abratis A, Eidizadeh A, Kaltenbach S, Schanz J, Groß U, Leha A, Kröger A, Andag R, Zautner AE, Fischer A, Erpenbeck L, Schnelle M. Humoral and cellular immune responses in fully vaccinated individuals with or without SARS-CoV-2 breakthrough infection: Results from the CoV-ADAPT cohort. J Med Virol 2023; 95:e29122. [PMID: 37787583 DOI: 10.1002/jmv.29122] [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: 03/31/2023] [Revised: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
Despite recent advances in prophylactic vaccination, SARS-CoV-2 infections continue to cause significant morbidity. A better understanding of immune response differences between vaccinated individuals with and without later SARS-CoV-2 breakthrough infection is urgently needed. CoV-ADAPT is a prospective long-term study comparing humoral (anti-spike-RBD-IgG, neutralization capacity, avidity) and cellular (spike-induced T-cell interferon-γ [IFN-γ] release) immune responses in individuals vaccinated against SARS-CoV-2 at four different time points (three before and one after third vaccination). In this cohort study, 62 fully vaccinated individuals presented with SARS-CoV-2 breakthrough infections vs 151 without infection 3-7 months following third vaccination. Breakthrough infections significantly increased anti-spike-RBD-IgG (p < 0.01), but not spike-directed T-cell IFN-γ release (TC) or antibody avidity. Despite comparable surrogate neutralization indices, the functional neutralization capacity against SARS-CoV-2-assessed via a tissue culture-based assay-was significantly higher following breakthrough vs no breakthrough infection. Anti-spike-RBD-IgG and antibody avidity decreased with age (p < 0.01) and females showed higher anti-spike-RBD-IgG (p < 0.01), and a tendency towards higher antibody avidity (p = 0.051). The association between humoral and cellular immune responses previously reported at various time points was lost in subjects after breakthrough infections (p = 0.807). Finally, a machine-learning approach based on our large immunological dataset (a total of 49 variables) from different time points was unable to predict breakthrough infections (area under the curve: 0.55). In conclusion, distinct differences in humoral vs cellular immune responses in fully vaccinated individuals with or without breakthrough infection could be demonstrated. Breakthrough infections predominantly drive the humoral response without boosting the cellular component. Breakthrough infections could not be predicted based on immunological data, which indicates a superior role of environmental factors (e.g., virus exposure) in individualized risk assessment.
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Affiliation(s)
- Moritz M Hollstein
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Sascha Dierks
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Armin Bergmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Anna Abratis
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Abass Eidizadeh
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Sarah Kaltenbach
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Julie Schanz
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Uwe Groß
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
- Institute of Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas Leha
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Kröger
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Research Group Innate Immunity and Infection, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Reiner Andag
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas E Zautner
- Institute of Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Center for Health and Medical Prevention (CHaMP), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Andreas Fischer
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
| | - Luise Erpenbeck
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
- Department of Dermatology, University of Münster, Münster, Germany
| | - Moritz Schnelle
- Department of Clinical Chemistry, University Medical Center Göttingen, Göttingen, Germany
- Interdisciplinary UMG Laboratory, University Medical Center Göttingen, Göttingen, Germany
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20
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Qi X, Yang Y, Gong B, Li Z, Liang D. Real-world effectiveness of azvudine for patients infected with the SARS-CoV-2 omicron subvariant BA.5 in an intensive care unit. J Thorac Dis 2023; 15:4925-4937. [PMID: 37868850 PMCID: PMC10586978 DOI: 10.21037/jtd-23-1093] [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: 07/15/2023] [Accepted: 09/13/2023] [Indexed: 10/24/2023]
Abstract
Background Azvudine (FNC) has been shown to be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but data regarding the Omicron BA.5.1.3 subvariant are lacking. This retrospective analysis investigated the effectiveness and safety of FNC against the SARS-CoV-2 Omicron BA.5.1.3 subvariant in a real-world setting, utilizing data from a patient cohort at our institution. Methods Data were retrospectively collected from patients admitted to the intensive care unit (ICU) of Sanya Central Hospital during the Sanya outbreak (August 13 to September 7, 2022). The patients, all infected with the Omicron BA.5.1.3 subvariant, were selected based on predefined inclusion and exclusion criteria. The patients were classified as the FNC (azvudine 5 mg, qd + standard supportive treatment) and non-FNC (standard supportive treatment only) groups. Results The study comprised 13 patients, with 6 and 7 in the FNC and non-FNC groups, respectively. Baseline data, clinical features, and imaging manifestations were generally similar between the two groups. However, patients administered FNC demonstrated significantly lower levels of inflammatory indicators at baseline. Although there was no significant difference in the duration of ICU stay between the FNC and non-FNC groups, overall ICU stay appeared to be reduced in the FNC group. Conclusions FNC emerges as a feasible treatment against the Omicron BA.5.1.3 subvariant. It may reduce ICU stay and demonstrate a promising safety profile without major side effects or disruption to normal physiological parameters.
