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Huang T, Yu J, Zhang S, Teng D, Dai D, Zhu Y, Gao L. Immunogenicity and safety of concomitant administration of recombinant COVID-19 vaccine and quadrivalent inactivated influenza vaccine in Chinese adults: An open-label, randomized, controlled trial. Hum Vaccin Immunother 2024; 20:2330770. [PMID: 38602539 PMCID: PMC11017946 DOI: 10.1080/21645515.2024.2330770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/12/2024] Open
Abstract
The immunogenicity and safety of the concomitant administration of recombinant COVID-19 vaccine and quadrivalent inactivated influenza vaccine (Split Virion) (QIIV) in Chinese adults are unclear. In this open-label, randomized controlled trial, participants aged ≥ 18 years were recruited. Eligible healthy adults were randomly assigned (1:1) to receive QIIV at the same time as the first dose of COVID-19 vaccine (simultaneous-group) or 14 days after the second dose of COVID-19 vaccine (non-simultaneous-group). The primary outcome was to compare the difference in immunogenicity of QIIV (H1N1, H3N2, Yamagata, and Victoria) between the two groups. A total of 299 participants were enrolled, 149 in the simultaneous-group and 150 in the non-simultaneous-group. There were no significant differences in geometric mean titer (GMT) [H1N1: 386.4 (95%CI: 299.2-499.0) vs. 497.4 (95%CI: 377.5-655.3); H3N2: 66.9 (95%CI: 56.1-79.8) vs. 81.4 (95%CI: 67.9-97.5); Yamagata: 95.6 (95%CI: 79.0-115.8) vs. 74.3 (95%CI: 58.6-94.0); and Victoria: 48.5 (95%CI: 37.6-62.6) vs. 65.8 (95%CI: 49.0-88.4)] and seroconversion rate (H1N1: 87.5% vs. 90.1%; H3N2: 58.1% vs. 62.0%; Yamagata: 75.0% vs. 64.5%; and Victoria: 55.1% vs. 62.8%) of QIIV antibodies between the simultaneous and non-simultaneous groups. For the seroprotection rate of QIIV antibodies, a higher seroprotection rate of Yamagata antibody was observed only in the simultaneous-group than in the non-simultaneous-group [86.0% vs. 76.0%, p = .040]. In addition, no significant difference in adverse events was observed between the two groups (14.2% vs. 23.5%, p = .053). In conclusion, no immune interference or safety concerns were found for concomitant administration of COVID-19 vaccine with QIIV in adults aged ≥ 18 years.
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Affiliation(s)
- Tao Huang
- Department of Vaccine Clinical Observation Center, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, P.R. China
| | - Jun Yu
- Jiangsu GDK Biological Technology Co, Ltd, Taizhou, Jiangsu, P.R. China
| | - Siyuan Zhang
- Department of Vaccine Clinical Observation Center, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, P.R. China
| | - Dewei Teng
- Department of Vaccine Clinical Observation Center, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, P.R. China
| | - Defang Dai
- Department of Vaccine Clinical Observation Center, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, P.R. China
| | - Yinbiao Zhu
- Jiangsu GDK Biological Technology Co, Ltd, Taizhou, Jiangsu, P.R. China
| | - Lidong Gao
- Department of Vaccine Clinical Observation Center, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, P.R. China
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Sun R, Zhang X, Hou J, Jia W, Li P, Song C. Development and validation of nomogram for predicting the risk of transferring to the ICU for children with influenza. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04898-5. [PMID: 39002105 DOI: 10.1007/s10096-024-04898-5] [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: 05/16/2024] [Accepted: 07/08/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Development of a nomogram model for predicting the magnitude of risk of transferring hospitalized children with influenza to the ICU. METHODS In a single-center retrospective study, 318 children with influenza who were hospitalized in our hospital from January 2018 to August 2023 were collected as study subjects. Children with influenza were randomly assigned to the training set and validation set in a ratio of 4:1. In the training set, risk factors were identified using univariate and multivariate logistic regression analyses, and a nomogram model was created on this basis. The validation set was used to evaluate the predictive power of the model. RESULTS Multifactorial logistic regression analysis revealed six independent risk factors for transfer to the ICU in hospitalized children with influenza, including elevated peripheral white blood cell counts, elevated large platelet ratios, reduced mean platelet width, reduced complement C3, elevated serum globulin levels, and reduced total immunoglobulin M levels. Using these six metrics as predictors to construct a nomogram graphical model, the C-index was 0.970 (95% Cl: 0.953-0.988). The areas under the curve for the training and validation sets were 0.966 (95%Cl 0.947-0.985) and 0.919 (95%Cl 0.851-0.986), respectively. CONCLUSION A nomogram for predicting the risk of transferring to the ICU for children with influenza was developed and validated, which demonstrates good calibration and clinical benefits.
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Affiliation(s)
- Ruiyang Sun
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China
| | - Xue Zhang
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China
| | - Jiapu Hou
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China
| | - Wanyu Jia
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China
| | - Peng Li
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China
| | - Chunlan Song
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, 450052, China.
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Yin Y, Lai M, Lu K, Jiang X, Chen Z, Li T, Wang L, Zhang Y, Peng Z. Association between ambient temperature and influenza prevalence: A nationwide time-series analysis in 201 Chinese cities from 2013 to 2018. ENVIRONMENT INTERNATIONAL 2024; 189:108783. [PMID: 38823156 DOI: 10.1016/j.envint.2024.108783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Temperature affects influenza transmission; however, currently, limited evidence exists about its effect in China at the national and city levels as well as how temperature can be integrated into influenza interventions. METHODS Meteorological, pollutant, and influenza data from 201 cities in mainland China between 2013 and 2018 were analyzed at both the city and national levels to investigate the relationship between temperature and influenza prevalence. We examined the impact of temperature on the time-varying reproduction number (Rt) using generalized additive quasi-Poisson regression models combined with the distributed lag nonlinear model. Threshold temperatures were determined for seven regions based on the early warning threshold of serious influenza outbreaks, set at Rt = 1.2. A multivariate random-effects meta-analysis was employed to assess region-specific associations. The excess risk (ER) index was defined to investigate the correlation between Rt and temperature, modified based on seasonal and regional characteristics. RESULTS At the national level and in the central, northern, northwestern, and southern regions, temperature was found to be negatively correlated with relative risk, whereas the shapes of the data curves for the eastern, southwestern, and northeastern regions were not well defined. Low temperatures had an observable effect on influenza prevalence; however, the effects of high temperatures were not obvious. At an Rt of 1.2, the threshold temperatures for reaching a warning for serious influenza outbreaks were - 24.3 °C in the northeastern region, 16.6 °C in the northwestern region, and between 1℃ and 10 °C in other regions. CONCLUSION The study findings revealed that temperature had a varying effect on influenza transmission trends (Rt) across different regions in China. By identifying region-specific temperature thresholds at Rt = 1.2, more effective early warning systems for influenza outbreaks could be tailored. These findings emphasize the significance of the region-specific adaptation of influenza prevention and control measures.
