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Sukik L, Chemaitelly H, Ayoub HH, Coyle P, Tang P, Yassine HM, Al Thani AA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abdel-Rahman ME, Abu-Raddad LJ. Effectiveness of two and three doses of COVID-19 mRNA vaccines against infection, symptoms, and severity in the pre-omicron era: A time-dependent gradient. Vaccine 2024:S0264-410X(24)00440-7. [PMID: 38616439 DOI: 10.1016/j.vaccine.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Vaccines were developed and deployed to combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to characterize patterns in the protection provided by the BNT162b2 and mRNA-1273 mRNA vaccines against a spectrum of SARS-CoV-2 infection symptoms and severities. METHODS A national, matched, test-negative, case-control study was conducted in Qatar between January 1 and December 18, 2021, utilizing a sample of 238,896 PCR-positive tests and 6,533,739 PCR-negative tests. Vaccine effectiveness was estimated against asymptomatic, symptomatic, severe coronavirus disease 2019 (COVID-19), critical COVID-19, and fatal COVID-19 infections. Data sources included Qatar's national databases for COVID-19 laboratory testing, vaccination, hospitalization, and death. RESULTS Effectiveness of two-dose BNT162b2 vaccination was 75.6% (95% CI: 73.6-77.5) against asymptomatic infection and 76.5% (95% CI: 75.1-77.9) against symptomatic infection. Effectiveness against each of severe, critical, and fatal COVID-19 infections surpassed 90%. Immediately after the second dose, all categories-namely, asymptomatic, symptomatic, severe, critical, and fatal COVID-19-exhibited similarly high effectiveness. However, from 181 to 270 days post-second dose, effectiveness against asymptomatic and symptomatic infections declined to below 40%, while effectiveness against each of severe, critical, and fatal COVID-19 infections remained consistently high. However, estimates against fatal COVID-19 often had wide 95% confidence intervals. Analogous patterns were observed in three-dose BNT162b2 vaccination and two- and three-dose mRNA-1273 vaccination. Sensitivity analyses confirmed the results. CONCLUSION A gradient in vaccine effectiveness exists and is linked to the symptoms and severity of infection, providing higher protection against more symptomatic and severe cases. This gradient intensifies over time as vaccine immunity wanes after the last vaccine dose. These patterns appear consistent irrespective of the vaccine type or whether the vaccination involves the primary series or a booster.
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Affiliation(s)
- Layan Sukik
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics and Statistics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar; Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mohammad R Hasan
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Hamad Medical Corporation, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | | | - Manar E Abdel-Rahman
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
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Chemaitelly H, Coyle P, Kacem MAB, Ayoub HH, Tang P, Hasan MR, Yassine HM, Al Thani AA, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Protection of natural infection against reinfection with SARS-CoV-2 JN.1 variant. J Travel Med 2024:taae053. [PMID: 38591115 DOI: 10.1093/jtm/taae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
Overall effectiveness of infection in preventing reinfection with SARS-CoV-2 JN.1 variant was estimated at 1.8% (95% CI: -9.3-12.6%), and demonstrated rapid decline over time since the previous infection, decreasing from 82.4% (95% CI: 40.9 to 94.7%) within 3 to less than 6 months, to a negligible level after one year.
