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Pontiroli AE, Scovenna F, Carlini V, Tagliabue E, Martin-Delgado J, Sala LL, Tanzi E, Zanoni I. Vaccination against influenza viruses reduces infection, not hospitalization or death, from respiratory COVID-19: A systematic review and meta-analysis. J Med Virol 2024; 96:e29343. [PMID: 38163281 PMCID: PMC10924223 DOI: 10.1002/jmv.29343] [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: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and has brought a huge burden in terms of human lives. Strict social distance and influenza vaccination have been recommended to avoid co-infections between influenza viruses and SARS-CoV-2. Scattered reports suggested a protective effect of influenza vaccine on COVID-19 development and severity. We analyzed 51 studies on the capacity of influenza vaccination to affect infection with SARS-CoV-2, hospitalization, admission to Intensive Care Units (ICU), and mortality. All subjects taken into consideration did not receive any anti-SARS-CoV-2 vaccine, although their status with respect to previous infections with SARS-CoV-2 is not known. Comparison between vaccinated and not-vaccinated subjects for each of the four endpoints was expressed as odds ratio (OR), with 95% confidence intervals (CIs); all analyses were performed by DerSimonian and Laird model, and Hartung-Knapp model when studies were less than 10. In a total of 61 029 936 subjects from 33 studies, influenza vaccination reduced frequency of SARS-CoV-2 infection [OR plus 95% CI = 0.70 (0.65-0.77)]. The effect was significant in all studies together, in health care workers and in the general population; distance from influenza vaccination and the type of vaccine were also of importance. In 98 174 subjects from 11 studies, frequency of ICU admission was reduced with influenza vaccination [OR (95% CI) = 0.71 (0.54-0.94)]; the effect was significant in all studies together, in pregnant women and in hospitalized subjects. In contrast, in 4 737 328 subjects from 14 studies hospitalization was not modified [OR (95% CI) = 1.05 (0.82-1.35)], and in 4 139 660 subjects from 19 studies, mortality was not modified [OR (95% CI) = 0.76 (0.26-2.20)]. Our study emphasizes the importance of influenza vaccination in the protection against SARS-CoV-2 infection.
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Affiliation(s)
- Antonio E. Pontiroli
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Francesco Scovenna
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Valentina Carlini
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
| | - Elena Tagliabue
- IRCCS MultiMedica, Value-Based Healthcare Unit, 20099 Milan, Italy
| | - Jimmy Martin-Delgado
- Hospital Luis Vernaza, Junta de Beneficiencia de Guayaquil 090603, Ecuador
- Instituto de Investigacion e Innovacion en Salud Integral, Universidad Catolica de Santiago de Guayaquil, Guayaquil 090603, Ecuador
| | - Lucia La Sala
- IRCCS MultiMedica, Laboratory of Cardiovascular and Dysmetabolic Disease, 20138 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Elisabetta Tanzi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milan, Italy
| | - Ivan Zanoni
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology and Division of Gastroenterology, Boston, MA 02115, USA
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Lee YC, Liu L, Yuan L, Risk M, Heinrich K, Witteveen-Lane M, Hayek S, Malosh R, Pop-Busui R, Jiang B, Shen C, Chesla D, Kennedy R, Xu S, Sims M, Homayouni R, Zhao L. Influenza vaccine effectiveness against hospitalized SARS-CoV-2 infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.27.23297682. [PMID: 37961376 PMCID: PMC10635222 DOI: 10.1101/2023.10.27.23297682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Some studies conducted before the Delta and Omicron variant-dominant periods have indicated that influenza vaccination provided protection against COVID-19 infection or hospitalization, but these results were limited by small study cohorts and a lack of comprehensive data on patient characteristics. No studies have examined this question during the Delta and Omicron periods (08/01/2021 to 2/22/2022). Methods We conducted a retrospective cohort study of influenza-vaccinated and unvaccinated patients in the Corewell Health East(CHE, formerly known as Beaumont Health), Corewell Health West(CHW, formerly known as Spectrum Health) and Michigan Medicine (MM) healthcare system during the Delta-dominant and Omicron-dominant periods. We used a test-negative, case-control analysis to assess the effectiveness of the influenza vaccine against hospitalized SARS-CoV-2 outcome in adults, while controlling for individual characteristics as well as pandameic severity and waning immunity of COVID-19 vaccine. Results The influenza vaccination has shown to provided some protection against SARS-CoV-2 hospitalized outcome across three main healthcare systems. CHE site (odds ratio [OR]=0.73, vaccine effectiveness [VE]=27%, 95% confidence interval [CI]: [18-35], p<0.001), CHW site (OR=0.85, VE=15%, 95% CI: [6-24], p<0.001), MM (OR=0.50, VE=50%, 95% CI: [40-58], p <0.001) and overall (OR=0.75, VE=25%, 95% CI: [20-30], p <0.001). Conclusion The influenza vaccine provides a small degree of protection against SARS-CoV-2 infection across our study sites.
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Riccò M, Ferraro P, Corrado S, Bottazzoli M, Marchesi F. Nitrous Oxide Inhalant Abuse: Preliminary Results from a Cross-Sectional Study on Knowledge, Attitudes, and Practices of Italian Physicians (2023). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1820. [PMID: 37893538 PMCID: PMC10608448 DOI: 10.3390/medicina59101820] [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: 09/03/2023] [Revised: 09/24/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Nitrous oxide (N2O) has recently emerged as a cheap alternative to other recreational substances. Although legally available, its chronic use is associated with severe neurological and hematological complications due to the irreversible inactivation of vitamin B12. While no reliable data on abuse of N2O in Italy have been provided to date, we assessed the knowledge, attitudes, and practices of Italian medical professionals on the management of N2O abuse cases. Materials and Methods: A cross-sectional study was performed as a web-based survey through a series of Facebook discussion groups (targeted medical professionals: 12,103), and participants were specifically asked about their previous understanding of N2O abuse and whether they had or not any previous experience in this topic. Results: A total 396 medical professionals participated in the survey. Overall, 115 participants had previous knowledge about N2O abuse (29.04%), with higher odds for professionals with a background in emergency medicine (adjusted odds ratio (aOR) 3.075; 95% confidence intervals (95%CI) 1.071 to 8.828) and lower for specialists in psychiatry (aOR 0.328; 95%CI 0.130 to 0.825). Knowledge status on N2O abuse was largely unsatisfying, as knowledge status, reported as a percent value, was estimated to 45.33% ± 24.71. Having previously managed a case of N2O abuse was associated with higher risk perception of the actual severity of this condition (aOR 5.070; 95%CI 1.520 to 16.980). Conclusions: Our study suggests that N2O poisoning cases are occurring in Italian settings but are not reasonably reported to national authorities. As substantial knowledge gaps of Italian medical workforces were identified, we cannot rule out that the actual abuse of N2O in the population may be far larger than currently suspected.
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Affiliation(s)
- Matteo Riccò
- Occupational Health and Safety Service on the Workplace/Servizio di Prevenzione e Sicurezza Ambienti di Lavoro (SPSAL), Department of Public Health, AUSL–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Pietro Ferraro
- Occupational Medicine Unit, Direzione Sanità, Italian Railways’ Infrastructure Division, RFI SpA, 00161 Rome, Italy;
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della donna e Area Materno-Infantile, UOC Pediatria, 20024 Garbagnate Milanese, Italy;
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 31223 Trento, Italy;
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
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Salas J, Morley JE, Hoft DF, Scherrer JF. Lower risk for COVID-19 hospitalization among patients in the United States with past vaccinations for herpes zoster and tetanus, diphtheria and pertussis. Prev Med Rep 2023; 35:102302. [PMID: 37441187 PMCID: PMC10290736 DOI: 10.1016/j.pmedr.2023.102302] [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: 02/16/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Influenza, tetanus, diphtheria, and herpes zoster (HZ) vaccination received within 10 years of the COVID-19 pandemic have been associated with less severe COVID-19 infection. We expanded on this evidence to determine if a receiving two different vaccinations (i.e., HZ and tetanus, diphtheria, and pertussis (Tdap)) was associated with a lower risk for COVID-19 hospitalization. De-identified medical record data from a large mid-western health care system was used to determine if, compared to those with neither HZ or Tdap vaccination, patients with either HZ or Tdap and patients with both HZ and Tdap vaccination had lower risk for COVID-19 hospitalization between 4/1/2020 and 12/31/2020. Confounding was controlled using entropy balancing. Patients (n = 363,293) were 71.5 (±8.4) years of age, 57.8% female and 89.2% White race. Prior to controlling for confounding, as compared to patients without either vaccination, those that had either HZ or Tdap were significantly less likely to have a COVID-19 hospitalization (RR = 0.85; 95 %CI: 0.75-0.95). The risk for hospitalization decreased further among those with both HZ and Tdap vaccination (RR = 0.45; 95 %CI:0.28-0.71). After controlling for confounding, including healthy patient bias, receiving both vs. neither vaccinations remained significantly associated with a lower risk of COVID-19 hospitalization (RR = 0.48; 95 %CI: 0.26-0.90). Receiving both Tdap and HZ vaccination is associated with lower risk for COVID-19 hospitalization. Whether there is any benefit of past vaccination exposure in COVID-19 vaccinated patients should be investigated.
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Affiliation(s)
- Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 3545 Lafayette Ave, 4th Floor, St. Louis, MO 63104, United States
| | - John E. Morley
- Saint Louis University, School of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Saint Louis University, School of Medicine. 1402 South Grand Blvd, St. Louis, MO, United States
| | - Daniel F. Hoft
- Saint Louis University, School of Medicine, Department of Internal Medicine Division of Infectious Diseases, Allergy, and Immunology, Saint Louis, MO, United States
- Saint Louis University, Department of Molecular Microbiology & Immunology, Saint Louis, MO, United States
| | - Jeffrey F. Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, St. Louis, MO 63110, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 3545 Lafayette Ave, 4th Floor, St. Louis, MO 63104, United States
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Blvd., St. Louis, MO 63104, United States
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Root-Bernstein R, Huber J, Ziehl A, Pietrowicz M. SARS-CoV-2 and Its Bacterial Co- or Super-Infections Synergize to Trigger COVID-19 Autoimmune Cardiopathies. Int J Mol Sci 2023; 24:12177. [PMID: 37569555 PMCID: PMC10418384 DOI: 10.3390/ijms241512177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Autoimmune cardiopathies (AC) following COVID-19 and vaccination against SARS-CoV-2 occur at significant rates but are of unknown etiology. This study investigated the possible roles of viral and bacterial mimicry, as well as viral-bacterial co-infections, as possible inducers of COVID-19 AC using proteomic methods and enzyme-linked immunoadsorption assays. BLAST and LALIGN results of this study demonstrate that SARS-CoV-2 shares a significantly greater number of high quality similarities to some cardiac protein compared with other viruses; that bacteria such as Streptococci, Staphylococci and Enterococci also display very significant similarities to cardiac proteins but to a different set than SARS-CoV-2; that the importance of these similarities is largely validated by ELISA experiments demonstrating that polyclonal antibodies against SARS-CoV-2 and COVID-19-associated bacteria recognize cardiac proteins with high affinity; that to account for the range of cardiac proteins targeted by autoantibodies in COVID-19-associated autoimmune myocarditis, both viral and bacterial triggers are probably required; that the targets of the viral and bacterial antibodies are often molecularly complementary antigens such as actin and myosin, laminin and collagen, or creatine kinase and pyruvate kinase, that are known to bind to each other; and that the corresponding viral and bacterial antibodies recognizing these complementary antigens also bind to each other with high affinity as if they have an idiotype-anti-idiotype relationship. These results suggest that AC results from SARS-CoV-2 infections or vaccination complicated by bacterial infections. Vaccination against some of these bacterial infections, such as Streptococci and Haemophilus, may therefore decrease AC risk, as may the appropriate and timely use of antibiotics among COVID-19 patients and careful screening of vaccinees for signs of infection such as fever, diarrhea, infected wounds, gum disease, etc.
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Affiliation(s)
- Robert Root-Bernstein
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA; (J.H.); (A.Z.); (M.P.)