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Affiliation(s)
- Yi Yin
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Miao Lai
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Kailai Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Jiang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ziying Chen
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liping Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanping Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
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Kim SH, Españo E, Padasas BT, Son JH, Oh J, Webby RJ, Lee YR, Park CS, Kim JK. Influenza Virus-Derived CD8 T Cell Epitopes: Implications for the Development of Universal Influenza Vaccines. Immune Netw 2024; 24:e19. [PMID: 38974213 PMCID: PMC11224667 DOI: 10.4110/in.2024.24.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 07/09/2024] Open
Abstract
The influenza virus poses a global health burden. Currently, an annual vaccine is used to reduce influenza virus-associated morbidity and mortality. Most influenza vaccines have been developed to elicit neutralizing Abs against influenza virus. These Abs primarily target immunodominant epitopes derived from hemagglutinin (HA) or neuraminidase (NA) of the influenza virus incorporated in vaccines. However, HA and NA are highly variable proteins that are prone to antigenic changes, which can reduce vaccine efficacy. Therefore, it is essential to develop universal vaccines that target immunodominant epitopes derived from conserved regions of the influenza virus, enabling cross-protection among different virus variants. The internal proteins of the influenza virus serve as ideal targets for universal vaccines. These internal proteins are presented by MHC class I molecules on Ag-presenting cells, such as dendritic cells, and recognized by CD8 T cells, which elicit CD8 T cell responses, reducing the likelihood of disease and influenza viral spread by inducing virus-infected cell apoptosis. In this review, we highlight the importance of CD8 T cell-mediated immunity against influenza viruses and that of viral epitopes for developing CD8 T cell-based influenza vaccines.
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Affiliation(s)
- Sang-Hyun Kim
- Department of Pharmacy, Korea University College of Pharmacy, Sejong 30019, Korea
- Department of Pharmaceutics, College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Erica Españo
- Department of Pharmacy, Korea University College of Pharmacy, Sejong 30019, Korea
| | | | - Ju-Ho Son
- Department of Pharmacy, Korea University College of Pharmacy, Sejong 30019, Korea
| | - Jihee Oh
- Department of Pharmacy, Korea University College of Pharmacy, Sejong 30019, Korea
| | - Richard J. Webby
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN 38195, USA
| | - Young-Ran Lee
- Bio-Convergence R&D Division, Korea Institute of Ceramic Engineering and Technology, Cheongju 28160, Korea
| | - Chan-Su Park
- Department of Pharmaceutics, College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Jeong-Ki Kim
- Department of Pharmacy, Korea University College of Pharmacy, Sejong 30019, Korea
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Xu MM, Kang JY, Wang QY, Zuo X, Tan YY, Wei YY, Zhang DW, Zhang L, Wu HM, Fei GH. Melatonin improves influenza virus infection-induced acute exacerbation of COPD by suppressing macrophage M1 polarization and apoptosis. Respir Res 2024; 25:186. [PMID: 38678295 PMCID: PMC11056066 DOI: 10.1186/s12931-024-02815-0] [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: 02/19/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Influenza A viruses (IAV) are extremely common respiratory viruses for the acute exacerbation of chronic obstructive pulmonary disease (AECOPD), in which IAV infection may further evoke abnormal macrophage polarization, amplify cytokine storms. Melatonin exerts potential effects of anti-inflammation and anti-IAV infection, while its effects on IAV infection-induced AECOPD are poorly understood. METHODS COPD mice models were established through cigarette smoke exposure for consecutive 24 weeks, evaluated by the detection of lung function. AECOPD mice models were established through the intratracheal atomization of influenza A/H3N2 stocks in COPD mice, and were injected intraperitoneally with melatonin (Mel). Then, The polarization of alveolar macrophages (AMs) was assayed by flow cytometry of bronchoalveolar lavage (BAL) cells. In vitro, the effects of melatonin on macrophage polarization were analyzed in IAV-infected Cigarette smoking extract (CSE)-stimulated Raw264.7 macrophages. Moreover, the roles of the melatonin receptors (MTs) in regulating macrophage polarization and apoptosis were determined using MTs antagonist luzindole. RESULTS The present results demonstrated that IAV/H3N2 infection deteriorated lung function (reduced FEV20,50/FVC), exacerbated lung damages in COPD mice with higher dual polarization of AMs. Melatonin therapy improved airflow limitation and lung damages of AECOPD mice by decreasing IAV nucleoprotein (IAV-NP) protein levels and the M1 polarization of pulmonary macrophages. Furthermore, in CSE-stimulated Raw264.7 cells, IAV infection further promoted the dual polarization of macrophages accompanied with decreased MT1 expression. Melatonin decreased STAT1 phosphorylation, the levels of M1 markers and IAV-NP via MTs reflected by the addition of luzindole. Recombinant IL-1β attenuated the inhibitory effects of melatonin on IAV infection and STAT1-driven M1 polarization, while its converting enzyme inhibitor VX765 potentiated the inhibitory effects of melatonin on them. Moreover, melatonin inhibited IAV infection-induced apoptosis by suppressing IL-1β/STAT1 signaling via MTs. CONCLUSIONS These findings suggested that melatonin inhibited IAV infection, improved lung function and lung damages of AECOPD via suppressing IL-1β/STAT1-driven macrophage M1 polarization and apoptosis in a MTs-dependent manner. Melatonin may be considered as a potential therapeutic agent for influenza virus infection-induced AECOPD.