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Chemaitelly H, Ayoub HH, Tang P, Yassine HM, Al Thani AA, Hasan MR, Coyle P, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Addressing bias in the definition of SARS-CoV-2 reinfection: implications for underestimation. Front Med (Lausanne) 2024; 11:1363045. [PMID: 38529118 PMCID: PMC10961414 DOI: 10.3389/fmed.2024.1363045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Reinfections are increasingly becoming a feature in the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, accurately defining reinfection poses methodological challenges. Conventionally, reinfection is defined as a positive test occurring at least 90 days after a previous infection diagnosis. Yet, this extended time window may lead to an underestimation of reinfection occurrences. This study investigated the prospect of adopting an alternative, shorter time window for defining reinfection. Methods A longitudinal study was conducted to assess the incidence of reinfections in the total population of Qatar, from February 28, 2020 to November 20, 2023. The assessment considered a range of time windows for defining reinfection, spanning from 1 day to 180 days. Subgroup analyses comparing first versus repeat reinfections and a sensitivity analysis, focusing exclusively on individuals who underwent frequent testing, were performed. Results The relationship between the number of reinfections in the population and the duration of the time window used to define reinfection revealed two distinct dynamical domains. Within the initial 15 days post-infection diagnosis, almost all positive tests for SARS-CoV-2 were attributed to the original infection. However, surpassing the 30-day post-infection threshold, nearly all positive tests were attributed to reinfections. A 40-day time window emerged as a sufficiently conservative definition for reinfection. By setting the time window at 40 days, the estimated number of reinfections in the population increased from 84,565 to 88,384, compared to the 90-day time window. The maximum observed reinfections were 6 and 4 for the 40-day and 90-day time windows, respectively. The 40-day time window was appropriate for defining reinfection, irrespective of whether it was the first, second, third, or fourth occurrence. The sensitivity analysis, confined to high testers exclusively, replicated similar patterns and results. Discussion A 40-day time window is optimal for defining reinfection, providing an informed alternative to the conventional 90-day time window. Reinfections are prevalent, with some individuals experiencing multiple instances since the onset of the pandemic.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A. Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mohammad R. Hasan
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Peter Coyle
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Hamad Medical Corporation, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | | | | | | | | | | | | | - Hanan F. Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K. Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
- Hamad Medical Corporation, Doha, Qatar
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | | | | | | | | | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Ahmed A, Hossain L, Banik G, Sayeed A, Sajib MRUZ, Hasan MM, Hoque DE, Hasan ASM, Raghuyamshi V, Zaman S, Akter E, Nusrat N, Rahman F, Raza S, Hasan MR, Uddin J, Sarkar S, Adnan SD, Rahman A, Ameen S, Jabeen S, El Arifeen S, Rahman AE. Measuring the effectiveness of an integrated intervention package to improve the level of infection prevention and control: a multi-centre study in Bangladesh. J Hosp Infect 2024; 145:22-33. [PMID: 38157940 DOI: 10.1016/j.jhin.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Infection prevention and control (IPC) is a critical component of delivering safe, effective and high-quality healthcare services, and eliminating avoidable healthcare-associated infections (HAIs) in health facilities, predominantly in population-dense settings such as Bangladesh. AIM Our study aimed to assess the effect of an integrated intervention package in improving the IPC level of the health facilities in Bangladesh. METHODS We conducted a pre-post intervention study in six district hospitals (DHs) and 13 Upazila Health Complexes (UHCs) in the six districts of Bangladesh. Baseline and endline assessments were conducted between March and December 2021 using the adapted World Health Organization Infection Prevention and Control Assessment Framework (WHO-IPCAF) tool. The IPCAF score, ranging from 0-800, was calculated by adding the scores of eight components, and the IPC promotion and practice level was categorized as Inadequate (0-200), Basic (201-400), Intermediate (401-600) and Advanced (601-800). The integrated intervention package including IPC committee formation, healthcare provider training, logistics provision, necessary guidelines distribution, triage/flu corners establishment, and infrastructure development was implemented in all facilities. RESULTS The average IPCAF score across all the facilities showed a significant increase from 16% (95% CI: 11.5-20.65%) to 54% (95% CI: 51.4-57.1%). Overall, the IPCAF score increased by 34 percentage points (P<0.001) in DHs and 40 percentage points (P<0.001) in UHCs. Following the intervention, 12 (three DHs, nine UHCs) of 19 facilities progressed from inadequate to intermediate, and another three DHs upgraded from basic to intermediate in terms of IPC level. CONCLUSION The integrated intervention package improved IPCAF score in all facilities.