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Ghazy RM, Sallam M, Abdullah FSA, Hussein M, Hussein MF. The Effect of Combining the COVID-19 Vaccine with the Seasonal Influenza Vaccine on Reducing COVID-19 Vaccine Rejection Among Libyans. J Epidemiol Glob Health 2023; 13:292-302. [PMID: 37171545 PMCID: PMC10176301 DOI: 10.1007/s44197-023-00107-2] [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: 10/24/2022] [Accepted: 04/21/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) vaccine coverage remains low in Libya compared to other countries in the Eastern Mediterranean Region. This study aimed to evaluate the willingness of the general public in Libya to receive COVID-19 and seasonal influenza vaccines. Additionally, the study aimed to investigate the potential effect of combining the two vaccines to reduce COVID-19 vaccine rejection. METHODS An anonymous nationwide online cross-sectional survey was carried out from 1st September to 16th October 2022. Libyans aged 18 years or older were recruited using convenience and snowball sampling approaches. The participants were surveyed for sociodemographic information, health status, and vaccination attitude towards COVID-19 and seasonal influenza vaccines. RESULTS A total of 2484 participants formed the final study sample: 68.7% were females, 39.4% were aged 18-25 years, 50.4% were single, 32.5% had previous COVID-19 infection, and 47.2% experienced COVID-19 death among relatives. Three-fourths of the respondents showed COVID-19 vaccine rejection: 57.3% did not receive COVID-19 vaccination, 10.1% would not complete the primary vaccination series, and 7.8% refused booster doses. About 55.0% rejected seasonal influenza vaccination, while 1.9% reported influenza vaccine uptake and 21.2% were willing to get the influenza vaccine for the first time. Additionally, 18.8% had already received influenza vaccination in the last year and intended to get the vaccine this season, while 3.3% were unwilling to get influenza vaccination this year despite receiving it in the last influenza season. Age, sex, and occupation were significantly associated with COVID-19 and influenza vaccine rejection. Rejection of COVID-19 vaccination decreased if its combination with influenza vaccine as a single dose was suggested, with 28.2% of the COVID-19 vaccine rejector group accepting the combined vaccine as it would be safer (50.9%), needing fewer injections (24.0%), would be more effective (19.1%), and would be less expensive (3%). Approximately 73.0% of the COVID-19 vaccine rejector group refused this combination due to fear of side effects (48.7%), absence of published studies on this combination (29.8%), and considering this combination as useless (11.2%). CONCLUSION In Libya, the prevalence of COVID-19 vaccine rejection was high, while the rejection of seasonal influenza vaccination was relatively lower. If influenza and COVID-19 vaccines are administered simultaneously as a single injection, this may reduce the rejection of the COVID-19 vaccine due to better-perceived vaccine safety and efficacy besides being more convenient in terms of the number of injections and cost.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, 21561 Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942 Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, 11942 Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | | | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria, Egypt
- Ministry of Health and Population, Cairo, Egypt
| | - Mohamed Fakhry Hussein
- Occupational Health and Industrial Medicine Department, High Institute of Public Health, Alexandria University, Alexandria, 21561 Egypt
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Yilmaz FK, Cakir M, Ikiisik H, Maral I. The Effect of Pneumococcal, Influenza, and COVID-19 Vaccinations on COVID-19 Hospitalization and Progression in People over 65 Years Old Living in Nursing Homes. Vaccines (Basel) 2023; 11:vaccines11050943. [PMID: 37243046 DOI: 10.3390/vaccines11050943] [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: 03/31/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
Infectious diseases pose a major threat to elderly populations. Streptococcus pneumonia bacteria, influenza-causing viruses, and COVID-19 viruses cause three pathologies in the respiratory system with similar symptoms, transmission routes, and risk factors. Our study aimed to evaluate the effects of pneumococcal, influenza, and COVID-19 vaccinations on the status of COVID-19 hospitalization and progression in people over 65 years of age living in nursing homes. This study was performed in all nursing homes and elderly care centers in the Uskudar district of Istanbul.The diagnosis rate of COVID-19 was determined as 49%, the rate of hospitalization as 22.4%, the rate of hospitalization in the intensive care unit as 12.2%. The rate of intubation was determined as 10.4%, the rate of mechanical ventilation as 11.1% and the rate of COVID-19 related mortality rate as 9.7%. When the factors affecting the diagnosis of COVID-19 were examined, the presence and dose of COVID-19 vaccine was protective. When the factors affecting hospitalization status were examined, male sex and presence of chronic disease were risk factors; four doses of COVID-19 vaccine and influenza vaccine and pneumococcal vaccine together with COVID-19 vaccine were protective. When the factors affecting COVID-19-related death were examined, the male sex was a risk factor; the pneumococcal and influenza vaccine together with COVID-19 vaccine were protective. Our results revealed that the availability of influenza and pneumococcal vaccines positively impacted the progression of COVID-19 disease in the elderly population living in nursing homes.
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Affiliation(s)
- Feyza Kutay Yilmaz
- Department of Public Health, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34700, Turkey
| | - Mustafa Cakir
- Department of Public Health, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34700, Turkey
| | - Hatice Ikiisik
- Department of Public Health, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34700, Turkey
| | - Isil Maral
- Department of Public Health, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34700, Turkey
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Root-Bernstein R. From Co-Infections to Autoimmune Disease via Hyperactivated Innate Immunity: COVID-19 Autoimmune Coagulopathies, Autoimmune Myocarditis and Multisystem Inflammatory Syndrome in Children. Int J Mol Sci 2023; 24:ijms24033001. [PMID: 36769320 PMCID: PMC9917907 DOI: 10.3390/ijms24033001] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Neutrophilia and the production of neutrophil extracellular traps (NETs) are two of many measures of increased inflammation in severe COVID-19 that also accompany its autoimmune complications, including coagulopathies, myocarditis and multisystem inflammatory syndrome in children (MIS-C). This paper integrates currently disparate measures of innate hyperactivation in severe COVID-19 and its autoimmune complications, and relates these to SARS-CoV-2 activation of innate immunity. Aggregated data include activation of Toll-like receptors (TLRs), nucleotide-binding oligomerization domain (NOD) receptors, NOD leucine-rich repeat and pyrin-domain-containing receptors (NLRPs), retinoic acid-inducible gene I (RIG-I) and melanoma-differentiation-associated gene 5 (MDA-5). SARS-CoV-2 mainly activates the virus-associated innate receptors TLR3, TLR7, TLR8, NLRP3, RIG-1 and MDA-5. Severe COVID-19, however, is characterized by additional activation of TLR1, TLR2, TLR4, TLR5, TLR6, NOD1 and NOD2, which are primarily responsive to bacterial antigens. The innate activation patterns in autoimmune coagulopathies, myocarditis and Kawasaki disease, or MIS-C, mimic those of severe COVID-19 rather than SARS-CoV-2 alone suggesting that autoimmunity follows combined SARS-CoV-2-bacterial infections. Viral and bacterial receptors are known to synergize to produce the increased inflammation required to support autoimmune disease pathology. Additional studies demonstrate that anti-bacterial antibodies are also required to account for known autoantigen targets in COVID-19 autoimmune complications.
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Root-Bernstein R, Churchill E, Oliverio S. T Cell Receptor Sequences Amplified during Severe COVID-19 and Multisystem Inflammatory Syndrome in Children Mimic SARS-CoV-2, Its Bacterial Co-Infections and Host Autoantigens. Int J Mol Sci 2023; 24:ijms24021335. [PMID: 36674851 PMCID: PMC9861234 DOI: 10.3390/ijms24021335] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
Published hypervariable region V-beta T cell receptor (TCR) sequences were collected from people with severe COVID-19 characterized by having various autoimmune complications, including blood coagulopathies and cardiac autoimmunity, as well as from patients diagnosed with the Kawasaki disease (KD)-like multisystem inflammatory syndrome in children (MIS-C). These were compared with comparable published v-beta TCR sequences from people diagnosed with KD and from healthy individuals. Since TCR V-beta sequences are supposed to be complementary to antigens that induce clonal expansion, it was surprising that only a quarter of the TCR sequences derived from severe COVID-19 and MIS-C patients mimicked SARS-CoV-2 proteins. Thirty percent of the KD-derived TCR mimicked coronaviruses other than SARS-CoV-2. In contrast, only three percent of the TCR sequences from healthy individuals and those diagnosed with autoimmune myocarditis displayed similarities to any coronavirus. In each disease, significant increases were found in the amount of TCRs from healthy individuals mimicking specific bacterial co-infections (especially Enterococcus faecium, Staphylococcal and Streptococcal antigens) and host autoantigens targeted by autoimmune diseases (especially myosin, collagen, phospholipid-associated proteins, and blood coagulation proteins). Theoretical explanations for these surprising observations and implications to unravel the causes of autoimmune diseases are explored.
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Affiliation(s)
- Robert Root-Bernstein
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
- Correspondence:
| | - Elizabeth Churchill
- School of Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Shelby Oliverio
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
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Laupèze B, Doherty TM. Maintaining a 'fit' immune system: the role of vaccines. Expert Rev Vaccines 2023; 22:256-266. [PMID: 36864769 DOI: 10.1080/14760584.2023.2185223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Conventionally, vaccines are thought to induce a specific immune response directed against a target pathogen. Long recognized but poorly understood nonspecific benefits of vaccination, such as reduced susceptibility to unrelated diseases or cancer, are now being investigated and may be due in part to "trained immunity'. AREAS COVERED We discuss 'trained immunity' and whether vaccine-induced 'trained immunity' could be leveraged to prevent morbidity due to a broader range of causes. EXPERT OPINION The prevention of infection i.e. maintaining homeostasis by preventing the primary infection and resulting secondary illnesses, is the pivotal strategy used to direct vaccine design and may have long-term, positive impacts on health at all ages. In the future, we anticipate that vaccine design will change to not only prevent the target infection (or related infections) but to generate positive modifications to the immune response that could prevent a wider range of infections and potentially reduce the impact of immunological changes associated with aging. Despite changing demographics, adult vaccination has not always been prioritized. However, the SARS-CoV-2 pandemic has demonstrated that adult vaccination can flourish given the right circumstances, demonstrating that harnessing the potential benefits of life-course vaccination is achievable for all.
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McIntosh EDG, Feemster K, Rello J. Protecting adults at risk of pneumococcal infection and influenza from exposure to SARS-CoV-2. Hum Vaccin Immunother 2022; 18:1-7. [PMID: 34406914 PMCID: PMC8920219 DOI: 10.1080/21645515.2021.1957647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
There is a paucity of evidence linking pneumococcal infection and influenza with SARS-CoV-2 and COVID-19. There is circumstantial evidence of the possibility of an association between S. pneumoniae and SARS-CoV-2 such as the increased binding of S. pneumoniae to coronavirus-infected human airway epithelium, the frequent use of broad-spectrum antibiotics in the management of COVID-19 which could mask secondary bacterial infection, and the observation that pneumococcal vaccination is associated with decreased SARS-CoV-2 nasopharyngeal swab positivity. We performed a targeted literature review for the year 2020, using search terms S. pneumoniae, influenza, SARS-CoV-2, and found 25 relevant articles of a total of 291. Pneumococcal and influenza vaccinations have the potential to contribute toward efforts aimed at reducing the health burden of SARS-CoV-2, especially by reducing preventable admissions to hospital for pneumonia and the consequent risk of nosocomial SARS-CoV-2 transmission.
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Affiliation(s)
| | - K. Feemster
- Medical Affairs, Pneumococcal Vaccines, Global Medical and Scientific Affairs, Merck Research Laboratories, Merck & Co., Inc, Kenilworth, NJ, USA
| | - J. Rello
- Universitat Internacional de Catalunya, Head Research Group, Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES) and Head, Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d’Hebron Institute of Research (VHIR), Barcelona, Spain
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Ergin AU, Karagöz Özen DS, Demirağ MD. The Effect of the COVID-19 Pandemic on Vaccination Behaviour of Individuals over the Age of 65 Years in Turkey: Single-Centre Experience. Vaccines (Basel) 2022; 11:vaccines11010034. [PMID: 36679879 PMCID: PMC9862139 DOI: 10.3390/vaccines11010034] [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: 12/01/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
The aim of this study is to evaluate the awareness of individuals over 65 years of age who have had the COVID-19 vaccine at the Samsun Research and Training Hospital and to evaluate whether the COVID-19 pandemic affected the vaccination behaviour in the geriatric age group. A total of 290 people who were vaccinated against COVID-19 at the Samsun Training and Research Hospital between 16 April 2021 and 16 April 2022 and volunteered to participate in the study were included. The questionnaire form was created by the researchers. According to the national and global guidelines, the seasonal influenza vaccine, Td or Tdap vaccines (tetanus, diphtheria, and pertussis), shingles vaccine, and pneumococcal conjugate vaccine (PCV15 or PCV20), have been recommended to all adults over the age of 65. It was questioned whether the participants had the vaccines recommended for them before and after the pandemic, if they were not vaccinated, what were the reasons, and whether the COVID-19 pandemic affected the general view on vaccination in this age group. Demographic data and comorbidities were also recorded. After each response that showed that the participant was not vaccinated, reasons were investigated with new questions to find out the causes of vaccine refusal or vaccine hesitancy. Finally, all participants were asked whether they would have the relevant vaccinations when offered. It was shown that 282 (94.3%) of the 299 people who participated in the study were considering getting a regular COVID-19 vaccine from now on, while 84.3% of the participants mentioned that the COVID-19 pandemic had a positive effect on their general vaccination behaviour. While 39 (13%) people stated that their view on vaccination was not affected by the pandemic, 8 (2.7%) people stated that it was negatively affected. The most common reason about low vaccination rates before the pandemic was a lack of enough knowledge about the recommended vaccines. The pandemic increased the vaccination awareness among the adult population. We think that vaccination rates may be improved by education of the geriatric population on this subject.