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Affiliation(s)
- Xiuping Qi
- Department of Clinical Pharmacy, Sanya Central Hospital (The Third People’s Hospital of Hainan Province), Sanya, China
| | - Yun Yang
- Department of Intensive Care Medicine, Sanya Central Hospital (The Third People’s Hospital of Hainan Province), Sanya, China
| | - Baoqiang Gong
- Department of Intensive Care Medicine, Sanya Central Hospital (The Third People’s Hospital of Hainan Province), Sanya, China
| | - Zhiwei Li
- Department of Radiology, Sanya Central Hospital (The Third People’s Hospital of Hainan Province), Sanya, China
| | - Dong Liang
- Department of Respiratory and Critical Care Medicine, Sanya Central Hospital (The Third People’s Hospital of Hainan Province), Sanya, China
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21
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Flisiak R, Zarębska-Michaluk D, Dobrowolska K, Rorat M, Rogalska M, Kryńska JA, Moniuszko-Malinowska A, Czupryna P, Kozielewicz D, Jaroszewicz J, Sikorska K, Bednarska A, Piekarska A, Rzymski P. Change in the Clinical Picture of Hospitalized Patients with COVID-19 between the Early and Late Period of Dominance of the Omicron SARS-CoV-2 Variant. J Clin Med 2023; 12:5572. [PMID: 37685639 PMCID: PMC10488127 DOI: 10.3390/jcm12175572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
This study aimed to compare the clinical picture of COVID-19 in the initial and later period of Omicron dominance and to identify populations still at risk. A retrospective comparison of the clinical data of 965 patients hospitalized during the early period of Omicron's dominance (EO, January-June 2022) with 897 patients from a later period (LO, July 2022-April 2023) from the SARSTer database was performed. Patients hospitalized during LO, compared to EO, were older, had a better clinical condition on admission, had a lower need for oxygen and mechanical ventilation, had less frequent lung involvement in imaging, and showed much faster clinical improvement. Moreover, the overall mortality during EO was 14%, higher than that in LO-9%. Despite the milder course of the disease, mortality exceeding 15% was similar in both groups among patients with lung involvement. The accumulation of risk factors such as an age of 60+, comorbidities, lung involvement, and oxygen saturation <90% resulted in a constant need for oxygen in 98% of patients, an 8% risk of mechanical ventilation, and a 30% mortality rate in the LO period. Multiple logistic regression revealed lower odds of death during the LO phase. Despite the milder course of infections caused by the currently dominant subvariants, COVID-19 prophylaxis is necessary in people over 60 years of age, especially those with comorbidities, and in the case of pneumonia and respiratory failure.
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Affiliation(s)
- Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland; (R.F.); (M.R.); (J.A.K.)
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland;
| | | | - Marta Rorat
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, 51-149 Wrocław, Poland;
- Department of Forensic Medicine, Wrocław Medical University, 50-367 Wrocław, Poland
| | - Magdalena Rogalska
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland; (R.F.); (M.R.); (J.A.K.)
| | - Justyna Anna Kryńska
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland; (R.F.); (M.R.); (J.A.K.)
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, 15-809 Białystok, Poland; (A.M.-M.); (P.C.)
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, 15-809 Białystok, Poland; (A.M.-M.); (P.C.)