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MESH Headings
- Animals
- Melatonin/pharmacology
- Pulmonary Disease, Chronic Obstructive/drug therapy
- Pulmonary Disease, Chronic Obstructive/metabolism
- Pulmonary Disease, Chronic Obstructive/virology
- Pulmonary Disease, Chronic Obstructive/physiopathology
- Mice
- Apoptosis/drug effects
- RAW 264.7 Cells
- Influenza A Virus, H3N2 Subtype/drug effects
- Orthomyxoviridae Infections/drug therapy
- Orthomyxoviridae Infections/metabolism
- Orthomyxoviridae Infections/immunology
- Mice, Inbred C57BL
- Male
- Macrophages/drug effects
- Macrophages/metabolism
- Disease Progression
- Cell Polarity/drug effects
- Disease Models, Animal
- Macrophages, Alveolar/drug effects
- Macrophages, Alveolar/metabolism
- Macrophages, Alveolar/virology
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Affiliation(s)
- Meng-Meng Xu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Jia-Ying Kang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Qiu-Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Xing Zuo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Yuan-Yuan Tan
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Emergency Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Yuan-Yuan Wei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Da-Wei Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Ling Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Hui-Mei Wu
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
- Anhui Geriatric Institute, Department of Geriatric Respiratory Critical and Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Guang-He Fei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
- Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
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Yadegarynia D, Keyvanfar A, Keyvani H, Tehrani S, Sali S, Abolghasemi S. Immunogenicity and safety of a quadrivalent recombinant influenza vaccine manufactured in Iran (FluGuard) in volunteers aged 18-60 years: A double-blind, non-inferiority, randomized controlled trial. Vaccine 2024; 42:2254-2259. [PMID: 38423811 DOI: 10.1016/j.vaccine.2024.02.073] [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: 10/26/2023] [Revised: 02/17/2024] [Accepted: 02/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND This study aimed to evaluate the non-inferiority of the FluGuard (a quadrivalent recombinant vaccine manufactured by Nivad Pharmed Salamat Company in Iran) by comparing its immunogenicity and safety with Vaxigrip Tetra (a quadrivalent inactivated vaccine manufactured by Sanofi Pasteur in France). MATERIALS AND METHODS In this double-blind, randomized controlled trial, eligible volunteers aged 18-60 were randomized to receive either FluGuard or Vaxigrip Tetra vaccines. Immunogenicity was evaluated using the Hemagglutination Inhibition (HAI) assay and reported with the geometric mean titer (GMT), seroprotection, and seroconversion. In addition, vaccine safety was assessed by interviewing participants through phone calls. RESULTS Out of 110 randomized volunteers, 51 and 53 were entered into the final analysis in the Vaxigrip and FluGuard groups, respectively. Vaxigrip had a higher seroprotection rate for the H1N1 strain compared with FluGuard (98 % vs. 91 %). Besides, FluGuard had higher seroprotection rates for H3N2 (74 % vs. 69 %), B-Yamagata (87 % vs. 84 %), and B-Victoria (66 % vs. 41 %) strains compared with Vaxigrip. In all four strains, FluGuard was non-inferior to Vaxigrip with the upper bounds of the 95 % CI on the ratio of the GMTs < 1.5: H1N1 (1.25), H3N2 (0.94), B-Yamagata (0.62), and B-Victoria (0.59). Furthermore, FluGuard was non-inferior to Vaxigrip with the upper bounds of the 95 % CI on the difference between the seroconversion rates < 10 %: H1N1 (2 %), H3N2 (10 %), B-Yamagata (-10 %), and B-Victoria (-29 %). The prevalence of solicited adverse drug reactions did not differ between groups. Furthermore, participants did not experience serious adverse events. CONCLUSION Our findings support the non-inferiority of the FluGuard vaccine to the Vaxigrip vaccine regarding immunogenicity and safety. CLINICAL TRIAL REGISTRY The study protocol was approved by the Iranian Registry of Clinical Trials (IRCT20210901052358N5).
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Affiliation(s)
- Davood Yadegarynia
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirreza Keyvanfar
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hossein Keyvani
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Tehrani
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahnaz Sali
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Abolghasemi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Allen JD, Ross TM. mRNA vaccines encoding computationally optimized hemagglutinin elicit protective antibodies against future antigenically drifted H1N1 and H3N2 influenza viruses isolated between 2018-2020. Front Immunol 2024; 15:1334670. [PMID: 38533508 PMCID: PMC10963417 DOI: 10.3389/fimmu.2024.1334670] [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: 11/07/2023] [Accepted: 02/12/2024] [Indexed: 03/28/2024] Open
Abstract
Background The implementation of mRNA vaccines against COVID-19 has successfully validated the safety and efficacy of the platform, while at the same time revealing the potential for their applications against other infectious diseases. Traditional seasonal influenza vaccines often induce strain specific antibody responses that offer limited protection against antigenically drifted viruses, leading to reduced vaccine efficacy. Modern advances in viral surveillance and sequencing have led to the development of in-silico methodologies for generating computationally optimized broadly reactive antigens (COBRAs) to improve seasonal influenza vaccines. Methods In this study, immunologically naïve mice were intramuscularly vaccinated with mRNA encoding H1 and H3 COBRA hemagglutinins (HA) or wild-type (WT) influenza HAs encapsulated in lipid nanoparticles (LNPs). Results Mice vaccinated with H1 and H3 COBRA HA-encoding mRNA vaccines generated robust neutralizing serum antibody responses against more antigenically distinct contemporary and future drifted H1N1 and H3N2 influenza strains than those vaccinated with WT H1 and H3 HA-encoding mRNA vaccines. The H1 and H3 COBRA HA-encoding mRNA vaccines also prevented influenza illness, including severe disease in the mouse model against H1N1 and H3N2 viruses. Conclusions This study highlights the potential benefits of combining universal influenza antigen design technology with modern vaccine delivery platforms and exhibits how these vaccines can be advantageous over traditional WT vaccine antigens at eliciting superior protective antibody responses against a broader number of influenza virus isolates.