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Kapoula GV, Vennou KE, Bagos PG. Influenza and Pneumococcal Vaccination and the Risk of COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:3086. [PMID: 36553093 PMCID: PMC9776999 DOI: 10.3390/diagnostics12123086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
A number of studies have investigated the potential on-specific effects of some routinely administered vaccines (e.g., influenza, pneumococcal) on COVID-19 related outcomes, with contrasting results. In order to elucidate this discrepancy, we conducted a systematic review and meta-analysis to assess the association between seasonal influenza vaccination and pneumococcal vaccination with SARS-CoV-2 infection and its clinical outcomes. PubMed and medRxiv databases were searched up to April 2022. A random effects model was used in the meta-analysis to pool odds ratio (OR) and adjusted estimates with 95% confidence intervals (CIs). Heterogeneity was quantitatively assessed using the Cochran's Q and the I2 index. Subgroup analysis, sensitivity analysis and assessment of publication bias were performed for all outcomes. In total, 38 observational studies were included in the meta-analysis and there was substantial heterogeneity. Influenza and pneumococcal vaccination were associated with lower risk of SARS-CoV-2 infection (OR: 0.80, 95% CI: 0.75-0.86 and OR: 0.70, 95% CI: 0.57-0.88, respectively). Regarding influenza vaccination, it seems that the majority of studies did not properly adjust for all potential confounders, so when the analysis was limited to studies that adjusted for age, gender, comorbidities and socioeconomic indices, the association diminished. This is not the case regarding pneumococcal vaccination, for which even after adjustment for such factors the association persisted. Regarding harder endpoints such as ICU admission and death, current data do not support the association. Possible explanations are discussed, including trained immunity, inadequate matching for socioeconomic indices and possible coinfection.
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Affiliation(s)
- Georgia V. Kapoula
- Department of Biochemistry, General Hospital of Lamia, 35131 Lamia, Greece
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Konstantina E. Vennou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
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14
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Perdixi E, Bernini S, Conti S, Jesuthasan N, Cotta Ramusino M, Costa A, Prinelli F. Pre-existing mental health disorders and fear of COVID-19 pandemic: Data from a phone survey in community-dwelling older adults recruited in the NutBrain study. Front Psychiatry 2022; 13:995308. [PMID: 36419980 PMCID: PMC9676658 DOI: 10.3389/fpsyt.2022.995308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Background COVID-19 has caused a parallel epidemic of fear, anxiety, depression, stress, and frustration, particularly among the most fragile and vulnerable individuals, such as older people and those with previous mental health disorders. The present study aims to investigate the association between pre-existing mental health disorders, particularly depressive symptoms and Mild Cognitive Impairment (MCI), and the fear of COVID-19 and to explore which cognitive domains were involved in coping with fear in older people. Materials and methods In April 2020, we conducted a phone-interview questionnaire on community-dwelling older adults living in Lombardy Region (Italy) who participated in the NutBrain study. At baseline, socio-demographic characteristics along with lifestyles, and medical history were recorded. Participants underwent a neuropsychological battery exploring the global cognitive function and specific cognitive domains, to detect cases of MCI. The Center for Epidemiologic Studies Depression scale (CES-D) was used for screening depressive symptoms. During the phone survey, respondents were assessed using a structured questionnaire querying about fear of the COVID-19 pandemic. We performed multivariate logistic regression models to study the association between MCI and depressive symptomatology and fear. We also explored which cognitive domains were associated with fear. Odds Ratios (OR) with Confidence Intervals (95%CI) were estimated adjusting for potential confounders. Results Out of the 351 respondents (mean age 73.5 ± 6.1 years, 59.8% women, 49.1% high education), at baseline, 22.9% had MCI and 18.8% had depressive symptoms. In the multivariate analyses gender, age, and body mass index were significantly associated with the fear score. Considering different domains of fear, MCI was associated with fear of being infected themselves (OR 2.55, 95%CI 1.39-4.70) while depressive symptoms were associated with fear of contagion for family members (OR 2.38, 95%CI 1.25-4.52). Impaired executive cognitive function was positively associated with the highest tertile of the fear score (OR 3.28, 95%CI 1.37-7.74) and with fear of contagion for themselves (OR 3.39, 95%CI 1.61-7.17). Conclusion Older adults experienced different fear reactions, particularly when suffering from neurocognitive disorders and depressive symptoms; executive dysfunction was associated with increased fear. These results highlighted the need to pay attention to the psychological effects of the outbreak of COVID-19 to target intervention, especially among vulnerable subgroups of individuals. Clinical trial registration [ClinicalTrials.gov], identifier [NCT04461951].
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Affiliation(s)
- Elena Perdixi
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Sara Bernini
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Conti
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Nithiya Jesuthasan
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, Segrate, MI, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Alfredo Costa
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Prinelli
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, Segrate, MI, Italy
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Georgakilas GK, Galanopoulos AP, Tsinaris Z, Kyritsi M, Mouchtouri VA, Speletas M, Hadjichristodoulou C. Machine-Learning-Assisted Analysis of TCR Profiling Data Unveils Cross-Reactivity between SARS-CoV-2 and a Wide Spectrum of Pathogens and Other Diseases. BIOLOGY 2022; 11:1531. [PMID: 36290433 PMCID: PMC9598299 DOI: 10.3390/biology11101531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/04/2022]
Abstract
During the last two years, the emergence of SARS-CoV-2 has led to millions of deaths worldwide, with a devastating socio-economic impact on a global scale. The scientific community's focus has recently shifted towards the association of the T cell immunological repertoire with COVID-19 progression and severity, by utilising T cell receptor sequencing (TCR-Seq) assays. The Multiplexed Identification of T cell Receptor Antigen (MIRA) dataset, which is a subset of the immunoACCESS study, provides thousands of TCRs that can specifically recognise SARS-CoV-2 epitopes. Our study proposes a novel Machine Learning (ML)-assisted approach for analysing TCR-Seq data from the antigens' point of view, with the ability to unveil key antigens that can accurately distinguish between MIRA COVID-19-convalescent and healthy individuals based on differences in the triggered immune response. Some SARS-CoV-2 antigens were found to exhibit equal levels of recognition by MIRA TCRs in both convalescent and healthy cohorts, leading to the assumption of putative cross-reactivity between SARS-CoV-2 and other infectious agents. This hypothesis was tested by combining MIRA with other public TCR profiling repositories that host assays and sequencing data concerning a plethora of pathogens. Our study provides evidence regarding putative cross-reactivity between SARS-CoV-2 and a wide spectrum of pathogens and diseases, with M. tuberculosis and Influenza virus exhibiting the highest levels of cross-reactivity. These results can potentially shift the emphasis of immunological studies towards an increased application of TCR profiling assays that have the potential to uncover key mechanisms of cell-mediated immune response against pathogens and diseases.
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Affiliation(s)
- Georgios K. Georgakilas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larisa, Greece
- Laboratory of Genetics, Department of Biology, University of Patras, 26500 Patras, Greece
| | - Achilleas P. Galanopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larisa, Greece
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larisa, Greece
| | - Zafeiris Tsinaris
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larisa, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larisa, Greece
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larisa, Greece
| | - Matthaios Speletas
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larisa, Greece
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Stahlfeld A, Glick LR, Ott IM, Craft SB, Yolda-Carr D, Harden CA, Nakahata M, Farhadian SF, Grant LR, Alexander-Parrish R, Arguedas A, Gessner BD, Weinberger DM, Wyllie AL. Detection of pneumococcus during hospitalization for SARS-CoV-2. FEMS MICROBES 2022; 3:xtac026. [PMID: 37332510 PMCID: PMC10117745 DOI: 10.1093/femsmc/xtac026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/29/2022] [Accepted: 10/12/2022] [Indexed: 10/22/2023] Open
Abstract
Background Infections with respiratory viruses [e.g. influenza and respiratory syncytial virus (RSV)] can increase the risk of severe pneumococcal infections. Likewise, pneumococcal coinfection is associated with poorer outcomes in viral respiratory infection. However, there are limited data describing the frequency of pneumococcus and SARS-CoV-2 coinfection and the role of coinfection in influencing COVID-19 severity. We, therefore, investigated the detection of pneumococcus in COVID-19 inpatients during the early pandemic period. Methods The study included patients aged 18 years and older, admitted to the Yale-New Haven Hospital who were symptomatic for respiratory infection and tested positive for SARS-CoV-2 during March-August 2020. Patients were tested for pneumococcus through culture-enrichment of saliva followed by RT-qPCR (to identify carriage) and serotype-specific urine antigen detection (UAD) assays (to identify presumed lower respiratory tract pneumococcal disease). Results Among 148 subjects, the median age was 65 years; 54.7% were male; 50.7% had an ICU stay; 64.9% received antibiotics; and 14.9% died while admitted. Pneumococcal carriage was detected in 3/96 (3.1%) individuals tested by saliva RT-qPCR. Additionally, pneumococcus was detected in 14/127 (11.0%) individuals tested by UAD, and more commonly in severe than moderate COVID-19 [OR: 2.20; 95% CI: (0.72, 7.48)]; however, the numbers were small with a high degree of uncertainty. None of the UAD-positive individuals died. Conclusions Pneumococcal lower respiratory tract infection (LRTI), as detected by positive UAD, occurred in patients hospitalized with COVID-19. Moreover, pneumococcal LRTI was more common in those with more serious COVID-19 outcomes. Future studies should assess how pneumococcus and SARS-CoV-2 interact to influence COVID-19 severity in hospitalized patients.
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Affiliation(s)
- Anne Stahlfeld
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Laura R Glick
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06511, United States
| | - Isabel M Ott
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Samuel B Craft
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06511, United States
| | - Devyn Yolda-Carr
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Christina A Harden
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Maura Nakahata
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Shelli F Farhadian
- Yale School of Medicine, 333 Cedar St, New Haven, CT 06511, United States
| | - Lindsay R Grant
- Medical and Scientific Affairs, Pfizer Inc, 500 Arcola Rd, Collegeville, PA 19426, United States
| | - Ronika Alexander-Parrish
- Medical and Scientific Affairs, Pfizer Inc, 500 Arcola Rd, Collegeville, PA 19426, United States
| | - Adriano Arguedas
- Medical and Scientific Affairs, Pfizer Inc, 500 Arcola Rd, Collegeville, PA 19426, United States
| | - Bradford D Gessner
- Medical and Scientific Affairs, Pfizer Inc, 500 Arcola Rd, Collegeville, PA 19426, United States
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
| | - Anne L Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, LEPH823, 60 College St, New Haven, CT 06510, United States
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Jiang B, Huang Q, Jia M, Xue X, Wang Q, Yang W, Feng L. Association between influenza vaccination and SARS-CoV-2 infection and its outcomes: systematic review and meta-analysis. Chin Med J (Engl) 2022; 135:2282-2293. [PMID: 36378238 PMCID: PMC9771237 DOI: 10.1097/cm9.0000000000002427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION PROSPERO, CRD42022333747.
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Affiliation(s)
- Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiangru Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xinai Xue
- Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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18
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Root-Bernstein R, Huber J, Ziehl A. Complementary Sets of Autoantibodies Induced by SARS-CoV-2, Adenovirus and Bacterial Antigens Cross-React with Human Blood Protein Antigens in COVID-19 Coagulopathies. Int J Mol Sci 2022; 23:ijms231911500. [PMID: 36232795 PMCID: PMC9569991 DOI: 10.3390/ijms231911500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/11/2022] Open
Abstract
COVID-19 patients often develop coagulopathies including microclotting, thrombotic strokes or thrombocytopenia. Autoantibodies are present against blood-related proteins including cardiolipin (CL), serum albumin (SA), platelet factor 4 (PF4), beta 2 glycoprotein 1 (β2GPI), phosphodiesterases (PDE), and coagulation factors such as Factor II, IX, X and von Willebrand factor (vWF). Different combinations of autoantibodies associate with different coagulopathies. Previous research revealed similarities between proteins with blood clotting functions and SARS-CoV-2 proteins, adenovirus, and bacterial proteins associated with moderate-to-severe COVID-19 infections. This study investigated whether polyclonal antibodies (mainly goat and rabbit) against these viruses and bacteria recognize human blood-related proteins. Antibodies against SARS-CoV-2 and adenovirus recognized vWF, PDE and PF4 and SARS-CoV-2 antibodies also recognized additional antigens. Most bacterial antibodies tested (group A streptococci [GAS], staphylococci, Escherichia coli [E. coli], Klebsiella pneumoniae, Clostridia, and Mycobacterium tuberculosis) cross-reacted with CL and PF4. while GAS antibodies also bound to F2, Factor VIII, Factor IX, and vWF, and E. coli antibodies to PDE. All cross-reactive interactions involved antibody-antigen binding constants smaller than 100 nM. Since most COVID-19 coagulopathy patients display autoantibodies against vWF, PDE and PF4 along with CL, combinations of viral and bacterial infections appear to be necessary to initiate their autoimmune coagulopathies.