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Affiliation(s)
- A Ahmed
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - L Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - G Banik
- Health and Nutrition Sector, Save the Children, Dhaka, Bangladesh
| | - A Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R U-Z Sajib
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois Urbana-Champaign, USA
| | - M M Hasan
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | | | | | - E Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - N Nusrat
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - F Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Raza
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - M R Hasan
- Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh
| | - J Uddin
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - S Sarkar
- Hospital Service Management, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S D Adnan
- Hospital and Clinics, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - A Rahman
- Communicable Disease Control, Directorate General of Health Services, Government of Bangladesh, Bangladesh
| | - S Ameen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S Jabeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A E Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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Chemaitelly H, Faust JS, Krumholz HM, Ayoub HH, Tang P, Coyle P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Short- and longer-term all-cause mortality among SARS-CoV-2- infected individuals and the pull-forward phenomenon in Qatar: a national cohort study. Int J Infect Dis 2023; 136:81-90. [PMID: 37717648 DOI: 10.1016/j.ijid.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES We assessed short-, medium-, and long-term all-cause mortality risks after a primary SARS-CoV-2 infection. METHODS A national, matched, retrospective cohort study was conducted in Qatar to assess risk of all-cause mortality in the national SARS-CoV-2 primary infection cohort compared with the national infection-naïve cohort. Associations were estimated using Cox proportional-hazards regression models. Analyses were stratified by vaccination status and clinical vulnerability status. RESULTS Among unvaccinated persons, within 90 days after primary infection, the adjusted hazard ratio (aHR) comparing mortality incidence in the primary-infection cohort with the infection-naïve cohort was 1.19 (95% confidence interval 1.02-1.39). aHR was 1.34 (1.11-1.63) in persons more clinically vulnerable to severe COVID-19 and 0.94 (0.72-1.24) in those less clinically vulnerable. Beyond 90 days after primary infection, aHR was 0.50 (0.37-0.68); aHR was 0.41 (0.28-0.58) at 3-7 months and 0.76 (0.46-1.26) at ≥8 months. The aHR was 0.37 (0.25-0.54) in more clinically vulnerable persons and 0.77 (0.48-1.24) in less clinically vulnerable persons. Among vaccinated persons, mortality incidence was comparable in the primary-infection versus infection-naïve cohorts, regardless of clinical vulnerability status. CONCLUSIONS COVID-19 mortality was primarily driven by an accelerated onset of death among individuals who were already vulnerable to all-cause mortality, but vaccination prevented these accelerated deaths.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar; Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Hamad Medical Corporation, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
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Mahmoud MA, Ayoub HH, Coyle P, Tang P, Hasan MR, Yassine HM, Al Thani AA, Al‐Kanaani Z, Al‐Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul‐Rahim HF, Nasrallah GK, Al‐Kuwari MG, Butt AA, Al‐Romaihi HE, Al‐Thani MH, Al‐Khal A, Bertollini R, Abu‐Raddad LJ, Chemaitelly H. SARS-CoV-2 infection and effects of age, sex, comorbidity, and vaccination among older individuals: A national cohort study. Influenza Other Respir Viruses 2023; 17:e13224. [PMID: 38019700 PMCID: PMC10663173 DOI: 10.1111/irv.13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND We investigated the contribution of age, coexisting medical conditions, sex, and vaccination to incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and of severe, critical, or fatal COVID-19 in older adults since pandemic onset. METHODS A national retrospective cohort study was conducted in the population of Qatar aged ≥50 years between February 5, 2020 and June 15, 2023. Adjusted hazard ratios (AHRs) for infection and for severe coronavirus disease 2019 (COVID-19) outcomes were estimated through Cox regression models. RESULTS Cumulative incidence was 25.01% (95% confidence interval [CI]: 24.86-25.15%) for infection and 1.59% (95% CI: 1.55-1.64%) for severe, critical, or fatal COVID-19 after a follow-up duration of 40.9 months. Risk of infection varied minimally by age and sex but increased significantly with coexisting conditions. Risk of infection was reduced with primary-series vaccination (AHR: 0.91, 95% CI: 0.90-0.93) and further with first booster vaccination (AHR: 0.75, 95% CI: 0.74-0.77). Risk of severe, critical, or fatal COVID-19 increased exponentially with age and linearly with coexisting conditions. AHRs for severe, critical, or fatal COVID-19 were 0.86 (95% CI: 0.7-0.97) for one dose, 0.15 (95% CI: 0.13-0.17) for primary-series vaccination, and 0.11 (95% CI: 0.08-0.14) for first booster vaccination. Sensitivity analysis restricted to only Qataris yielded similar results. CONCLUSION Incidence of severe COVID-19 in older adults followed a dynamic pattern shaped by infection incidence, variant severity, and population immunity. Age, sex, and coexisting conditions were strong determinants of infection severity. Vaccine protection against severe outcomes showed a dose-response relationship, highlighting the importance of booster vaccination for older adults.