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Affiliation(s)
- James D Allen
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, United States
- Department of Infectious Diseases, University of Georgia, Athens, GA, United States
- Florida Research and Innovation Center, Cleveland Clinic, Port Saint Lucie, FL, United States
| | - Ted M Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, United States
- Department of Infectious Diseases, University of Georgia, Athens, GA, United States
- Florida Research and Innovation Center, Cleveland Clinic, Port Saint Lucie, FL, United States
- Department of Infection Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
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Malița MA, Manolescu LSC, Perieanu VȘ, Babiuc I, Marcov EC, Ionescu C, Beuran IA, Prasacu I, Perieanu MV, Voinescu I, Radu MC, Burlibasa L, Dumitrescu AI, Burlibasa M. COVID-19 and flu vaccination in Romania, post pandemic lessons in healthcare workers and general population. PLoS One 2024; 19:e0299568. [PMID: 38451954 PMCID: PMC10919663 DOI: 10.1371/journal.pone.0299568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Influenza and corona viruses generate vaccine preventable diseases and have pandemic potential, frequently dramatic. A co-infection with these viruses, may be a new worldwide threat, researchers name it flurona. The aim of our study is to assess flu and COVID-19 Romanian vaccination for 2022-2023 season and the factor associated with higher odds to receive flu and COVID-19 vaccine. METHODS An analytical cross-sectional observational survey was conducted in the general population; a self-administered questionnaire was used. RESULTS 1056 responders were analyzed, mean age 32.08 ±13.36 years (limits:18-76), majority, 880 (83.33%), from urban areas, 608 (57.58%), high school graduated, 400 (37.88%) parents. More than half of the responders were healthcare workers, 582 (55.11%), also considered study population. In the study group, 796 (73.37%) responders consider flurona vaccination useful; and 872 (82.57%) responders consider that no sanctions are needed for not flurona vaccinating. In the 2022-2023 season, 162 (15.34%) responders vaccinated against the flu and 300 (28.41%) against COVID-19. The factor associated with higher odds to receive flu and COVID-19 vaccine was the habit of flu vaccination: for flu (OR = 58.43; 95% CI: (34.95-97.67)) and for COVID-19 (OR = 1.67; 95% CI: (1.21-2.31)). Other factors such as having university degree (OR = 1.46; 95% CI: (1.08-1.98)) and being a healthcare worker, (OR = 1.41; 95% CI: (1.07-1.87)) were influencing factors only for adult COVID-19 vaccination in the 2022-2023 season. In the parents' group, in 2022-2023 season, only 48 (12%) vaccinated their children against the flu and 68 (17%) against COVID-19, mostly parents that vaccinated themselves, p<0.001. In the 2022-2023 season, there were only 82 (7.65%) responders vaccinated against both diseases. Logistic regression analysis showed that no factor analyzed influenced the flurona vaccinated parent's decision to vaccinate their children for flu and for COVID-19. CONCLUSIONS In the season 2022-2023, in Romania, the vaccination against flu and COVOD-19 is low, in adults and children as well. More efforts must be done to increase flurona vaccination, public health educational programs are strongly needed. Children, that are at greater risk when co-infecting with these viruses, must be vaccinated, school vaccination programs should be considered.
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Affiliation(s)
- Mădălina Adriana Malița
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Loredana Sabina Cornelia Manolescu
- Department of Microbiology, Parasitology and Virology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Viorel Ștefan Perieanu
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Iuliana Babiuc
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Elena Cristina Marcov
- Department of Restorative Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Camelia Ionescu
- Department of Dental Prostheses, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Adriana Beuran
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Prasacu
- Department of Fundamental Sciences, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mădălina Violeta Perieanu
- Department of Restorative Dentistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioana Voinescu
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihaela Corina Radu
- Department of Microbiology, Parasitology and Virology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Liliana Burlibasa
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Anca Irina Dumitrescu
- Department of Fundamental Sciences, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Burlibasa
- Department of Dental Technology, Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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9
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Gheitasi H, Sabbaghian M, Fadaee M, Mohammadzadeh N, Shekarchi AA, Poortahmasebi V. The relationship between autophagy and respiratory viruses. Arch Microbiol 2024; 206:136. [PMID: 38436746 DOI: 10.1007/s00203-024-03838-3] [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: 11/26/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 03/05/2024]
Abstract
Respiratory viruses have caused severe global health problems and posed essential challenges to the medical community. In recent years, the role of autophagy as a critical process in cells in viral respiratory diseases has been noticed. One of the vital catabolic biological processes in the body is autophagy. Autophagy contributes to energy recovery by targeting and selectively directing foreign microorganisms, organelles, and senescent intracellular proteins to the lysosome for degradation and phagocytosis. Activation or suppression of autophagy is often initiated when foreign pathogenic organisms such as viruses infect cells. Because of its antiviral properties, several viruses may escape or resist this process by encoding viral proteins. Viruses can also use autophagy to enhance their replication or prolong the persistence of latent infections. Here, we provide an overview of autophagy and respiratory viruses such as coronavirus, rhinovirus, parainfluenza, influenza, adenovirus, and respiratory syncytial virus, and examine the interactions between them and the role of autophagy in the virus-host interaction process and the resulting virus replication strategy.
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Affiliation(s)
- Hamidreza Gheitasi
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Sabbaghian
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Manouchehr Fadaee
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader Mohammadzadeh
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akbar Shekarchi
- Department of Pathology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahdat Poortahmasebi
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran.
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10
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Chen D, Zhang T, Chen S, Ru X, Shao Q, Ye Q, Cheng D. The effect of nonpharmaceutical interventions on influenza virus transmission. Front Public Health 2024; 12:1336077. [PMID: 38389947 PMCID: PMC10881707 DOI: 10.3389/fpubh.2024.1336077] [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: 11/10/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background The use of nonpharmaceutical interventions (NPIs) during severe acute respiratory syndrome 2019 (COVID-19) outbreaks may influence the spread of influenza viruses. This study aimed to evaluate the impact of NPIs against SARS-CoV-2 on the epidemiological features of the influenza season in China. Methods We conducted a retrospective observational study analyzing influenza monitoring data obtained from the China National Influenza Center between 2011 and 2023. We compared the changes in influenza-positive patients in the pre-COVID-19 epidemic, during the COVID-19 epidemic, and post-COVID-19 epidemic phases to evaluate the effect of NPIs on influenza virus transmission. Results NPIs targeting COVID-19 significantly suppressed influenza activity in China from 2019 to 2022. In the seventh week after the implementation of the NPIs, the number of influenza-positive patients decreased by 97.46% in southern regions of China and 90.31% in northern regions of China. However, the lifting of these policies in December 2022 led to an unprecedented surge in influenza-positive cases in autumn and winter from 2022 to 2023. The percentage of positive influenza cases increased by 206.41% (p < 0.001), with high positivity rates reported in both the northern and southern regions of China. Conclusion Our findings suggest that NPIs against SARS-CoV-2 are effective at controlling influenza epidemics but may compromise individuals' immunity to the virus.