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19
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Does Influenza Vaccination Reduce the Risk of Contracting COVID-19? J Clin Med 2022; 11:jcm11185297. [PMID: 36142944 PMCID: PMC9504696 DOI: 10.3390/jcm11185297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
The concurrent timing of the COVID-19 pandemic and the seasonal occurrence of influenza, makes it especially important to analyze the possible effect of the influenza vaccine on the risk of contracting COVID-19, or in reducing the complications caused by both diseases, especially in vulnerable populations. There is very little scientific information on the possible protective role of the influenza vaccine against the risk of contracting COVID-19, particularly in groups at high-risk of influenza complications. Reducing the risk of contracting COVID-19 in high-risk patients (those with a higher risk of infection, complications, and death) is essential to improve public well-being and to reduce hospital pressure and the collapse of primary health centers. Apart from overlapping in time, COVID-19 and flu share common aspects of transmission, so that measures to protect against flu might be effective in reducing the risk of contracting COVID-19. In this study, we conclude that the risk of contracting COVID-19 is reduced if patients are vaccinated against flu, but the reduction is small (0.22%) and therefore not clinically important. When this reduction is analysed based on the risk factor suffered by the patient, statistically significant differences have been obtained for patients with cardiovascular problems, diabetics, chronic lung and chronic kidney disease; in all four cases the reduction in the risk of contagion does not reach 1%. It is worth highlighting the behaviour that is completely different from the rest of the data for institutionalized patients. The data for these patients does not suggest a reduction in the risk of contagion for patients vaccinated against the flu, but rather the opposite, a significant increase of 6%. Socioeconomic conditions, as measured by the MEDEA deprivation index, explain increases in the risk of contracting COVID-19, and awareness campaigns should be increased to boost vaccination programs.
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Su W, Wang H, Sun C, Li N, Guo X, Song Q, Liang Q, Liang M, Ding X, Sun Y. The Association Between Previous Influenza Vaccination and COVID-19 Infection Risk and Severity: A Systematic Review and Meta-analysis. Am J Prev Med 2022; 63:121-130. [PMID: 35410774 PMCID: PMC8920881 DOI: 10.1016/j.amepre.2022.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The association between influenza vaccination and COVID-19 remains controversial. This meta-analysis aimed to investigate whether influenza vaccination reduces the susceptibility and severity of SARS-CoV-2 infection. METHODS A systematic literature search of PubMed, Web of Science, the Cochrane Library, Embase, China National Knowledge Infrastructure, SinoMed, Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP Database was conducted from database inception to August 2021. The pooled RR with 95% CI was used to estimate the effect of influenza vaccination on COVID-19. The I2 value was used to assess heterogeneity. If I2>50%, the random-effects model was used as the pooling method. RESULTS A total of 23 published articles with 1,037,445 participants were identified. This meta-analysis showed that influenza vaccination was associated with reduced risk of COVID-19 infection (RR=0.83, 95% CI=0.76, 0.90) and hospitalization (RR=0.71, 95% CI=0.59, 0.84), although not significantly associated with intensive care unit admission and death (risk of intensive care unit admission: RR=0.93, 95% CI=0.64, 1.36; risk of death: RR=0.83, 95% CI=0.68, 1.01). Further analysis suggested that the tetravalent influenza vaccine may be associated with a reduced risk of COVID-19 infection (RR=0.74, 95% CI=0.65, 0.84). DISCUSSION The results suggest that influenza vaccination is associated with reduced susceptibility to or disease severity of COVID-19 and that influenza vaccination may reduce the risk of COVID-19 and improve clinical outcomes.
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Affiliation(s)
- Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Chenyu Sun
- Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, P. R. China; Center for Evidence-Based Practice, Anhui Medical University, Anhui, P. R. China.
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Veronese N, Smith L, Di Gennaro F, Bruyère O, Yang L, Demurtas J, Maggi S, Sabico S, Al-Daghri NM, Barbagallo M, Dominguez LJ, Koyanagi A. Influenza Vaccination and COVID-19 Outcomes in People Older than 50 Years: Data from the Observational Longitudinal SHARE Study. Vaccines (Basel) 2022; 10:vaccines10060899. [PMID: 35746506 PMCID: PMC9229857 DOI: 10.3390/vaccines10060899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 02/01/2023] Open
Abstract
Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the association between influenza vaccination and COVID-19 outcomes. A total of 48,408 participants (mean age 67 years; 54.1% females) were included. The prevalence of influenza vaccination was 38.3%. After adjusting for 15 potential confounders, influenza vaccination was significantly associated with a lower risk of positivity for COVID-19 (OR = 0.95; p < 0.0001), symptomatic forms (OR = 0.87; p < 0.0001), and hospitalization for COVID-19 (OR = 0.95; p < 0.0001). The results were similar when using a propensity score approach. In conclusion, influenza vaccination may be beneficial for the prevention of COVID-19, as the present study found that influenza vaccination was associated with a small/moderate lower risk of COVID-19 infection and adverse outcomes.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
- Correspondence:
| | - Lee Smith
- Center for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PTT, UK;
| | | | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium;
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3E4, Canada;
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jacopo Demurtas
- Primary Care Department, Azienda USL Toscana Sud Est, 52100 Grosseto, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefania Maggi
- Institute of Neuroscience, National Research Council, 00185 Padova, Italy;
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (S.S.); (N.M.A.-D.)
| | - Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (S.S.); (N.M.A.-D.)
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
| | - Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy; (M.B.); (L.J.D.)
- Faculty of Medicine, University of Kore, 94100 Enna, Italy
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu/CIBERSAM, ISCIII, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08014 Barcelona, Spain;
- ICREA, 08010 Barcelona, Spain
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22
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Tavares Costa M, Ribeiro AS, Oliveira Almeida D, Ochoa-Leite C. Pneumococcal vaccination in a northern Portugal health centre during COVID-19 pandemic. Semergen 2022; 48:293-294. [PMID: 35491376 PMCID: PMC8801971 DOI: 10.1016/j.semerg.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- M Tavares Costa
- Unidade de Saúde Familiar Monte Crasto, ACeS Gondomar, ARS Norte, Portugal.
| | - A S Ribeiro
- Unidade de Saúde Familiar Monte Crasto, ACeS Gondomar, ARS Norte, Portugal
| | | | - C Ochoa-Leite
- IPO Porto - Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal; FMUP - Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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23
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Arce-Salinas CA, Esquivel-Torruco YN, Bejarano-Juvera AA, Bustamante-Flores AK, Aguilar-Martínez N, Azcorra-López JG, Cabañas-Espinosa B, Luna-Rivera EM, Hernández-Alarcón A, Reyna Figueroa J. Asociación entre la vacunación contra influenza y la mortalidad por COVID-19. VACUNAS 2022; 23:113-118. [PMID: 34751213 PMCID: PMC8566694 DOI: 10.1016/j.vacun.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022]
Affiliation(s)
- C A Arce-Salinas
- Servicio de Medicina Interna, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - Y N Esquivel-Torruco
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A A Bejarano-Juvera
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A K Bustamante-Flores
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - N Aguilar-Martínez
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - J G Azcorra-López
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - B Cabañas-Espinosa
- Servicio de Pediatría, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - E M Luna-Rivera
- Departamento de Enseñanza e Investigación, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - A Hernández-Alarcón
- Servicio de Consulta Externa, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
| | - J Reyna Figueroa
- Departamento de Enseñanza e Investigación, Hospital Central Sur Petróleos Mexicanos, Ciudad de México, México
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24
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An Independent Study to Compare Compliance, Attitudes, Knowledge, and Sources of Knowledge about Pneumococcal Vaccinations among an Italian Sample of Older Adults. Vaccines (Basel) 2022; 10:vaccines10040490. [PMID: 35455239 PMCID: PMC9030078 DOI: 10.3390/vaccines10040490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Streptococcus pneumoniae is one of the leading causes of pneumoniae deaths, especially among elderly individuals, with the vaccine being the primary prevention instrument. However, information on national vaccine coverage among the elderly population is scarce and sparse. Methods: A survey involved a representative sample of Italians older than 65 years (n = 600), who agreed to participate in the study through a phone interview. Participants’ self-reported pneumococcal vaccination status, vaccine literacy, information source, and risk perception related to the infection and to vaccines-adverse reactions were assessed. Results: The reported vaccination status is very low (11.2%), with respondents largely uninformed about vaccination opportunities. The results also show that the predominant (and most effective) source of information is healthcare providers, with vaccine hesitancy being positively linked to risk perception related to disease and negatively linked to risk perception of vaccine adverse reactions. Conclusions: This study suggests the need to collect data to systematically monitor vaccination coverage and calls for information campaigns to improve elderly literacy to increase vaccination uptake.
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25
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Influenza Vaccination Uptake in the General Italian Population during the 2020–2021 Flu Season: Data from the EPICOVID-19 Online Web-Based Survey. Vaccines (Basel) 2022; 10:vaccines10020293. [PMID: 35214751 PMCID: PMC8877796 DOI: 10.3390/vaccines10020293] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/16/2022] Open
Abstract
To assess influenza vaccine uptake during the 2020/2021 flu season and compare it with that of the 2019/2020 flu season among respondents to the second phase of the web-based EPICOVID-19 survey, we performed an observational web-based nationwide online survey (January–February 2021) in which respondents to the first survey (April–June 2020) were contacted and asked to complete a second questionnaire. Factors associated with vaccine uptake in the 2020/2021 flu season were assessed by applying a multivariable multinomial logistic regression model. Out of the 198,822 respondents to the first survey, 41,473 (20.9%) agreed to fill out the follow-up questionnaire; of these, 8339 (20.1%) were vaccinated only during the 2020/2021 season, 8828 (21.3%) were vaccinated during both seasons and 22,710 (54.8%) were vaccinated in neither season. Educational level (medium (aOR 1.33 95%CI 1.13–1.56) and high (aOR 1.69 95%CI 1.44–1.97) vs. low) and socio-economic deprivation according to SES scoring (1 point aOR 0.83 (95%CI 0.78–0.89), 2 aOR 0.68 (95%CI 0.60–0.77) points or ≥3 points aOR 0.42 (95%CI 0.28–0.45) vs. 0 points) were found to be associated with flu vaccine uptake. Our study shows that social determinants seemed to affect flu vaccination uptake and identifies specific categories of the population to target during future influenza vaccination campaigns.
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26
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Paganoti CDF, Rodrigues AS, Francisco RPV, da Costa RA. The Influenza Vaccine May Protect Pregnant and Postpartum Women against Severe COVID-19. Vaccines (Basel) 2022; 10:vaccines10020206. [PMID: 35214665 PMCID: PMC8875780 DOI: 10.3390/vaccines10020206] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/01/2023] Open
Abstract
The SARS-CoV-2 pandemic has imposed a huge challenge on the antenatal care of pregnant women worldwide, with the maternal mortality rate being raised to alarming levels. While COVID-19 vaccines were developed, some studies highlighted a possible relationship between influenza vaccination and lower odds of COVID-19 infection. As obstetric patients belong to a high-risk group for respiratory diseases, this study evaluated whether influenza vaccination reduces the severity of COVID-19 infection and mortality among pregnant and postpartum women. We conducted a retrospective cohort study on 3370 pregnant and postpartum women from the Brazilian national database, where they were grouped according to their influenza vaccination status before the onset of COVID-19 symptoms. The intensive care unit admission and intubation rates were significantly higher among subjects in the unvaccinated group (p = 0.002 and p < 0.001, respectively). The odds of mortality risk among those who received the vaccine was 0.33, with a 95% confidence interval of 0.23–0.47. The numbers of patients who needed to be vaccinated to avoid a case of intensive care unit admission, intubation, or death due to COVID-19 were 11, 15, and 11, respectively. Influenza vaccines could confer protection against severe COVID-19 infection in pregnant and postpartum women.