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Affiliation(s)
| | - Houssein H. Ayoub
- Mathematics ProgramDepartment of Mathematics, Statistics, and PhysicsCollege of Arts and SciencesQatar UniversityDohaQatar
| | - Peter Coyle
- Hamad Medical CorporationDohaQatar
- Biomedical Research CenterQU HealthQatar UniversityDohaQatar
- Wellcome‐Wolfson Institute for Experimental MedicineQueens UniversityBelfastUK
| | | | - Mohammad R. Hasan
- Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonCanada
| | - Hadi M. Yassine
- Department of Biomedical ScienceCollege of Health SciencesQU HealthQatar UniversityDohaQatar
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
| | - Asmaa A. Al Thani
- Department of Biomedical ScienceCollege of Health SciencesQU HealthQatar UniversityDohaQatar
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
| | | | | | | | | | | | | | - Hanan F. Abdul‐Rahim
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
| | - Gheyath K. Nasrallah
- Department of Biomedical ScienceCollege of Health SciencesQU HealthQatar UniversityDohaQatar
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
| | | | - Adeel A. Butt
- Hamad Medical CorporationDohaQatar
- Department of MedicineWeill Cornell MedicineCornell UniversityNew YorkNew YorkUSA
- Department of Population Health SciencesWeill Cornell MedicineCornell UniversityNew YorkNew YorkUSA
| | | | | | | | | | - Laith J. Abu‐Raddad
- Department of Public HealthCollege of Health SciencesQU HealthQatar UniversityDohaQatar
- Department of Population Health SciencesWeill Cornell MedicineCornell UniversityNew YorkNew YorkUSA
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐QatarCornell UniversityDohaQatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDSSexually Transmitted Infections, and Viral HepatitisWeill Cornell Medicine–QatarCornell University, Qatar Foundation – Education CityDohaQatar
- College of Health and Life SciencesHamad bin Khalifa UniversityDohaQatar
| | - Hiam Chemaitelly
- Department of Population Health SciencesWeill Cornell MedicineCornell UniversityNew YorkNew YorkUSA
- Infectious Disease Epidemiology GroupWeill Cornell Medicine‐QatarCornell UniversityDohaQatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDSSexually Transmitted Infections, and Viral HepatitisWeill Cornell Medicine–QatarCornell University, Qatar Foundation – Education CityDohaQatar
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7
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Chemaitelly H, Ayoub HH, Tang P, Coyle PV, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. History of primary-series and booster vaccination and protection against Omicron reinfection. Sci Adv 2023; 9:eadh0761. [PMID: 37792951 PMCID: PMC10550237 DOI: 10.1126/sciadv.adh0761] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/26/2023] [Indexed: 10/06/2023]
Abstract
Laboratory evidence suggests a possibility of immune imprinting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the differences in the incidence of SARS-CoV-2 reinfection in a cohort of persons who had a primary Omicron infection, but different vaccination histories using matched, national, retrospective, cohort studies. Adjusted hazard ratio for reinfection incidence, factoring adjustment for differences in testing rate, was 0.43 [95% confidence interval (CI): 0.39 to 0.49] comparing history of two-dose vaccination to no vaccination, 1.47 (95% CI: 1.23 to 1.76) comparing history of three-dose vaccination to two-dose vaccination, and 0.57 (95% CI: 0.48 to 0.68) comparing history of three-dose vaccination to no vaccination. Divergence in cumulative incidence curves increased markedly when the incidence was dominated by BA.4/BA.5 and BA.2.75* Omicron subvariants. The history of primary-series vaccination enhanced immune protection against Omicron reinfection, but history of booster vaccination compromised protection against Omicron reinfection. These findings do not undermine the public health utility of booster vaccination.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Peter V. Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Hadi M. Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A. Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A. Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F. Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K. Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Hamad Medical Corporation, Doha, Qatar