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Affiliation(s)
- Danlei Chen
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Ting Zhang
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Simiao Chen
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Xuanwen Ru
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Qingyi Shao
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Qing Ye
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Dongqing Cheng
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
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11
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Wang M, Hao MC, Huangfu Y, Yang KZ, Zhang XQ, Zhang Y, Chen J, Zhang ZL. A Universal Aptamer for Influenza A Viruses: Selection, Recognition, and Infection Inhibition. ACS Pharmacol Transl Sci 2024; 7:249-258. [PMID: 38230279 PMCID: PMC10789145 DOI: 10.1021/acsptsci.3c00258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 01/18/2024]
Abstract
It is crucial to develop universal inhibitors for viral inhibition due to the rapid mutation of viruses. Herein, a universal aptamer inhibitor was developed that enabled a single DNA molecule to recognize several hemeagglutinin (HA) protein subtypes, inducing broad neutralization against influenza A viruses (IAVs). Through a multi-channel enrichment (MCE) strategy, a high-affinity aptamer named UHA-2 was obtained, with its dissociation constants (Kd) for three different HA proteins being 1.5 ± 0.2 nM (H5N1), 3.7 ± 0.4 nM (H7N9), and 10.1 ± 1.1 nM (H9N2). The UHA-2 aptamer had a universal inhibition effect, by which it could broadly neutralize influenza A H5N1, H7N9, H9N2, H1N1, and H3N2 viruses. Universal aptamer inhibitors have the advantages of acquisition in vitro, stability, simple structure, small size, etc. This study not only develops a novel universal aptamer to achieve a broad inhibition effect on various IAVs, but also opens up an efficient strategy for the development of universal inhibitors against viruses.
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Affiliation(s)
- Meng Wang
- College
of Chemistry and Molecular Sciences, Wuhan
University, Wuhan, Hubei 430072, China
| | - Meng-Chan Hao
- Key
Laboratory of Special Pathogens and Biosafety, Wuhan Institute of
Virology, Center for Biosafety Mega-Science,
Chinese Academy of Sciences, Wuhan, Hubei 430071, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Yueyue Huangfu
- College
of Chemistry and Molecular Sciences, Wuhan
University, Wuhan, Hubei 430072, China
| | - Ke-Zhu Yang
- College
of Chemistry and Molecular Sciences, Wuhan
University, Wuhan, Hubei 430072, China
| | - Xiao-Qing Zhang
- Key
Laboratory of Special Pathogens and Biosafety, Wuhan Institute of
Virology, Center for Biosafety Mega-Science,
Chinese Academy of Sciences, Wuhan, Hubei 430071, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuan Zhang
- Key
Laboratory of Special Pathogens and Biosafety, Wuhan Institute of
Virology, Center for Biosafety Mega-Science,
Chinese Academy of Sciences, Wuhan, Hubei 430071, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Jianjun Chen
- Key
Laboratory of Special Pathogens and Biosafety, Wuhan Institute of
Virology, Center for Biosafety Mega-Science,
Chinese Academy of Sciences, Wuhan, Hubei 430071, China
- University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhi-Ling Zhang
- College
of Chemistry and Molecular Sciences, Wuhan
University, Wuhan, Hubei 430072, China
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12
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Jiang W, Lu C, Yan X, Tucker JD, Lin L, Li J, Larson HJ, Gong W, Wu D. Vaccine confidence mediates the association between a pro-social pay-it-forward intervention and improved influenza vaccine uptake in China: A mediation analysis. Vaccine 2024; 42:362-368. [PMID: 38103961 PMCID: PMC10789265 DOI: 10.1016/j.vaccine.2023.11.046] [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: 09/04/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION A Chinese clinical trial has demonstrated that a prosocial pay-it-forward intervention that offered subsidized vaccination and postcard messages effectively increased influenza vaccine uptake and vaccine confidence. This secondary analysis explored the potential mediating role of vaccine confidence on the association between a pay-it-forward intervention and influenza vaccine uptake, and how this might vary by individual annual income levels. METHODS Data from 300 participants (150 standard-of-care and 150 pay-it-forward participants) were included in the analysis. We conducted descriptive analysis of demographic and vaccine confidence variables. Multivariable regression and mediation analysis on interventions, vaccine confidence and vaccine uptake were conducted. A sub-group analysis was conducted to further understand whether associations between these variables vary by income levels (<=$1860 or >$1860). RESULTS The pay-it-forward intervention was significantly associated with greater levels of perceived influenza vaccine importance (adjusted odds ratio (aOR) = 3.60, 95 %CI: 1.77-7.32), effectiveness (aOR = 3.37, 95 %CI: 1.75-6.52) and safety (aOR = 2.20, 95 %CI: 1.17-4.15). Greater perceived influenza vaccine importance was associated with increased vaccine uptake (aOR = 8.51, 95 %CI: 3.04-23.86). The indirect effect of the pay-it-forward intervention on vaccination was significant through improved perceived influenza vaccine importance (indirect effect1 = 0.07, 95 %CI: 0.02-0.11). This study further revealed that, irrespective of the individual income level, the pay-it-forward intervention was associated with increased vaccine uptake when compared to the standard-of-care approach. CONCLUSIONS Pay-it-forward intervention may be a promising strategy to improve influenza vaccine uptake. Perceived confidence in vaccine importance appears to be a potential mediator of the association between pay-it-forward and vaccine uptake.
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Affiliation(s)
- Wenwen Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chunlei Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xumeng Yan
- University of North Carolina Project-China, Guangzhou, China; SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Joseph D Tucker
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London WC1E 7HT, UK
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region; WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Wenfeng Gong
- China Country Office of the Bill and Melinda Gates Foundation, China
| | - Dan Wu
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London WC1E 7HT, UK; Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, Nanjing, Jiangsu, China.