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Affiliation(s)
- Cristiane de Freitas Paganoti
- Division of Clinical Obstetrics, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
- Correspondence: ; Tel.: +55-11-2661-6209
| | | | - Rossana Pulcineli Vieira Francisco
- Discipline of Obstetrics, Department of Obstetrics and Gynecology, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
| | - Rafaela Alkmin da Costa
- Division of Clinical Obstetrics, Hospital das Clinicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil;
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27
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Adorni F, Jesuthasan N, Perdixi E, Sojic A, Giacomelli A, Noale M, Trevisan C, Franchini M, Pieroni S, Cori L, Mastroianni CM, Bianchi F, Antonelli-Incalzi R, Maggi S, Galli M, Prinelli F. Epidemiology of SARS-CoV-2 Infection in Italy Using Real-World Data: Methodology and Cohort Description of the Second Phase of Web-Based EPICOVID19 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1274. [PMID: 35162295 PMCID: PMC8835202 DOI: 10.3390/ijerph19031274] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 12/29/2022]
Abstract
Digital technologies have been extensively employed in response to the SARS-CoV-2 pandemic worldwide. This study describes the methodology of the two-phase internet-based EPICOVID19 survey, and the characteristics of the adult volunteer respondents who lived in Italy during the first (April-May 2020) and the second wave (January-February 2021) of the epidemic. Validated scales and ad hoc questionnaires were used to collect socio-demographic, medical and behavioural characteristics, as well as information on COVID-19. Among those who provided email addresses during phase I (105,355), 41,473 participated in phase II (mean age 50.7 years ± 13.5 SD, 60.6% females). After a median follow-up of ten months, 52.8% had undergone nasopharyngeal swab (NPS) testing and 13.2% had a positive result. More than 40% had undergone serological test (ST) and 11.9% were positive. Out of the 2073 participants with at least one positive ST, 72.8% had only negative results from NPS or never performed it. These results indicate that a large fraction of individuals remained undiagnosed, possibly contributing to the spread of the virus in the community. Participatory online surveys offer a unique opportunity to collect relevant data at individual level from large samples during confinement.
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Affiliation(s)
- Fulvio Adorni
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Nithiya Jesuthasan
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Elena Perdixi
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Aleksandra Sojic
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
| | - Andrea Giacomelli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (A.G.); (M.G.)
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Aging Branch, Via Vincenzo Maria Gallucci 16, 35128 Padova, Italy; (M.N.); (S.M.)
| | - Caterina Trevisan
- Geriatric Unit, Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128 Padova, Italy;
- Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, Cona, 44124 Ferrara, Italy
| | - Michela Franchini
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Stefania Pieroni
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Liliana Cori
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
| | - Fabrizio Bianchi
- National Research Council, Institute of Clinical Physiology, Via G. Moruzzi 1, 56124 Pisa, Italy; (M.F.); (S.P.); (L.C.); (F.B.)
| | | | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Via Vincenzo Maria Gallucci 16, 35128 Padova, Italy; (M.N.); (S.M.)
| | - Massimo Galli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (A.G.); (M.G.)
| | - Federica Prinelli
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi 93, 20054 Segrate, Italy; (N.J.); (E.P.); (A.S.); (F.P.)
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28
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Hupert N, Marín-Hernández D, Gao B, Águas R, Nixon DF. Heterologous vaccination interventions to reduce pandemic morbidity and mortality: Modeling the US winter 2020 COVID-19 wave. Proc Natl Acad Sci U S A 2022; 119:e2025448119. [PMID: 35012976 PMCID: PMC8784160 DOI: 10.1073/pnas.2025448119] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/02/2021] [Indexed: 12/12/2022] Open
Abstract
COVID-19 remains a stark health threat worldwide, in part because of minimal levels of targeted vaccination outside high-income countries and highly transmissible variants causing infection in vaccinated individuals. Decades of theoretical and experimental data suggest that nonspecific effects of non-COVID-19 vaccines may help bolster population immunological resilience to new pathogens. These routine vaccinations can stimulate heterologous cross-protective effects, which modulate nontargeted infections. For example, immunization with Bacillus Calmette-Guérin, inactivated influenza vaccine, oral polio vaccine, and other vaccines have been associated with some protection from SARS-CoV-2 infection and amelioration of COVID-19 disease. If heterologous vaccine interventions (HVIs) are to be seriously considered by policy makers as bridging or boosting interventions in pandemic settings to augment nonpharmaceutical interventions and specific vaccination efforts, evidence is needed to determine their optimal implementation. Using the COVID-19 International Modeling Consortium mathematical model, we show that logistically realistic HVIs with low (5 to 15%) effectiveness could have reduced COVID-19 cases, hospitalization, and mortality in the United States fall/winter 2020 wave. Similar to other mass drug administration campaigns (e.g., for malaria), HVI impact is highly dependent on both age targeting and intervention timing in relation to incidence, with maximal benefit accruing from implementation across the widest age cohort when the pandemic reproduction number is >1.0. Optimal HVI logistics therefore differ from optimal rollout parameters for specific COVID-19 immunizations. These results may be generalizable beyond COVID-19 and the US to indicate how even minimally effective heterologous immunization campaigns could reduce the burden of future viral pandemics.
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Affiliation(s)
- Nathaniel Hupert
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065;
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
- Cornell Institute for Disease and Disaster Preparedness, Cornell University, New York, NY 10065
| | - Daniela Marín-Hernández
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
| | - Bo Gao
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, United Kingdom
| | - Ricardo Águas
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, United Kingdom
| | - Douglas F Nixon
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY 10065
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29
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Kristensen JH, Hasselbalch RB, Pries-Heje M, Nielsen PB, Dehlbæk Knudsen A, Fogh K, Boesgaard Norsk J, Eiken A, Andersen O, Fischer TK, Juul Jensen CA, Torp-Pedersen C, Rungby J, Ditlev SB, Hageman I, Møgelvang R, Gybel-Brask M, Dessau RB, Sørensen E, Harritshøj L, Folke F, Engel Møller ME, Benfield T, Ullum H, Jørgensen CS, Rye Ostrowski S, Nielsen SD, Bundgaard H, Iversen K. Effect of influenza vaccination on risk of COVID-19 - A prospective cohort study of 46,000 health care workers. J Infect Dis 2022; 226:6-10. [PMID: 34989811 PMCID: PMC8755365 DOI: 10.1093/infdis/jiac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/04/2022] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to assess if influenza vaccination has an impact on the risk of COVID-19. A cohort of 46,112 health care workers were tested for antibodies against SARS-CoV-2 and filled in a survey on COVID-19 symptoms, hospitalization, and influenza vaccination. The RR of hospitalization due to SARS-CoV-2 for influenza vaccinated compared with unvaccinated participants was 1.00 for the seasonal vaccination in 2019/2020 (CI 0.56-1.78, p=1.00). Likewise, no clinical effect of influenza vaccination on development of antibodies against SARS-CoV-2 was found. The present findings indicate that influenza vaccination does not affect the risk of SARS-CoV-2 infection or COVID-19.
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Affiliation(s)
- Jonas Henrik Kristensen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Rasmus Bo Hasselbalch
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Mia Pries-Heje
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Pernille Brok Nielsen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Andreas Dehlbæk Knudsen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Infectious Disease, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Kamille Fogh
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Jakob Boesgaard Norsk
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Aleksander Eiken
- Department of Endocrinology and Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23. 2400 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Ove Andersen
- Department of Emergency and Department of Clinical Research, Copenhagen University Hospital - Amager og Hvidovre, Kettegård Alle 30, 2650 Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Thea Kølsen Fischer
- Department of Clinical Research, Copenhagen University Hospital - Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.,Department of Public Health, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Claus Antonio Juul Jensen
- Department of Clinical Biochemistry, Copenhagen University Hospital - Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Clinical Research, Copenhagen University Hospital - Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.,Department of Public Health, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Jørgen Rungby
- Department of Endocrinology and Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23. 2400 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Sisse Bolm Ditlev
- Department of Pulmonary Medicine and Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Ida Hageman
- Mental Health Services - The Capital Region of Denmark, Kristineberg 3, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Rasmus Møgelvang
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Mikkel Gybel-Brask
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Ram Benny Dessau
- Department of Clinical Microbiology, Zealand University Hospital - Slagelse, Ingemannsvej 46, 4200 Slagelse, Denmark.,Institut for Regional Sundhedsforskning, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Lene Harritshøj
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Copenhagen University Hospital - Copenhagen Emergency Medical Services, Telegrafvej 5A, Stairway 2, 2750 Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Maria Elizabeth Engel Møller
- Department of Infectious Disease, Copenhagen University Hospital - Amager and Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark
| | - Thomas Benfield
- Department of Infectious Disease, Copenhagen University Hospital - Amager and Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Henrik Ullum
- Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark
| | | | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Department of Infectious Disease, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Kasper Iversen
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
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30
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Root‐Bernstein R. COVID-19 coagulopathies: Human blood proteins mimic SARS-CoV-2 virus, vaccine proteins and bacterial co-infections inducing autoimmunity: Combinations of bacteria and SARS-CoV-2 synergize to induce autoantibodies targeting cardiolipin, cardiolipin-binding proteins, platelet factor 4, prothrombin, and coagulation factors. Bioessays 2021; 43:e2100158. [PMID: 34677872 PMCID: PMC8646673 DOI: 10.1002/bies.202100158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 12/15/2022]
Abstract
Severe COVID-19 is often accompanied by coagulopathies such as thrombocytopenia and abnormal clotting. Rarely, such complications follow SARS-CoV-2 vaccination. The cause of these coagulopathies is unknown. It is hypothesized that coagulopathies accompanying SARS-CoV-2 infections and vaccinations result from bacterial co-infections that synergize with virus-induced autoimmunity due to antigenic mimicry of blood proteins by both bacterial and viral antigens. Coagulopathies occur mainly in severe COVID-19 characterized by bacterial co-infections with Streptococci, Staphylococci, Klebsiella, Escherichia coli, and Acinetobacter baumannii. These bacteria express unusually large numbers of antigens mimicking human blood antigens, as do both SARS-CoV-2 and adenoviruses. Bacteria mimic cardiolipin, prothrombin, albumin, and platelet factor 4 (PF4). SARS-CoV-2 mimics complement factors, Rh antigens, platelet phosphodiesterases, Factors IX and X, von Willebrand Factor (VWF), and VWF protease ADAMTS13. Adenoviruses mimic prothrombin and platelet factor 4. Bacterial prophylaxis, avoidance of vaccinating bacterially infected individuals, and antigen deletion for vaccines may reduce coagulopathy risk. Also see the video abstract here: https://youtu.be/zWDOsghrPg8.
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Zeynali Bujani M, Behnampour M, Rahimi N, Safari T, Khazaei Feizabad A, Hossein Sarbazi A, Baniasadi M, Rezaei N, Ansari Moghaddam A. The Effect of Influenza Vaccination on COVID-19 Morbidity, Severity and Mortality: Systematic Review and Meta-Analysis. Malays J Med Sci 2021; 28:20-31. [PMID: 35002487 PMCID: PMC8715887 DOI: 10.21315/mjms2021.28.6.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/20/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is rapidly developing worldwide with a high mortality rate. In this meta-analysis study, the effect of influenza vaccination on the prevention of COVID-19 and its consequences in patients were investigated. The systematic search for this study was performed from November 2019 to 25 November 2020, in the databases of Medline, PubMed, Scopus, Web of Science, Embase, Ebsco, Cochrane and medRxiv. Search terms used included COVID-19, coronavirus, SARS-CoV-2, covid, influenza, flu, grippe and vaccine. The present study examined the association between influenza vaccination and COVID-19 including COVID-19 infection, mortality, hospitalisation and intensive care unit (ICU) admission. Finally, the pooled estimates for different outcomes were calculated by the software for statistics and data science (STATA) version 15 and I2 was used to determine the heterogeneity. By analysing the data of articles, the pooled estimates of these data indicated that influenza vaccination could lower probability of COVID-19 infection up to 24% (OR = 0.77; 95% CI: 0.65, 0.91), of death up to 32% (OR = 0.68; 95% CI: 0.42, 1.11), of the hospitalisation up to 25% (OR = 0.75; 95% CI: 0.46; 1.23) and of admission to ICU up to 29% (OR = 0.71; 95% CI: 0.40, 1.27). Influenza vaccination can help decrease the COVID-19 infection and reduce hospitalisation and the need for ICU and mortality rates.