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | | | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Biswas D, Nag S, Khan AU, Ahamed F, Karim MR, Hasan MR, Haque AK. Hypoalbuminaemia as a Marker of Severity of Patients of Community Acquired Pneumonia. Mymensingh Med J 2023; 32:968-974. [PMID: 37777888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Community-acquired pneumonia (CAP) is a common presentation with an acute infection of the pulmonary parenchyma occurring in the community level. Despite the availability of potent antibiotics, it remains as a serious illness with significant morbidity and mortality in both developed and developing countries. This study was undertaken to determine the relation between serum Albumin and severity of CAP. This was a cross sectional descriptive study which was carried out in the Department of Medicine of Mymensingh Medical College Hospital (MMCH), Bangladesh from July 2019 to December 2019. The sample size was 67. Purposive sampling technique was employed. Patients of community acquired pneumonia (CAP), aged ≥14 years of both sex with recently developed radiological pulmonary shadowing with compatible clinical symptoms and signs were included. Patients who were chronically immunosuppressed, with chronic starvation, advanced liver disease or chronic kidney disease with or without receiving haemodialysis were excluded. Data analysis was done by SPSS software for Windows (version 23.0). The mean age 65.7±15.3 years, majority 13(19.4%) patients had chronic lung disease, 12(17.9%) had diabetes mellitus, 9(13.4%) had heart failure, 6(9.0%) had cerebrovascular disease, 6(9.0%) had neoplastic disease and 5(7.5%) had chronic renal failure. Majority 22(32.8%) patients had CURB-65 score 3, out of which 12(54.5%) had albumin level <20g/l, 9(40.9%) had albumin level 20.0-24.9g/l and 1(4.5%) had albumin level 25-29g/l. 17(25.4%) had score 4-5 out of which 10(58.8%) had albumin level <20g/l and 7(41.2%) had albumin level 20.0-24.9g/l, 15(22.4%) had score 2 and 13(19.4%) had score 0-1. Negative significant correction (r=-0.782; p=0.001) was found between CURB-65 score and albumin level. Significant number of patients with severe CAP show low serum albumin level at admission which is statistically significant when compared with CURB-65 score. Thus hypoalbuminaemia may be a good marker of severity of patients with CAP.
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Affiliation(s)
- D Biswas
- Dr Debashish Biswas, Indoor Medical Officer, Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh
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Chemaitelly H, Ayoub HH, AlMukdad S, Faust JS, Tang P, Coyle P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Bivalent mRNA-1273.214 vaccine effectiveness against SARS-CoV-2 omicron XBB* infections. J Travel Med 2023; 30:taad106. [PMID: 37555656 PMCID: PMC10481416 DOI: 10.1093/jtm/taad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/10/2023]
Abstract
Effectiveness of the 50-μg mRNA-1273.214 bivalent vaccine against SARS-CoV-2 infection was modest at 25% in a matched, retrospective, cohort study in Qatar comparing infection incidence in the bivalent cohort to that in the national no-recent-vaccination resident cohort. XBB* immune evasion, immune imprinting effects, or both, may explain findings.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, PO Box 24144, Doha, Qatar