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13
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Lin F, Chen MT, Zhang L, Wu M, Xie H, Guan ZX, Yang Z, Cai ZX, Wen JZ, Yang LY. Resurgence of influenza A after SARS-CoV-2 omicron wave and comparative analysis of hospitalized children with COVID-19 and influenza A virus infection. Front Med (Lausanne) 2024; 10:1289487. [PMID: 38274442 PMCID: PMC10810023 DOI: 10.3389/fmed.2023.1289487] [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: 09/06/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Context The highly infectious Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have caused large-scale transmission from Dec 2022 to Feb 2023 in China. After this event, a remarkable surge of influenza A (Flu A) occurred from March to May 2023, especially in pediatric patients. Objectives This study aimed to investigate the differences between pediatric patients infected with COVID-19 Omicron and Flu A virus. Methods A total of 1,063 hospitalized children who admitted into two tertiary general hospital of Guangdong province of China were included. Medical records were compared retrospectively in these patients during the pandemic periods of SARS-CoV-2 omicron and Flu A. Results A total of 592 Patients with Flu A were mostly preschool and school-aged (>3y, 76.0%), they showed higher ratio of high fever (≥39°C), cough, rhinorrhea, and vomiting than patients with SARS-CoV-2 omicron. Most of the 471 Omicron patients were young children (0-3y, 74.5%) and had more poor appetite and dyspnea symptom. Benign acute children myositis (BACM) was only observed in patients with Flu A, and a significant male predominance. Multisystem inflammatory syndrome in children (MIS-C) was only found in patients with SARS-CoV-2 Omicron. Compared to the SARS-CoV-2 Omicron group, for both age groups (0-3 years and > 3 years), the Flu A group showed significantly reduced lymphocyte (Lym) counts (P < 0.001), and elevated levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and creatinine kinase-MB (CK-MB) in laboratory indexes (all P < 0.001). Additionally, it was found that more children hospitalized with COVID-19 had increased C-reactive protein (CRP) levels compared to those with Flu A. Conclusion Influenza A infections have notably surged in children, coinciding with the relaxation of COVID-19 related social restrictions. During the epidemic periods of Omicron and Flu A virus infection, different clinical and laboratory characteristics were observed in hospitalized children.
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Affiliation(s)
- Fen Lin
- Precision Medical Lab Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Man-Tong Chen
- Precision Medical Lab Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Lin Zhang
- Precision Medical Lab Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Min Wu
- Department of Pediatrics, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - He Xie
- Department of Pediatrics, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Ze-Xiang Guan
- Department of Pediatrics, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Zhe Yang
- Department of Pediatrics, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Zhong-Xian Cai
- Chaozhou Center for Disease Control and Prevention, Chaozhou, Guangdong, China
| | - Jin-Zhou Wen
- Chaozhou Center for Disease Control and Prevention, Chaozhou, Guangdong, China
| | - Li-Ye Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
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14
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Guo M, Li J, Wang Y, Chen G, Chen R, Wang L. The association between influenza vaccination and the perception of COVID-19 as well as COVID-19 vaccination behavior among community residents in Anhui province, China. Hum Vaccin Immunother 2023; 19:2275464. [PMID: 37941303 PMCID: PMC10653700 DOI: 10.1080/21645515.2023.2275464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023] Open
Abstract
Influenza is a significant public health threat associated with high morbidity and mortality globally. This study investigated the influenza vaccination rate (IVR) among community residents in Anhui province, China, and explored the association between participants' influenza vaccination and their key sociodemographic characteristics, perception of COVID-19 as well as COVID-19 vaccination behavior. We found that the IVR among respondents in Anhui province was 27.85% in 2020. Regression analyses revealed that males (OR = 1.41, 95% CI: 1.01 ~ 1.96), residents with above middle school education (OR = 1.88, 95% CI: 1.04 ~ 3.39), considered themselves likely to be infected with COVID-19 (OR = 1.53, 95% CI: 1.04 ~ 2.24), had received the COVID-19 vaccine (OR = 9.85, 95% CI: 3.49 ~ 27.78), did not plan to receive COVID-19 vaccine in the future (OR = 1.70, 95% CI: 1.17 ~ 2.47), and had no adverse reactions after COVID-19 vaccination (OR = 1.54, 95% CI: 1.04 ~ 2.27) were associated with a higher IVR. The acceptance of influenza vaccination was mainly associated with respondents' gender, education, perception of COVID-19, history of COVID-19 vaccination in city and countryside community residents in Anhui province.
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Affiliation(s)
- Mengjie Guo
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
| | - Jian’an Li
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
| | - Yan Wang
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
| | - Guimei Chen
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
| | - Ren Chen
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
| | - Li Wang
- School of Health Service Management, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Health Economics and Policy Research, National Health and Wellness Commission, Jinan, Shandong Province, China
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15
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Chen K, Zhang L, Fang Z, Li J, Li C, Song W, Huang Z, Chen R, Zhang Y, Li J. Analysis of the protective efficacy of approved COVID-19 vaccines against Omicron variants and the prospects for universal vaccines. Front Immunol 2023; 14:1294288. [PMID: 38090587 PMCID: PMC10711607 DOI: 10.3389/fimmu.2023.1294288] [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: 09/14/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
By the end of 2022, different variants of Omicron had rapidly spread worldwide, causing a significant impact on the Coronavirus disease 2019 (COVID-19) pandemic situation. Compared with previous variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), these new variants of Omicron exhibited a noticeable degree of mutation. The currently developed platforms to design COVID-19 vaccines include inactivated vaccines, mRNA vaccines, DNA vaccines, recombinant protein vaccines, virus-like particle vaccines, and viral vector vaccines. Many of these platforms have obtained approval from the US Food and Drug Administration (FDA) or the WHO. However, the Omicron variants have spread in countries where vaccination has taken place; therefore, the number of cases has rapidly increased, causing concerns about the effectiveness of these vaccines. This article first discusses the epidemiological trends of the Omicron variant and reviews the latest research progress on available vaccines. Additionally, we discuss progress in the development progress and practical significance of universal vaccines. Next, we analyze the neutralizing antibody effectiveness of approved vaccines against different variants of Omicron, heterologous vaccination, and the effectiveness of multivalent vaccines in preclinical trials. We hope that this review will provide a theoretical basis for the design, development, production, and vaccination strategies of novel coronavirus vaccines, thus helping to end the SARS-CoV-2 pandemic.