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Affiliation(s)
- Meysam Zeynali Bujani
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Mohammad Behnampour
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Nima Rahimi
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Tahereh Safari
- Department of Physiology, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | | | - Armaghan Hossein Sarbazi
- Department of Emergency Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Marzieh Baniasadi
- Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Alireza Ansari Moghaddam
- Interest Group of Coronavirus 2019 (IGCV-19), Universal Scientific Education and Research Network (USERN), Zahedan, Iran
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Enners S, Gradl G, Kieble M, Böhm M, Laufs U, Schulz M. Utilization of drugs with reports on potential efficacy or harm on COVID-19 before, during, and after the first pandemic wave. Pharmacoepidemiol Drug Saf 2021; 30:1493-1503. [PMID: 34245078 PMCID: PMC8441787 DOI: 10.1002/pds.5324] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/14/2021] [Accepted: 07/02/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Conflicting information on potential benefits of drugs as well as reports on hypothetical harm of commonly used drugs in COVID-19 treatment have challenged clinicians and healthcare systems. We analyzed the change in ambulatory drug utilization before, during, and after the first wave of the pandemic in 2020. METHODS We explored dispensing data of nearly 19 000 pharmacies at the expense of the statutory health insurance funds covering 88% of Germany's population. We analyzed utilization of publicly discussed drugs with conflicting information. Drug utilization as number of packages dispensed per week from January to June 2020, reflecting 314 million claims, was compared with 2019. RESULTS Utilization of hydroxychloroquine increased +110% during March 2020 and then slightly decreased until week April 13-19. Renin-angiotensin-aldosterone system inhibitors and simvastatin/atorvastatin increased, +78% and +74%, respectively, and subsequently decreased below 2019 levels. Utilization of azithromycin and all systemic antibiotics decreased continuously from March 2-8 until June to levels considerably lower compared to 2019 (June 22-28: azithromycin: -55%, all systemic antibiotics: -27%). Pneumococcal vaccines utilization initially increased +373%, followed by supply shortages. Paracetamol utilization showed an initial increase of +111%, mainly caused by an increase of over-the-counter dispensings. CONCLUSIONS Apart from the pandemic itself, the data suggest that dissemination of misinformation and unsound speculations as well as supply shortages influenced drug prescribing, utilization, and purchasing behavior. The findings can inform post-pandemic policy to prevent unfounded over- and underprescribing and off-label use as well as drug shortages during a public health crisis.
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Affiliation(s)
- Salka Enners
- German Institute for Drug Use Evaluation (DAPI)BerlinGermany
| | - Gabriele Gradl
- German Institute for Drug Use Evaluation (DAPI)BerlinGermany
| | - Marita Kieble
- German Institute for Drug Use Evaluation (DAPI)BerlinGermany
| | - Michael Böhm
- Department of Internal Medicine III – Cardiology, Angiology and Intensive Care MedicineSaarland University Medical CenterHomburgGermany
| | - Ulrich Laufs
- Department of CardiologyUniversity Hospital LeipzigLeipzigGermany
| | - Martin Schulz
- German Institute for Drug Use Evaluation (DAPI)BerlinGermany
- Drug Commission of German Pharmacists (AMK)BerlinGermany
- Institute of PharmacyFreie Universität BerlinBerlinGermany
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33
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Littera R, Chessa L, Deidda S, Angioni G, Campagna M, Lai S, Melis M, Cipri S, Firinu D, Santus S, Lai A, Porcella R, Rassu S, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Ragatzu P, Vacca M, Cannas F, Alba F, Carta MG, Del Giacco S, Restivo A, Deidda S, Palimodde A, Congera P, Perra R, Orrù G, Pes F, Loi M, Murru C, Urru E, Onali S, Coghe F, Giglio S, Perra A. Natural killer-cell immunoglobulin-like receptors trigger differences in immune response to SARS-CoV-2 infection. PLoS One 2021; 16:e0255608. [PMID: 34352002 PMCID: PMC8341547 DOI: 10.1371/journal.pone.0255608] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background The diversity in the clinical course of COVID-19 has been related to differences in innate and adaptative immune response mechanisms. Natural killer (NK) lymphocytes are critical protagonists of human host defense against viral infections. It would seem that reduced circulating levels of these cells have an impact on COVID-19 progression and severity. Their activity is strongly regulated by killer-cell immuno-globulin-like receptors (KIRs) expressed on the NK cell surface. The present study’s focus was to investigate the impact of KIRs and their HLA Class I ligands on SARS-CoV-2 infection. Methods KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 396 Sardinian patients with SARS-CoV-2 infection. Comparisons were made between 2 groups of patients divided according to disease severity: 240 patients were symptomatic or paucisymptomatic (Group A), 156 hospitalized patients had severe disease (Group S). The immunogenetic characteristics of patients were also compared to a population group of 400 individuals from the same geographical areas. Results Substantial differences were obtained for KIR genes, KIR haplotypes and KIR-HLA ligand combinations when comparing patients of Group S to those of Group A. Patients in Group S had a statistically significant higher frequency of the KIR A/A haplotype compared to patients in Group A [34.6% vs 23.8%, OR = 1.7 (95% CI 1.1–2.6); P = 0.02, Pc = 0.04]. Moreover, the KIR2DS2/HLA C1 combination was poorly represented in the group of patients with severe symptoms compared to those of the asymptomatic-paucisymptomatic group [33.3% vs 50.0%, OR = 0.5 (95% CI 0.3–0.8), P = 0.001, Pc = 0.002]. Multivariate analysis confirmed that, regardless of the sex and age of the patients, the latter genetic variable correlated with a less severe disease course [ORM = 0.4 (95% CI 0.3–0.7), PM = 0.0005, PMC = 0.005]. Conclusions The KIR2DS2/HLA C1 functional unit resulted to have a strong protective effect against the adverse outcomes of COVID-19. Combined to other well known factors such as advanced age, male sex and concomitant autoimmune diseases, this marker could prove to be highly informative of the disease course and thus enable the timely intervention needed to reduce the mortality associated with the severe forms of SARS-CoV-2 infection. However, larger studies in other populations as well as experimental functional studies will be needed to confirm our findings and further pursue the effect of KIR receptors on NK cell immune-mediated response to SARS-Cov-2 infection.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Silvia Deidda
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Maurizio Melis
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Local Crisis Unit (UCL), ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Alba
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Paola Congera
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Loi
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Claudia Murru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Urru
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
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Redondo E, Rivero-Calle I, Mascarós E, Yuste JE, Fernández-Prada M, Ocaña D, Jimeno I, Gil A, Molina J, Díaz-Maroto JL, Linares M, Martinón-Torres F. [Vaccination against community acquired pneumonia in adults. Update 2021 of the position paper by Neumoexpertos en Prevención Group]. Semergen 2021; 47:411-425. [PMID: 34332864 DOI: 10.1016/j.semerg.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.
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Affiliation(s)
- E Redondo
- Medicina de Familia, Grupo de Actividades Preventivas y Salud Pública SEMERGEN, Centro de Salud Internacional, Ayuntamiento de Madrid, Madrid, España.
| | - I Rivero-Calle
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
| | - E Mascarós
- Medicina de Familia, Departamento de Salud Hospital la Fe, Consultorio Auxiliar Arquitecto Tolsá, Valencia, España
| | - J E Yuste
- Centro Nacional de Microbiología, Instituto de Salud Carlos III y CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - M Fernández-Prada
- Unidad de Vacunas, Servicio Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres, Asturias, España
| | - D Ocaña
- Medicina de Familia, Centro de Atención Primaria Algeciras-Norte, Algeciras, Cádiz, España
| | - I Jimeno
- Medicina de Familia, Centro de Salud Isla de Oza, Madrid, España
| | - A Gil
- Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - J Molina
- Medicina de Familia, Centro de Atención Primaria Francia, Fuenlabrada, Madrid, España
| | - J L Díaz-Maroto
- Medicina de Familia, Centro de Atención Primaria de Guadalajara, Guadalajara, España
| | - M Linares
- Medicina de Familia, Microbiología clínica, Miembro del Grupo de Enfermedades Infecciosas de SEMERGEN. Fundación iO, España
| | - F Martinón-Torres
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
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Laupèze B, Del Giudice G, Doherty MT, Van der Most R. Vaccination as a preventative measure contributing to immune fitness. NPJ Vaccines 2021; 6:93. [PMID: 34315886 PMCID: PMC8316335 DOI: 10.1038/s41541-021-00354-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
The primary goal of vaccination is the prevention of pathogen-specific infection. The indirect consequences may include maintenance of homeostasis through prevention of infection-induced complications; trained immunity that re-programs innate cells to respond more efficiently to later, unrelated threats; slowing or reversing immune senescence by altering the epigenetic clock, and leveraging the pool of memory B and T cells to improve responses to new infections. Vaccines may exploit the plasticity of the immune system to drive longer-term immune responses that promote health at a broader level than just the prevention of single, specific infections. In this perspective, we discuss the concept of “immune fitness” and how to potentially build a resilient immune system that could contribute to better health. We argue that vaccines may contribute positively to immune fitness in ways that are only beginning to be understood, and that life-course vaccination is a fundamental tool for achieving healthy aging.
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36
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Sandri MT, Azzolini E, Torri V, Carloni S, Pozzi C, Salvatici M, Tedeschi M, Castoldi M, Mantovani A, Rescigno M. SARS-CoV-2 serology in 4000 health care and administrative staff across seven sites in Lombardy, Italy. Sci Rep 2021; 11:12312. [PMID: 34112899 PMCID: PMC8192543 DOI: 10.1038/s41598-021-91773-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Lombardy is the Italian region most affected by COVID-19. We tested the presence of plasma anti-SARS-CoV-2 IgG antibodies in 3985 employees across 7 healthcare facilities in areas of Lombardy with different exposure to the SARS-CoV-2 epidemic. Subjects filled a questionnaire to self-report on COVID-19 symptoms, comorbidities, smoking, regular or remote working, and the exposure to COVID-infected individuals. We show that the number of individuals exposed to the virus depended on the geographical location of the facility, ranging between 3 and 43%, consistent with the spatial variation of COVID-19 incidence in Lombardy, and correlated with family interactions. We observed a higher prevalence of females than males positive for IgG, however the level of antibodies was similar, suggesting a comparable magnitude of the anti-spike antibody response. IgG positivity among smokers was lower (7.4% vs 13.5%) although without difference in IgG plasma levels. We observed 11.9% of IgG positive asymptomatic individuals and another 23.1% with one or two symptoms. Interestingly, among the IgG positive population, 81.2% of subjects with anosmia/dysgeusia and fever were SARS-CoV-2 infected, indicating that these symptoms are strongly associated to COVID-19. In conclusion, the frequency of IgG positivity and SARS-CoV-2 infection is dependent on the geographical exposure to the virus and primarily to family rather than hospital exposure.
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Affiliation(s)
| | - Elena Azzolini
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Valter Torri
- Istituto Di Ricerche Farmacologiche, Mario Negri" - IRCCS, Milan, Italy
| | - Sara Carloni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Chiara Pozzi
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | | | | | - Alberto Mantovani
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- The William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Maria Rescigno
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
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Park DE, Higdon MM, Prosperi C, Baggett HC, Brooks WA, Feikin DR, Hammitt LL, Howie SRC, Kotloff KL, Levine OS, Madhi SA, Murdoch DR, O’Brien KL, Scott JAG, Thea DM, Antonio M, Awori JO, Baillie VL, Bunthi C, Kwenda G, Mackenzie GA, Moore DP, Morpeth SC, Mwananyanda L, Paveenkittiporn W, Ziaur Rahman M, Rahman M, Rhodes J, Sow SO, Tapia MD, Deloria Knoll M. Upper Respiratory Tract Co-detection of Human Endemic Coronaviruses and High-density Pneumococcus Associated With Increased Severity Among HIV-Uninfected Children Under 5 Years Old in the PERCH Study. Pediatr Infect Dis J 2021; 40:503-512. [PMID: 33883479 PMCID: PMC8104011 DOI: 10.1097/inf.0000000000003139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Severity of viral respiratory illnesses can be increased with bacterial coinfection and can vary by sex, but influence of coinfection and sex on human endemic coronavirus (CoV) species, which generally cause mild to moderate respiratory illness, is unknown. We evaluated CoV and pneumococcal co-detection by sex in childhood pneumonia. METHODS In the 2011-2014 Pneumonia Etiology Research for Child Health study, nasopharyngeal and oropharyngeal (NP/OP) swabs and other samples were collected from 3981 children <5 years hospitalized with severe or very severe pneumonia in 7 countries. Severity by NP/OP detection status of CoV (NL63, 229E, OC43 or HKU1) and high-density (≥6.9 log10 copies/mL) pneumococcus (HDSpn) by real-time polymerase chain reaction was assessed by sex using logistic regression adjusted for age and site. RESULTS There were 43 (1.1%) CoV+/HDSpn+, 247 CoV+/HDSpn-, 449 CoV-/HDSpn+ and 3149 CoV-/HDSpn- cases with no significant difference in co-detection frequency by sex (range 51.2%-64.0% male, P = 0.06). More CoV+/HDSpn+ pneumonia was very severe compared with other groups for both males (13/22, 59.1% versus range 29.1%-34.7%, P = 0.04) and females (10/21, 47.6% versus 32.5%-43.5%, P = 0.009), but only male CoV+/HDSpn+ required supplemental oxygen more frequently (45.0% versus 20.6%-28.6%, P < 0.001) and had higher mortality (35.0% versus 5.3%-7.1%, P = 0.004) than other groups. For females with CoV+/HDSpn+, supplemental oxygen was 25.0% versus 24.8%-33.3% (P = 0.58) and mortality was 10.0% versus 9.2%-12.9% (P = 0.69). CONCLUSIONS Co-detection of endemic CoV and HDSpn was rare in children hospitalized with pneumonia, but associated with higher severity and mortality in males. Findings may warrant investigation of differences in severity by sex with co-detection of HDSpn and SARS-CoV-2.