| | - Dorota Kozielewicz
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 87-100 Toruń, Poland;
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, 41-902 Bytom, Poland;
| | - Katarzyna Sikorska
- Division of Tropical and Parasitic Diseases, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Agnieszka Bednarska
- Department of Adult’s Infectious Diseases, Medical University of Warsaw, Hospital for Infectious Diseases, 02-091 Warsaw, Poland;
| | - Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, 90-419 Łódź, Poland;
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznań University of Medical Sciences, 60-806 Poznań, Poland;
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22
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Rosso A, Flacco ME, Soldato G, Di Martino G, Acuti Martellucci C, Carota R, De Benedictis M, Di Marco G, Di Luzio R, Fiore M, Caponetti A, Manzoli L. COVID-19 Vaccination Effectiveness in the General Population of an Italian Province: Two Years of Follow-Up. Vaccines (Basel) 2023; 11:1325. [PMID: 37631893 PMCID: PMC10459219 DOI: 10.3390/vaccines11081325] [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: 07/10/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
We carried out a cohort study on the overall population of the province of Pescara, Italy, to assess the real-world effectiveness of SARS-CoV-2 vaccination against infection, severe, or lethal COVID-19, two years after the start of the vaccination campaign. We included all the resident or domiciled subjects, and extracted the official demographic, vaccination, COVID-19, hospital and co-pay exemption datasets from 1 January 2021, up to 15 February 2023. Cox proportional hazards analyses were adjusted for gender, age, diabetes, hypertension, COPD, major cardio- and cerebrovascular events, cancer, and kidney diseases. Throughout the follow-up (466 days on average), 186,676 subjects received greater than or equal to three vaccine doses (of ChAdOx1 nCoV-19, BNT162b2, mRNA-1273, NVX-CoV2373, or JNJ-78436735), 47,610 two doses, 11,452 one dose, and 44,989 none. Overall, 40.4% of subjects were infected with SARS-CoV-2. Of them, 2.74% had severe or lethal (1.30%) COVID-19. As compared to the unvaccinated, the individuals who received greater than or equal to one booster dose showed a ≥85% lower risk of severe or lethal COVID-19. A massive impact of vaccination was found among the elderly: 22.0% of the unvaccinated, infected individuals died, as opposed to less than 3% of those who received greater than or equal to three vaccine doses. No protection against infection was observed, although this finding was certainly influenced by the Italian restriction policies to control the pandemic. Importantly, during the Omicron predominance period, only the group who received at least a booster dose showed a reduced risk of COVID-19-related death.
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Affiliation(s)
- Annalisa Rosso
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (A.R.); (C.A.M.)
| | - Maria Elena Flacco
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (A.R.); (C.A.M.)
| | - Graziella Soldato
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Giuseppe Di Martino
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Cecilia Acuti Martellucci
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (A.R.); (C.A.M.)
| | - Roberto Carota
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Marco De Benedictis
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Graziano Di Marco
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Rossano Di Luzio
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Matteo Fiore
- Department of Medical and Surgical Sciences, University of Bologna, 40100 Bologna, Italy;
| | - Antonio Caponetti
- Local Health Unit of Pescara, 65124 Pescara, Italy; (G.S.); (G.D.M.); (R.C.); (M.D.B.); (G.D.M.); (R.D.L.); (A.C.)
| | - Lamberto Manzoli
- Department of Medical and Surgical Sciences, University of Bologna, 40100 Bologna, Italy;
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23
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Talha S, Lamrous S, Kassegne L, Lefebvre N, Zulfiqar AA, Tran Ba Loc P, Geny M, Meyer N, Hajjam M, Andrès E, Geny B. Early Hospital Discharge Using Remote Monitoring for Patients Hospitalized for COVID-19, Regardless of Need for Home Oxygen Therapy: A Descriptive Study. J Clin Med 2023; 12:5100. [PMID: 37568502 PMCID: PMC10419442 DOI: 10.3390/jcm12155100] [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: 06/02/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
AIM Since beds are unavailable, we prospectively investigated whether early hospital discharge will be safe and useful in patients hospitalized for COVID-19, regardless of their need for home oxygen therapy. POPULATION AND METHODS Extending the initial inclusion criteria, 62 patients were included and 51 benefited from home telemonitoring, mainly assessing clinical parameters (blood pressure, heart rate, respiratory rate, dyspnea, temperature) and peripheral saturation (SpO2) at follow-up. RESULTS 47% of the patients were older than 65 years; 63% needed home oxygen therapy and/or presented with more than one comorbidity. At home, the mean time to dyspnea and tachypnea resolutions ranged from 21 to 24 days. The mean oxygen-weaning duration was 13.3 ± 10.4 days, and the mean SpO2 was 95.7 ± 1.6%. The nurses and/or doctors managed 1238 alerts. Two re-hospitalizations were required, related to transient chest pain or pulmonary embolism, but no death occurred. Patient satisfaction was good, and 743 potential days of hospitalization were saved for other patients. CONCLUSION The remote monitoring of vital parameters and symptoms is safe, allowing for early hospital discharge in patients hospitalized for COVID-19, whether or not home oxygen therapy was required. Oxygen tapering outside the hospital allowed for a greater reduction in hospital stay. Randomized controlled trials are necessary to confirm this beneficial effect.