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Affiliation(s)
- Keda Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Ling Zhang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Zhongbiao Fang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Jiaxuan Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Chaonan Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Wancheng Song
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhiwei Huang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ruyi Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China
| | - Yanjun Zhang
- Department of Virus Inspection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jianhua Li
- Department of Virus Inspection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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16
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Morimoto R, Isegawa Y. Anti-Influenza Virus Activity of Citrullus lanatus var. citroides as a Functional Food: A Review. Foods 2023; 12:3866. [PMID: 37893759 PMCID: PMC10606521 DOI: 10.3390/foods12203866] [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: 09/13/2023] [Revised: 10/15/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Influenza is an acute respiratory illness caused by the influenza virus, in response to which vaccines and antiviral drugs are administered. In recent years, the antiviral effects of plants and foods have garnered attention. This review is the first to summarize the therapeutic properties of wild watermelon (Citrullus lanatus var. citroides) against influenza from a phytochemical viewpoint. Wild watermelon is a wild plant with significant potential as a therapeutic candidate in antiviral strategies, when focused on its multiple anti-influenza functionalities. Wild watermelon juice inhibits viral growth, entry, and replication. Hence, we highlight the possibility of utilizing wild watermelon for the prevention and treatment of influenza with stronger antiviral activity. Phytochemicals and phytoestrogen (polyphenol, flavonoids, and prenylated compounds) in wild watermelon juice contribute to this activity and inhibit various stages of viral replication, depending on the molecular structure. Wild plants and foods closely related to the original species contain many natural compounds such as phytochemicals, and exhibit various viral growth inhibitory effects. These natural products provide useful information for future antiviral strategies.
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Affiliation(s)
- Ryosuke Morimoto
- Department of Health and Nutrition, Faculty of Human Life Science, Shikoku University, Tokushima 771-1192, Japan;
| | - Yuji Isegawa
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Osaka Metropolitan University, Sakai, Osaka 599-8531, Japan
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17
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Yin Y, Lai M, Zhou S, Chen Z, Jiang X, Wang L, Li Z, Peng Z. Effects and interaction of temperature and relative humidity on the trend of influenza prevalence: A multi-central study based on 30 provinces in mainland China from 2013 to 2018. Infect Dis Model 2023; 8:822-831. [PMID: 37496828 PMCID: PMC10366480 DOI: 10.1016/j.idm.2023.07.005] [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: 05/30/2023] [Revised: 06/23/2023] [Accepted: 07/08/2023] [Indexed: 07/28/2023] Open
Abstract
Background Evidence is inefficient about how meteorological factors influence the trends of influenza transmission in different regions of China. Methods We estimated the time-varying reproduction number (Rt) of influenza and explored the impact of temperature and relative humidity on Rt using generalized additive quasi-Poisson regression models combined with the distribution lag non-linear model (DLNM). The effect of temperature and humidity interaction on Rt of influenza was explored. The multiple random-meta analysis was used to evaluate region-specific association. The excess risk (ER) index was defined to investigate the correlation between Rt and each meteorological factor with the modification of seasonal and regional characteristics. Results Low temperature and low relative humidity contributed to influenza epidemics on the national level, while shapes of merged cumulative effect plots were different across regions. Compared to that of median temperature, the merged RR (95%CI) of low temperature in northern and southern regions were 1.40(1.24,1.45) and 1.20 (1.14,1.27), respectively, while those of high temperature were 1.10(1.03,1.17) and 1.00 (0.95,1.04), respectively. There were negative interactions between temperature and relative humidity on national (SI = 0.59, 95%CI: 0.57-0.61), southern (SI = 0.49, 95%CI: 0.17-0.80), and northern regions (SI = 0.59, 95%CI: 0.56,0.62). In general, with the increase of the change of the two meteorological factors, the ER of Rt also gradually increased. Conclusions Temperature and relative humidity have an effect on the influenza epidemics in China, and there is an interaction between the two meteorological factors, but the effect of each factor is heterogeneous among regions. Meteorological factors may be considered to predict the trend of influenza epidemic.
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Affiliation(s)
- Yi Yin
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Miao Lai
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Sijia Zhou
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Ziying Chen
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Xin Jiang
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Liping Wang
- Division of Infectious Disease/Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongjie Li
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
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18
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Wei L, Wang X, Zhou H. Interaction among inflammasome, PANoptosise, and innate immune cells in infection of influenza virus: Updated review. Immun Inflamm Dis 2023; 11:e997. [PMID: 37773712 PMCID: PMC10521376 DOI: 10.1002/iid3.997] [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: 02/10/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Influenza virus (IV) is a leading cause of respiratory tract infections, eliciting responses from key innate immune cells such as Macrophages (MQs), Neutrophils, and Dendritic Cells (DCs). These cells employ diverse mechanisms to combat IV, with Inflammasomes playing a pivotal role in viral infection control. Cellular death mechanisms, including Pyroptosis, Apoptosis, and Necroptosis (collectively called PANoptosis), significantly contribute to the innate immune response. METHODS In this updated review, we delve into the intricate relationship between PANoptosis and Inflammasomes within innate immune cells (MQs, Neutrophils, and DCs) during IV infections. We explore the strategies employed by IV to evade these immune defenses and the consequences of unchecked PANoptosis and inflammasome activation, including the potential development of severe complications such as cytokine storms and tissue damage. RESULTS Our analysis underscores the interplay between PANoptosis and Inflammasomes as a critical aspect of the innate immune response against IV. We provide insights into IV's various mechanisms to subvert these immune pathways and highlight the importance of understanding these interactions to develop effective antiviral medications. CONCLUSION A comprehensive understanding of the dynamic interactions between PANoptosis, Inflammasomes, and IV is essential for advancing our knowledge of innate immune responses to viral infections. This knowledge will be invaluable in developing targeted antiviral therapies to combat IV and mitigate potential complications, including cytokine storms and tissue damage.