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Affiliation(s)
- Daniel E. Park
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Melissa M. Higdon
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Christine Prosperi
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Henry C. Baggett
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - W. Abdullah Brooks
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Daniel R. Feikin
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Laura L. Hammitt
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Steve R. C. Howie
- Medical Research Council Unit, Basse, The Gambia
- Department of Paediatrics, University of Auckland, New Zealand
| | - Karen L. Kotloff
- Department of Pediatrics and Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Orin S. Levine
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Bill & Melinda Gates Foundation, Seattle, Washington
| | - Shabir A. Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - David R. Murdoch
- Department of Pathology and Biomedical Sciences, University of Otago
- Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Katherine L. O’Brien
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - J. Anthony G. Scott
- KEMRI Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Coast, Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Donald M. Thea
- Department of Global Health and Development, Boston University School of Public Health, Boston, Massachusetts
| | - Martin Antonio
- Medical Research Council Unit, Basse, The Gambia
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine
- Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Juliet O. Awori
- KEMRI Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Coast, Kilifi, Kenya
| | - Vicky L. Baillie
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit
| | - Charatdao Bunthi
- Division of Global Health Protection, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Geoffrey Kwenda
- Right to Care-Zambia
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Grant A. Mackenzie
- Medical Research Council Unit, Basse, The Gambia
- Murdoch Children’s Research Institute, Melbourne, Australia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Paediatrics, University of Melbourne, Australia
| | - David P. Moore
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit
- Department of Paediatrics & Child Health, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, South Africa
| | - Susan C. Morpeth
- KEMRI Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Coast, Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Microbiology Laboratory, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Lawrence Mwananyanda
- Department of Global Health and Development, Boston University School of Public Health, Boston, Massachusetts
- EQUIP-Zambia, Lusaka, Zambia
| | | | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Julia Rhodes
- Division of Global Health Protection, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Samba O. Sow
- Centre pour le Développement des Vaccins (CVD-Mali), Bamako, Mali
| | - Milagritos D. Tapia
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Maria Deloria Knoll
- From the Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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38
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Huang K, Lin SW, Sheng WH, Wang CC. Influenza vaccination and the risk of COVID-19 infection and severe illness in older adults in the United States. Sci Rep 2021; 11:11025. [PMID: 34040014 PMCID: PMC8155195 DOI: 10.1038/s41598-021-90068-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 05/06/2021] [Indexed: 12/23/2022] Open
Abstract
The coronavirus disease of 2019 (COVID-19) has caused a global pandemic and led to nearly three million deaths globally. As of April 2021, there are still many countries that do not have COVID-19 vaccines. Before the COVID-19 vaccines were developed, some evidence suggested that an influenza vaccine may stimulate nonspecific immune responses that reduce the risk of COVID-19 infection or the severity of COVID-19 illness after infection. This study evaluated the association between influenza vaccination and the risk of COVID-19 infection. We conducted a retrospective cross-sectional study with data from July 1, 2019, to June 30, 2020 with the Claims data from Symphony Health database. The study population was adults age 65 years old or older who received influenza vaccination between September 1 and December 31 of 2019. The main outcomes and measures were odds of COVID-19 infection and severe COVID-19 illness after January 15, 2020. We found the adjusted odds ratio (aOR) of COVID-19 infection risk between the influenza-vaccination group and no-influenza-vaccination group was 0.76 (95% confidence interval (CI), 0.75-0.77). Among COVID-19 patients, the aOR of developing severe COVID-19 illness was 0.72 (95% CI, 0.68-0.76) between the influenza-vaccination group and the no-influenza-vaccination group. When the influenza-vaccination group and the other-vaccination group were compared, the aOR of COVID-19 infection was 0.95 (95% CI, 0.93-0.97), and the aOR of developing a severe COVID-19 illness was 0.95 (95% CI, 0.80-1.13). The influenza vaccine may marginally protect people from COVID-19 infection.
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Affiliation(s)
- Kelly Huang
- School of Pharmacy, College of Medicine, National Taiwan University, Room 202, No. 33, Linsen S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan
| | - Shu-Wen Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Room 202, No. 33, Linsen S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan.,Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Chuan Wang
- School of Pharmacy, College of Medicine, National Taiwan University, Room 202, No. 33, Linsen S. Rd., Zhongzheng Dist., Taipei City, 100, Taiwan. .,Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. .,Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
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39
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The Association between Influenza Vaccination and COVID-19 and Its Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Vaccines (Basel) 2021; 9:vaccines9050529. [PMID: 34065294 PMCID: PMC8161076 DOI: 10.3390/vaccines9050529] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Influenza could circulate in parallel with COVID-19. In the context of COVID-19, some studies observed inverse associations between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, while others did not. We conducted a meta-analysis to assess the association between influenza vaccination and SARS-CoV-2 infection and clinical outcomes, aiming to provide evidence for COVID-19 prevention and vaccination promotion. We searched four databases from inception to 10 March, 2021. Random effects and fixed effects models were used to pool odds ratios (ORs) and adjusted estimates with 95% confidence intervals (CIs). We used funnel plots to evaluate the publication bias, I2 statistics to evaluate the heterogeneity, and conducted subgroup analyses. Sixteen observational studies involving 290,327 participants were included. Influenza vaccination was associated with a lower risk of SARS-CoV-2 infection (pooled adjusted OR: 0.86, 95%CI: 0.81–0.91), while not significantly associated with adverse outcomes (intensive care: adjusted OR 0.63, 95%CI: 0.22–1.81; hospitalization: adjusted OR 0.74, 95%CI: 0.51–1.06; mortality: adjusted OR 0.89, 95%CI: 0.73–1.09). Our findings suggest that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection. It is crucial for policy makers to implement strategies on influenza vaccination, for it may also have benefits for COVID-19 prevention.
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40
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Chan YW, Wong ML, Kwok FY, Au AKW, Leung ECM, Chuang SK. The effect of seasonal influenza vaccine on medically-attended influenza and non-influenza respiratory viruses infections at primary care level, Hong Kong SAR, 2017/18 to 2019/20. Vaccine 2021; 39:3372-3378. [PMID: 34016472 DOI: 10.1016/j.vaccine.2021.04.059] [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: 12/30/2020] [Revised: 03/31/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
Effectiveness of seasonal influenza vaccine (SIV) varies with the degree of matching with the vaccine and circulating viruses. We continued our SIV effectiveness against medically-attended influenza-like illness (ILI) under the Department of Health Hong Kong's sentinel private medical practitioners (PMP) network, using the test-negative case-control design, for the 2018/19 and 2019/20 season. In addition, we studied the potential interference between SIV and ILI caused by non-influenza respiratory viruses (NIRV) based on data collated from 2017/18 to 2019/20 seasons. 3404 patients were analysed. Across the 2017/18 to 2019/20 seasons, the vaccine effectiveness (VE) of SIV was 44% (95% CI 30-56%) against pan-negative controls, 57% (95%CI. 42-68%) against NIRV controls and 50% (95%CI 38-59%) against both. SIV was moderately effective against medically-attended ILI caused by influenza A/B in both 2018/19 and 2019/20 winter seasons (53.2% (95%CI 36.7-65.5%) and 41.8% (95%CI 6.3-64.1%), respectively). The VE against the main circulating subtype, influenza A(H1), was higher for the 2018/19 season (57.2% (95%CI 39.8-69.9%), compared to 34.6% (95%CI -9.6-61.4%) in the 2019/20 season). When compared to pan negative controls, those with single NIRV infections were similarly likely to have received SIV (OR 1.05 (95%CI 0.72-1.54) within the influenza season; OR 0.97 (95%CI 0.73-1.29) when including non-influenza seasons). Analyses by type of virus showed no increased risk of SIV identified among those with single infections of EV/RV, HMPV and parainfluenza but a 2-fold increased risk was shown for those with single infections of adenovirus and parainfluenza virus (adenovirus: OR 2.54 (95%CI 1.24-5.14) within influenza season and OR 1.78 (95%CI 1.01-3.09) for the whole period; parainfluenza virus: OR 2.01 (95%CI 1.22-3.29) within influenza season and OR 1.89 (95%CI 1.29-2.76) for the whole period). SIV programme and surveillance of influenza and NIRV, including SARS-CoV-2, should continue during the COVID-19 pandemic.
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Affiliation(s)
- Yung-Wai Chan
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region.
| | - Miu-Ling Wong
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Fong-Yuen Kwok
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Albert Ka-Wing Au
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Emily Chi-Mei Leung
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Shuk-Kwan Chuang
- Communicable Disease Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
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41
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Influenza and pneumococcal vaccinations are not associated to COVID-19 outcomes among patients admitted to a university hospital. Vaccine 2021; 39:3493-3497. [PMID: 34020813 PMCID: PMC8106908 DOI: 10.1016/j.vaccine.2021.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/02/2022]
Abstract
In order to reduce the burden on healthcare systems and to support differential diagnosis with COVID-19, influenza and pneumococcal vaccinations were strongly recommended during the COVID-19 pandemic, especially in vulnerable groups. However, no univocal and conclusive evidence on the relationship between influenza and pneumococcal vaccinations and COVID‐19 outcomes exists. We evaluated the association between such vaccinations, COVID-19 hospitalization, intensive care unit admissions and deaths in a cohort (N = 741) of COVID-19 patients who had access to the emergency room of a large Italian University hospital between March 1, 2020 and June 1, 2020. Results show that influenza and pneumococcal vaccinations did not affect hospitalization, intensive care unit admission and deaths in COVID-19 patients in the overall sample and in those ≥65 years. The same pattern of results was confirmed considering timing of influenza vaccine administration, vaccination type, and number of uptakes in the last five vaccination campaigns. In conclusion, our study does not support an impact of influenza and pneumococcal vaccinations on COVID-19 outcomes.
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42
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Root-Bernstein R. Pneumococcal and Influenza Vaccination Rates and Pneumococcal Invasive Disease Rates Set Geographical and Ethnic Population Susceptibility to Serious COVID-19 Cases and Deaths. Vaccines (Basel) 2021; 9:474. [PMID: 34066697 PMCID: PMC8151685 DOI: 10.3390/vaccines9050474] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/01/2021] [Accepted: 05/05/2021] [Indexed: 12/21/2022] Open
Abstract
This study examines the relationship of pneumococcal vaccination rates, influenza, measles-mumps-rubella (MMR) diphtheria-tetanus-pertussis vaccinations (DTP), polio, Haemophilus influenzae type B (Hib), and Bacillus Calmette-Guerin (tuberculosis) vaccination rates to COVID-19 case and death rates for 51 nations that have high rates of COVID-19 testing and for which nearly complete childhood, at-risk adult and elderly pneumococcal vaccination data were available. The study is unique in a large number of nations examined, the range of vaccine controls, in testing effects of combinations of vaccinations, and in examining the relationship of COVID-19 and vaccination rates to invasive pneumococcal disease (IPD). Analysis of Italian regions and the states of the United States were also performed. Significant positive correlations were found between IPD (but not lower respiratory infections) and COVID-19 rates, while significant negative correlations were found between pneumococcal vaccination and COVID-19 rates. Influenza and MMR vaccination rates were negatively correlated with lower respiratory infection (LRI) rates and may synergize with pneumococcal vaccination rates to protect against COVID-19. Pneumococcal and influenza vaccination rates were independent of other vaccination rates. These results suggest that endemic rates of bacterial pneumonias, for which pneumococci are a sentinel, may set regional and national susceptibility to severe COVID-19 disease and death.