| | - Houssein H Ayoub
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, PO Box 24144, Doha, Qatar
| | - Jeremy S Faust
- Department of Emergency Medicine, Brigham and Women’s Hospital, MA 02115, Boston, Massachusetts, USA
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, PO Box 26999, Doha
| | - Peter Coyle
- Hamad Medical Corporation, POBox 3050, Doha, Qatar
| | - Hadi M Yassine
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Asmaa A Al Thani
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Hebah A Al-Khatib
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | | | | | | | | | | | - Ali N Latif
- Hamad Medical Corporation, POBox 3050, Doha, Qatar
| | | | - Hanan F Abdul-Rahim
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Gheyath K Nasrallah
- Departments of Mathematics, Statistics, and Physics, and of Biomedical Science, and of Public Health, Qatar University, PO Box 2713, Doha, Qatar
| | | | - Adeel A Butt
- Hamad Medical Corporation, POBox 3050, Doha, Qatar
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, PO Box 24144, Doha, Qatar
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Altarawneh HN, Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Yassine HM, Al-Khatib HA, Al Thani AA, Coyle P, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Effects of previous infection, vaccination, and hybrid immunity against symptomatic Alpha, Beta, and Delta SARS-CoV-2 infections: an observational study. EBioMedicine 2023; 95:104734. [PMID: 37515986 PMCID: PMC10404859 DOI: 10.1016/j.ebiom.2023.104734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/02/2023] [Accepted: 07/15/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Protection against SARS-CoV-2 symptomatic infection and severe COVID-19 of previous infection, mRNA two-dose vaccination, mRNA three-dose vaccination, and hybrid immunity of previous infection and vaccination were investigated in Qatar for the Alpha, Beta, and Delta variants. METHODS Six national, matched, test-negative, case-control studies were conducted between January 18 and December 18, 2021 on a sample of 239,120 PCR-positive tests and 6,103,365 PCR-negative tests. FINDINGS Effectiveness of previous infection against Alpha, Beta, and Delta reinfection was 89.5% (95% CI: 85.5-92.3%), 87.9% (95% CI: 85.4-89.9%), and 90.0% (95% CI: 86.7-92.5%), respectively. Effectiveness of two-dose BNT162b2 vaccination against Alpha, Beta, and Delta infection was 90.5% (95% CI, 83.9-94.4%), 80.5% (95% CI: 79.0-82.0%), and 58.1% (95% CI: 54.6-61.3%), respectively. Effectiveness of three-dose BNT162b2 vaccination against Delta infection was 91.7% (95% CI: 87.1-94.7%). Effectiveness of hybrid immunity of previous infection and two-dose BNT162b2 vaccination was 97.4% (95% CI: 95.4-98.5%) against Beta infection and 94.5% (95% CI: 92.8-95.8%) against Delta infection. Effectiveness of previous infection and three-dose BNT162b2 vaccination was 98.1% (95% CI: 85.7-99.7%) against Delta infection. All five forms of immunity had >90% protection against severe, critical, or fatal COVID-19 regardless of variant. Similar effectiveness estimates were observed for mRNA-1273. A mathematical model accurately predicted hybrid immunity protection by assuming that the individual effects of previous infection and vaccination acted independently. INTERPRETATION Hybrid immunity, offering the strongest protection, was mathematically predicted by assuming that the immunities obtained from previous infection and vaccination act independently, without synergy or redundancy. FUNDING The Biomedical Research Program and the Biostatistics, Epidemiology, and the Biomathematics Research Core, both at Weill Cornell Medicine-Qatar, Ministry of Public Health, Hamad Medical Corporation, Sidra Medicine, Qatar Genome Programme, Qatar University Biomedical Research Center, and Qatar University Internal Grant ID QUCG-CAS-23/24-114.