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Affiliation(s)
- Li Wei
- Intensive Care Unit, Huzhou Third Municipal hospitalThe Affiliated hospital of Huzhou UniversityHuzhouChina
| | - Xufang Wang
- Intensive Care Unit, Huzhou Third Municipal hospitalThe Affiliated hospital of Huzhou UniversityHuzhouChina
| | - Huifei Zhou
- Intensive Care Unit, Huzhou Third Municipal hospitalThe Affiliated hospital of Huzhou UniversityHuzhouChina
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19
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Xu H, Zhu S, Govinden R, Chenia HY. Multiple Vaccines and Strategies for Pandemic Preparedness of Avian Influenza Virus. Viruses 2023; 15:1694. [PMID: 37632036 PMCID: PMC10459121 DOI: 10.3390/v15081694] [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: 06/26/2023] [Revised: 07/14/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Avian influenza viruses (AIV) are a continuous cause of concern due to their pandemic potential and devasting effects on poultry, birds, and human health. The low pathogenic avian influenza virus has the potential to evolve into a highly pathogenic avian influenza virus, resulting in its rapid spread and significant outbreaks in poultry. Over the years, a wide array of traditional and novel strategies has been implemented to prevent the transmission of AIV in poultry. Mass vaccination is still an economical and effective approach to establish immune protection against clinical virus infection. At present, some AIV vaccines have been licensed for large-scale production and use in the poultry industry; however, other new types of AIV vaccines are currently under research and development. In this review, we assess the recent progress surrounding the various types of AIV vaccines, which are based on the classical and next-generation platforms. Additionally, the delivery systems for nucleic acid vaccines are discussed, since these vaccines have attracted significant attention following their significant role in the fight against COVID-19. We also provide a general introduction to the dendritic targeting strategy, which can be used to enhance the immune efficiency of AIV vaccines. This review may be beneficial for the avian influenza research community, providing ideas for the design and development of new AIV vaccines.
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Affiliation(s)
- Hai Xu
- Jiangsu Key Laboratory for High-Tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China;
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Durban 4001, South Africa;
| | - Shanyuan Zhu
- Jiangsu Key Laboratory for High-Tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-Animal Husbandry Vocational College, Taizhou 225300, China;
| | - Roshini Govinden
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Durban 4001, South Africa;
| | - Hafizah Y. Chenia
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Durban 4001, South Africa;
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20
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Hong Q, Liu J, Wei Y, Wei X. Application of Baculovirus Expression Vector System (BEVS) in Vaccine Development. Vaccines (Basel) 2023; 11:1218. [PMID: 37515034 PMCID: PMC10386281 DOI: 10.3390/vaccines11071218] [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: 05/28/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
Vaccination is one of the most effective strategies to control epidemics. With the deepening of people's awareness of vaccination, there is a high demand for vaccination. Hence, a flexible, rapid, and cost-effective vaccine platform is urgently needed. The baculovirus expression vector system (BEVS) has emerged as a promising technology for vaccine production due to its high safety, rapid production, flexible product design, and scalability. In this review, we introduced the development history of BEVS and the procedures for preparing recombinant protein vaccines using the BEVS platform and summarized the features and limitations of this platform. Furthermore, we highlighted the progress of the BEVS platform-related research, especially in the field of vaccine. Finally, we provided a new prospect for BEVS in future vaccine manufacturing, which may pave the way for future BEVS-derived vaccine development.
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Affiliation(s)
- Qiaonan Hong
- Department of Biotherapy, Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 17, Block 3, Southern Renmin Road, Chengdu 610041, China
| | - Jian Liu
- Department of Biotherapy, Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 17, Block 3, Southern Renmin Road, Chengdu 610041, China
| | - Yuquan Wei
- Department of Biotherapy, Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 17, Block 3, Southern Renmin Road, Chengdu 610041, China
| | - Xiawei Wei
- Department of Biotherapy, Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 17, Block 3, Southern Renmin Road, Chengdu 610041, China
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21
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Yi G, de Kraker MEA, Buetti N, Zhong X, Li J, Yuan Z, Zhu W, Zhou J, Zhou H. Risk factors for in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza: a large retrospective cohort study. Antimicrob Resist Infect Control 2023; 12:25. [PMID: 37004057 PMCID: PMC10064953 DOI: 10.1186/s13756-023-01234-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Secondary bacterial pneumonia is an important complication of seasonal influenza, but little data is available about impact on death and risk factors. This study identified risk factors for all-cause in-hospital mortality and secondary bacterial pneumonia among hospitalized adult patients with community-acquired influenza. METHODS A retrospective cohort study was performed at a tertiary teaching hospital in southwest China. The study cohort included all adult hospitalized patients with a laboratory-confirmed, community-acquired influenza virus infection during three consecutive influenza seasons from 2017 to 2020. Cause-specific Cox regression was used to analyze risk factors for mortality and secondary bacterial pneumonia, respectively, accounting for competing events (discharge alive and discharge alive or death without secondary bacterial pneumonia, respectively). RESULTS Among 174 patients enrolled in this study, 14.4% developed secondary bacterial pneumonia and 11.5% died during hospitalization. For all-cause in-hospital mortality, time-varying secondary bacterial pneumonia was a direct risk factor of death (cause-specific hazard ratio [csHR] 3.38, 95% confidence interval [CI] 1.25-9.17); underlying disease indirectly increased death risk through decreasing the hazard of being discharged alive (csHR 0.55, 95% CI 0.39-0.77). For secondary bacterial pneumonia, the final model only confirmed direct risk factors: age ≥ 65 years (csHR 2.90, 95% CI 1.27-6.62), male gender (csHR 3.78, 95% CI 1.12-12.84) and mechanical ventilation on admission (csHR 2.96, 95% CI 1.32-6.64). CONCLUSIONS Secondary bacterial pneumonia was a major risk factor for in-hospital mortality among adult hospitalized patients with community-acquired influenza. Prevention strategies for secondary bacterial pneumonia should target elderly male patients and critically ill patients under mechanical ventilation.
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Affiliation(s)
- Guangzhao Yi
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, You Yi Road 1, Chongqing, 400016, China
- Department of Disease Prevention and Health Protection, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Marlieke E A de Kraker
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Niccolò Buetti
- Infection Control Program, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Xiaoni Zhong
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jinyan Li
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhe Yuan
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, You Yi Road 1, Chongqing, 400016, China
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weimin Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Disease Prevention and Health Protection, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia Zhou
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyu Zhou
- Department of Hospital Infection Control, The First Affiliated Hospital of Chongqing Medical University, You Yi Road 1, Chongqing, 400016, China.
- Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China.
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