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Affiliation(s)
- Robert Root-Bernstein
- Department of Physiology, 567 Wilson Road, Room 1104 Biomedical and Physical Sciences Building, Michigan State University, East Lansing, MI 48824, USA
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43
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Bozek A, Kozłowska R, Galuszka B, Grzanka A. Impact of influenza vaccination on the risk of SARS-CoV-2 infection in a middle-aged group of people. Hum Vaccin Immunother 2021; 17:3126-3130. [PMID: 33913801 PMCID: PMC8095158 DOI: 10.1080/21645515.2021.1913961] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aims: An observational study of a retrospective cohort was performed to assess the impact of influenza vaccination (IV) on the risk of SARS-CoV-2 infection in a population of middle-aged people for 8 weeks after IV and compared with an unvaccinated group. Patients and methods: Data from 1098 middle-aged patients (53.7 ± 4.7 years) after IV and 1205 unvaccinated patients (50.1 ± 6.8 years) were analyzed based on medical documentation. The inclusion criteria were age between 40 − 60 years and IV in the period from 1−30 September 2020. The incidence of infection with SARS-CoV-2 was confirmed by PCR and the classification of ICD-10 (U07.1). Results and conclusions: After IV, patients had significantly fewer SARS-CoV–2 infections than the unvaccinated patients (P = .017). The hazard ratio was 0.74 (95% CI: 0.54−0.89). IV may partially reduce the risk of SARS-CoV-2 infection.
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Affiliation(s)
- Andrzej Bozek
- Clinical Department of Internal Disease, Dermatology and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland.,Medical Center Tysiaclecie, Katowice, Poland
| | - Renata Kozłowska
- Clinical Department of Internal Disease, Dermatology and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Alicja Grzanka
- Clinical Department of Internal Disease, Dermatology and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland
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44
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Prinelli F, Bianchi F, Drago G, Ruggieri S, Sojic A, Jesuthasan N, Molinaro S, Bastiani L, Maggi S, Noale M, Galli M, Giacomelli A, Antonelli Incalzi R, Adorni F, Cibella F. Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey. JMIR Public Health Surveill 2021; 7:e27091. [PMID: 33668011 PMCID: PMC8081027 DOI: 10.2196/27091] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
Background Several studies have reported a low prevalence of current smoking among hospitalized COVID-19 cases; however, no definitive conclusions can be drawn. Objective We investigated the association of tobacco smoke exposure with nasopharyngeal swab (NPS) test results for SARS-CoV-2 infection and disease severity accounting for possible confounders. Methods The nationwide, self-administered, cross-sectional web-based Italian National Epidemiological Survey on COVID-19 (EPICOVID19) was administered to an Italian population of 198,822 adult volunteers who filled in an online questionnaire between April 13 and June 2, 2020. For this study, we analyzed 6857 individuals with known NPS test results. The associations of smoking status and the dose-response relationship with a positive NPS test result and infection severity were calculated as odds ratios (ORs) with 95% CIs by means of logistic and multinomial regression models adjusting for sociodemographic, clinical, and behavioral characteristics. Results Out of the 6857 individuals (mean age 47.9 years, SD 14.1; 4516/6857, 65.9% female), 63.2% (4334/6857) had never smoked, 21.3% (1463/6857) were former smokers, and 15.5% (1060/6857) were current smokers. Compared to nonsmokers, current smokers were younger, were more educated, were less affected by chronic diseases, reported COVID-19–like symptoms less frequently, were less frequently hospitalized, and less frequently tested positive for COVID-19. In multivariate analysis, current smokers had almost half the odds of a positive NPS test result (OR 0.54, 95% CI 0.45-0.65) compared to nonsmokers. We also found a dose-dependent relationship with tobacco smoke: mild smokers (adjusted OR [aOR] 0.76, 95% CI 0.55-1.05), moderate smokers (aOR 0.56, 95% CI 0.42-0.73), and heavy smokers (aOR 0.38, 95% CI 0.27-0.53). This inverse association also persisted when considering the severity of the infection. Current smokers had a statistically significantly lower probability of having asymptomatic (aOR 0.50, 95% CI 0.27-0.92), mild (aOR 0.65, 95% CI 0.53-0.81), and severe infections (aOR 0.27, 95% CI 0.17-0.42) compared to those who never smoked. Conclusions Current smoking was negatively associated with SARS-CoV-2 infection with a dose-dependent relationship. Ad hoc experimental studies are needed to elucidate the mechanisms underlying this association. Trial Registration ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701
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Affiliation(s)
- Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Segrate (MI), Italy
| | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Gaspare Drago
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Silvia Ruggieri
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Aleksandra Sojic
- Institute of Biomedical Technologies, National Research Council, Segrate (MI), Italy
| | - Nithiya Jesuthasan
- Institute of Biomedical Technologies, National Research Council, Segrate (MI), Italy
| | - Sabrina Molinaro
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Luca Bastiani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Stefania Maggi
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Marianna Noale
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Massimo Galli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L Sacco, University of Milan, Milano, Italy
| | - Andrea Giacomelli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L Sacco, University of Milan, Milano, Italy
| | | | - Fulvio Adorni
- Institute of Biomedical Technologies, National Research Council, Segrate (MI), Italy
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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- see Acknowledgments, Segrate (MI), Italy
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45
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Zanettini C, Omar M, Dinalankara W, Imada EL, Colantuoni E, Parmigiani G, Marchionni L. Influenza Vaccination and COVID-19 Mortality in the USA: An Ecological Study. Vaccines (Basel) 2021; 9:vaccines9050427. [PMID: 33923159 PMCID: PMC8145634 DOI: 10.3390/vaccines9050427] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 mortality rate is higher in the elderly and in those with pre-existing chronic medical conditions. The elderly also suffer from increased morbidity and mortality from seasonal influenza infections; thus, an annual influenza vaccination is recommended for them. In this study, we explore a possible county-level association between influenza vaccination coverage in people aged 65 years and older and the number of deaths from COVID-19. To this end, we used COVID-19 data up to 14 December 2020 and US population health data at the county level. We fit quasi-Poisson regression models using influenza vaccination coverage in the elderly population as the independent variable and the COVID-19 mortality rate as the outcome variable. We adjusted for an array of potential confounders using different propensity score regression methods. Results show that, on the county level, influenza vaccination coverage in the elderly population is negatively associated with mortality from COVID-19, using different methodologies for confounding adjustment. These findings point to the need for studying the relationship between influenza vaccination and COVID-19 mortality at the individual level to investigate any underlying biological mechanisms.
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Affiliation(s)
- Claudio Zanettini
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Mohamed Omar
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Wikum Dinalankara
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Eddie Luidy Imada
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
| | - Elizabeth Colantuoni
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Giovanni Parmigiani
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA;
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Luigi Marchionni
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10065, USA; (C.Z.); (M.O.); (W.D.); (E.L.I.)
- Correspondence: ; Tel.: +001-646-962-8767
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46
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Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021. [DOI: 10.3390/vaccines9050415
expr 888502299 + 814659637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55–0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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47
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Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021; 9:415. [PMID: 33919206 PMCID: PMC8143078 DOI: 10.3390/vaccines9050415&set/a 843283251+814136669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55-0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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48
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Kowalska M, Niewiadomska E, Barański K, Kaleta-Pilarska A, Brożek G, Zejda JE. Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland. Vaccines (Basel) 2021; 9:415. [PMID: 33919206 PMCID: PMC8143078 DOI: 10.3390/vaccines9050415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55-0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.
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Affiliation(s)
- Małgorzata Kowalska
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Ewa Niewiadomska
- Department of Epidemiology and Biostatistics, School of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
| | - Kamil Barański
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Angelina Kaleta-Pilarska
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Grzegorz Brożek
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
| | - Jan Eugeniusz Zejda
- Department of Epidemiology, School of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (M.K.); (A.K.-P.); (G.B.); (J.E.Z.)
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49
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Giacomelli A, De Falco T, Oreni L, Pedroli A, Ridolfo AL, Calabrò E, Carrozzo G, Bonazzetti C, Antinori S, Brucato A. Impact of gender on patients hospitalized for SARS-COV-2 infection: A prospective observational study. J Med Virol 2021; 93:4597-4602. [PMID: 33710652 PMCID: PMC8250512 DOI: 10.1002/jmv.26933] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 01/08/2023]
Abstract
Biological sex could affect the natural history of severe acute respiratory syndrome coronavirus 2 infection. We enrolled all COVID‐19 patients admitted to two COVID‐19 hospitals in Milan in a prospective observational study. The primary outcome was death during the study period and the secondary outcome was critical disease at hospital admission. The association(s) between clinically relevant, noncollinear variables, and the primary outcome was assessed with uni‐ and multivariable Logistic regression models. A total of 520 patients were hospitalized of whom 349 (67%) were males with a median age 61 (interquartile range: 50–72). A higher proportion of males presented critically ill when compared to females (30.1% vs. 18.7%, p < .046). Death occurred in 86 (24.6%) males and 27 (15.8%) females (p = .024). In multivariable analysis age (per 10 years more) (adjusted odds ratio [AOR]: 1.83 [95% confidence interval {CI}: 1.42–2.35], p < .0001), obesity (AOR: 2.17 [95% CI: 1.10–4.31], p = .026), critical disease at hospital admission (AOR 6.34 [95% CI: 3.50–11.48], p < .0001) were independently associated to higher odds of death whereas gender was not. In conclusion, a higher proportion of males presented critically ill at hospital admission. Age, critical disease at hospital admission, obesity, anemia, D‐dimer, estimated glomerular filtration rate, lactate dehydrogenase, and creatine kinase predicted death in hospitalized COVID‐19 patients.
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Affiliation(s)
- Andrea Giacomelli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy
| | - Teresa De Falco
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
| | - Letizia Oreni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Alice Pedroli
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Elisa Calabrò
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
| | - Giorgia Carrozzo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy
| | - Cecilia Bonazzetti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy.,Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy
| | - Antonio Brucato
- Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, Università di Milano, Milan, Italy.,Division of Internal Medicine, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy
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50
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Cori L, Curzio O, Adorni F, Prinelli F, Noale M, Trevisan C, Fortunato L, Giacomelli A, Bianchi F. Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3248. [PMID: 33801074 PMCID: PMC8003842 DOI: 10.3390/ijerph18063248] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/08/2023]
Abstract
The study analyzed the association of the fear of contagion for oneself and for family members (FMs) during the first wave of the COVID-19 pandemic, with demographic and socioeconomic status (SES) and health factors. The study was performed within the EPICOVID19 web-based Italian survey, involving adults from April-June 2020. Out of 207,341 respondents, 95.9% completed the questionnaire (60% women with an average age of 47.3 vs. 48.9 years among men). The association between fear and demographic and SES characteristics, contacts with COVID-19 cases, nasopharyngeal swab, self-perceived health, flu vaccination, chronic diseases and specific symptoms was analyzed by logistic regression model; odds ratios adjusted for sex, age, education and occupation were calculated (aORs). Fear for FMs prevailed over fear for oneself and was higher among women than men. Fear for oneself decreased with higher levels of education and in those who perceived good health. Among those vaccinated for the flu, 40.8% responded they had feelings of fear for themselves vs. 34.2% of the not vaccinated. Fear increased when diseases were declared and it was higher when associated with symptoms such as chest pain, olfactory/taste disorders, heart palpitations (aORs > 1.5), lung or kidney diseases, hypertension, depression and/or anxiety. Trends in fear by region showed the highest percentage of positive responses in the southern regions. The knowledge gained from these results should be used to produce tailored messages and shared public health decisions.
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Affiliation(s)
- Liliana Cori
- Department of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.C.); (F.B.)
| | - Olivia Curzio
- Department of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.C.); (F.B.)
| | - Fulvio Adorni
- Unit of Epidemiology, Institute of Biomedical Technologies, National Research Council, Segrate, 20157 Milan, Italy; (F.A.); (F.P.)
| | - Federica Prinelli
- Unit of Epidemiology, Institute of Biomedical Technologies, National Research Council, Segrate, 20157 Milan, Italy; (F.A.); (F.P.)
| | - Marianna Noale
- Institute of Neurosciences, National Research Council, 35127 Padova, Italy; (M.N.); (C.T.)
| | - Caterina Trevisan
- Institute of Neurosciences, National Research Council, 35127 Padova, Italy; (M.N.); (C.T.)
| | - Loredana Fortunato
- Epidemiology and Health Research Laboratory, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy;
| | - Andrea Giacomelli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, ASST Fatebenefratelli Sacco, 20157 Milan, Italy;
| | - Fabrizio Bianchi
- Department of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.C.); (F.B.)
- Institute for Research and Innovation in Biomedicine, National Research Council, 90148 Palermo, Italy
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