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Affiliation(s)
- Heba N Altarawneh
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Peter Coyle
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Hamad Medical Corporation, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
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11
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Qassim SH, Chemaitelly H, Ayoub HH, Coyle P, Tang P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Population immunity of natural infection, primary-series vaccination, and booster vaccination in Qatar during the COVID-19 pandemic: an observational study. EClinicalMedicine 2023; 62:102102. [PMID: 37533414 PMCID: PMC10393554 DOI: 10.1016/j.eclinm.2023.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Background Waning of natural infection protection and vaccine protection highlight the need to evaluate changes in population immunity over time. Population immunity of previous SARS-CoV-2 infection or of COVID-19 vaccination are defined, respectively, as the overall protection against reinfection or against breakthrough infection at a given point in time in a given population. Methods We estimated these population immunities in Qatar's population between July 1, 2020 and November 30, 2022, to discern generic features of the epidemiology of SARS-CoV-2. Effectiveness of previous infection, mRNA primary-series vaccination, and mRNA booster (third-dose) vaccination in preventing infection were estimated, month by month, using matched, test-negative, case-control studies. Findings Previous-infection effectiveness against reinfection was strong before emergence of Omicron, but declined with time after a wave and rebounded after a new wave. Effectiveness dropped after Omicron emergence from 88.3% (95% CI: 84.8-91.0%) in November 2021 to 51.0% (95% CI: 48.3-53.6%) in December 2021. Primary-series effectiveness against infection was 84.0% (95% CI: 83.0-85.0%) in April 2021, soon after introduction of vaccination, before waning gradually to 52.7% (95% CI: 46.5-58.2%) by November 2021. Effectiveness declined linearly by ∼1 percentage point every 5 days. After Omicron emergence, effectiveness dropped from 52.7% (95% CI: 46.5-58.2%) in November 2021 to negligible levels in December 2021. Booster effectiveness dropped after Omicron emergence from 83.0% (95% CI: 65.6-91.6%) in November 2021 to 32.9% (95% CI: 26.7-38.5%) in December 2021, and continued to decline thereafter. Effectiveness of previous infection and vaccination against severe, critical, or fatal COVID-19 were generally >80% throughout the study duration. Interpretation High population immunity against infection may not be sustained beyond a year, but population immunity against severe COVID-19 is durable with slow waning even after Omicron emergence. Funding The Biomedical Research Program and the Biostatistics, Epidemiology, and the Biomathematics Research Core, both at Weill Cornell Medicine-Qatar, Ministry of Public Health, Hamad Medical Corporation, Sidra Medicine, Qatar Genome Programme, Qatar University Biomedical Research Center, and Qatar University Internal Grant ID QUCG-CAS-23/24-114.
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Affiliation(s)
- Suelen H. Qassim
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Asmaa A. Al Thani
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A. Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F. Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K. Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Hamad Medical Corporation, Doha, Qatar
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | | | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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Dasgupta S, Samad A, Howlader SS, Choudhury DI, Hossain A, Khan MS, Hasan MR, Talukder QI, Rahman MK. Complete Heparin Reversal by Protamine during Off-Pump Coronary Artery Bypass Surgery (OPCAB): A Necessity or Myth? Mymensingh Med J 2023; 32:421-429. [PMID: 37002753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
In our country majority of the coronary artery bypass surgery (CABG) are done off-pump and was reported having excellent clinical outcome along with cost efficiency by various investigators. Heparin is commonly used as most effective anticoagulant, and protamine sulfate is now generally used to reverse the anticoagulant action of heparin. While under dosing of protamine may result in incomplete heparin reversal and prolonged anticoagulation, protamine overdosing is associated with impaired clot formation exerted by the intrinsic anti-coagulation properties of protamine itself, moreover protamine administration is associated with mild to severe cardiovascular and pulmonary complications. Apart from traditional full neutralization of heparin now-a-days, half dose protamine was also introduced showing good outcome regarding lower activated clotting time (ACT), overall, less surgical bleeding with less transfusion. This comparative study was designed to detect differences between traditional and decreased protamine dosing in Off-Pump Coronary Artery Bypass (OPCAB) surgery. Four hundred (400) patients who underwent Off-Pump Coronary Artery Bypass Surgery (OPCAB) surgery at our institution over a period of 12 months were analyzed and were divided into two groups. Group A- received 0.5mg of protamine per 100 unit of heparin; Group B-received 1.0mg of protamine per 100 unit of heparin. ACT, blood loss, hemoglobin and platelet count units of blood and blood product transfusion requirements, clinical outcome and hospital stay were assessed in each patient. This study showed that 0.5mg of protamine per 100 unit of heparin was always able to reverse the anticoagulant effect of heparin with no significant difference in hemodynamic parameters, amount of blood loss and requirements of blood transfusion in between the groups. A standard protamine dosing formula (protamine-heparin at ratio of 1:1) adequate for on-pump cardiac surgical procedures significantly overestimates protamine requirements for OPCAB. Patients treated with decreased protamine do not appear to have adverse outcomes in terms of post-operative bleeding.