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Affiliation(s)
- Samy Talha
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67000 Strasbourg, France;
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
| | - Sid Lamrous
- UTBM, CNRS, FEMTO-ST Institute, 90000 Belfort, France;
| | - Loic Kassegne
- Pneumology Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Nicolas Lefebvre
- Infectious Disease Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Abrar-Ahmad Zulfiqar
- Internal Medicine Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Pierre Tran Ba Loc
- Public Health Department, University Hospital Strasbourg, 67000 Strasbourg, France; (P.T.B.L.); (N.M.)
| | - Marie Geny
- Association for Assistance to Victims, Place Alfred de Musset, BP 3314, CEDEX, 27033 Evreux, France;
| | - Nicolas Meyer
- Public Health Department, University Hospital Strasbourg, 67000 Strasbourg, France; (P.T.B.L.); (N.M.)
| | | | - Emmanuel Andrès
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
- Internal Medicine Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Bernard Geny
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67000 Strasbourg, France;
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
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Pazos-Guerra M, Ruiz-Sánchez JG, Pérez-Candel X, López-Nevado C, Hernández-Olmeda F, Cuesta-Hernández M, Martín-Sánchez J, Calle-Pascual AL, Runkle-de la Vega I. Inappropriate therapy of euvolemic hyponatremia, the most frequent type of hyponatremia in SARS-CoV-2 infection, is associated with increased mortality in COVID-19 patients. Front Endocrinol (Lausanne) 2023; 14:1227059. [PMID: 37560297 PMCID: PMC10408442 DOI: 10.3389/fendo.2023.1227059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/30/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction Admission hyponatremia, frequent in patients hospitalized for COVID-19, has been associated with increased mortality. However, although euvolemic hyponatremia secondary to the Syndrome of Inappropriate Antidiuresis (SIAD) is the single most common cause of hyponatremia in community-acquired pneumonia (CAP), a thorough and rigorous assessment of the volemia of hyponatremic COVID-19 subjects has yet to be described. We sought to identify factors contributing to mortality and hospital length-of-stay (LOS) in hospitalized COVID-19 patients admitted with hyponatremia, taking volemia into account. Method Retrospective study of 247 patients admitted with COVID-19 to a tertiary hospital in Madrid, Spain from March 1st through March 30th, 2020, with a glycemia-corrected serum sodium level (SNa) < 135 mmol/L. Variables were collected at admission, at 2nd-3rd day of hospitalization, and ensuing days when hyponatremia persisted. Admission volemia (based on both physical and analytical parameters), therapy, and its adequacy as a function of volemia, were determined. Results Age: 68 years [56-81]; 39.9% were female. Median admission SNa was 133 mmol/L [131- 134]. Hyponatremia was mild (SNa 131-134 mmol/L) in 188/247 (76%). Volemia was available in 208/247 patients; 57.2% were euvolemic and the rest (42.8%) hypovolemic. Hyponatremia was left untreated in 154/247 (62.3%) patients. Admission therapy was not concordant with volemia in 43/84 (51.2%). In fact, the majority of treated euvolemic patients received incorrect therapy with isotonic saline (37/41, 90.2%), whereas hypovolemics did not (p=0.001). The latter showed higher mortality rates than those receiving adequate or no therapy (36.7% vs. 19% respectively, p=0.023). The administration of isotonic saline to euvolemic hyponatremic subjects was independently associated with an elevation of in-hospital mortality (Odds Ratio: 3.877, 95%; Confidence Interval: 1.25-12.03). Conclusion Hyponatremia in COVID-19 is predominantly euvolemic. Isotonic saline infusion therapy in euvolemic hyponatremic COVID-19 patients can lead to an increased mortality rate. Thus, an exhaustive and precise volemic assessment of the hyponatremic patient with CAP, particularly when due to COVID-19, is mandatory before instauration of therapy, even when hyponatremia is mild.
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Affiliation(s)
- Mario Pazos-Guerra
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Jorge Gabriel Ruiz-Sánchez
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Fundación Jiménez-Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Xavier Pérez-Candel
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Celia López-Nevado
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Fernando Hernández-Olmeda
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Martin Cuesta-Hernández
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Javier Martín-Sánchez
- Medicine II Department, Universidad Complutense de Madrid, Madrid, Spain
- Emergency Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Emergency Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Medicine II Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Isabelle Runkle-de la Vega
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
- Medicine II Department, Universidad Complutense de Madrid, Madrid, Spain
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