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Affiliation(s)
- S Dasgupta
- Dr Saikat Das Gupta, Associate Consultant, Department of Cardiac Surgery, Square Hospitals Ltd, Dhaka, Bangladesh; E-mail:
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Chemaitelly H, Ayoub HH, Coyle P, Tang P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Romaihi HE, Butt AA, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. BNT162b2 antigen dose and SARS-CoV-2 omicron infection in adolescents. Lancet Infect Dis 2023; 23:276-277. [PMID: 36738760 PMCID: PMC9891733 DOI: 10.1016/s1473-3099(23)00005-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, PO Box 24144, Doha, Qatar.
| | - Houssein H Ayoub
- Department of Mathematics, Statistics, and Physics, and Biomedical Research Center, Qatar University, Doha, Qatar
| | | | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M Yassine
- Department of Biomedical Science, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, PO Box 24144, Doha, Qatar; Department of Public Health, Qatar University, Doha, Qatar.
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Chemaitelly H, Tang P, Coyle P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Ayoub HH, Altarawneh HN, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Protection against Reinfection with the Omicron BA.2.75 Subvariant. N Engl J Med 2023; 388:665-667. [PMID: 36652342 PMCID: PMC9878583 DOI: 10.1056/nejmc2214114] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Alnomasy SF, Alotaibi BS, Aldosari ZM, Mujamammi AH, Alzamami A, Anand P, Akhter Y, Khan FR, Hasan MR. Molecular Interactions of Zyesami with the SARS-CoV-2 nsp10/nsp16 Protein Complex. Comb Chem High Throughput Screen 2023; 26:1196-1203. [PMID: 35975856 DOI: 10.2174/1386207325666220816141028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND SARS-CoV-2 emerged in late 2019 and caused COVID-19. Patients treated with Zyesami were found to have a 3-fold decrease in respiratory failure and improved clinical outcomes. It was reported that Zyesami inhibits RNA replication of SARS-CoV-2, including several non-structural proteins essential in viral RNA replication. SARS-CoV-2 is a distinctive virus that requires nsp10 and nsp16 for its methyltransferases activity which is crucial for RNA stability and protein synthesis. OBJECTIVE We aimed the in silico determination of inhibitory consequences of Zyesami on the SARS-CoV-2 nsp10/nsp16 complex. Targeting SARS-CoV-2 nsp10/ nsp16 protein complex may be used to develop a drug against COVID-19. METHODS I-TASSER was used for secondary structure prediction of Zyesami. CABS-dock was used to model Zyesami with SARS-CoV-2 nsp16 interaction. The docked complex was visualized using PyMol. The quality of the docking model was checked by using ProQdock. RESULTS The 3D structure of SARS-CoV 2, nsp10/nsp16 showed that essential interactions exist between nsp10 and nsp16. Significant contact areas of Zyesami exist across amino acid residues of nsp10; Asn40-Thr47, Val57-Pro59, Gly69-Ser72, Cys77-Pro84, Lys93-Tyr96. In addition, polar contacts between nsp16 and Zyesami are Asn299-Ser440, Val297-Asn443, Gly149-Tyr437, Gln159-Lys430, Asn178- Arg429, Ser146-Arg429, Ser146-Arg429, Lys147-Arg429, Asr221-Thr422, Lys183-Asp423, Lys183-Asp423, and Gln219-Asp423 the residues are shown of nsp16 and Zyesami respectively. CONCLUSION The structural bioinformatics analyses have indicated the potential binding specificity of Zyesami and nsp16. Data predict how the initial binding of Zyesami with nsp10 and nsp16 may occur. Moreover, this binding could significantly inhibit the 2 -O-MTase activity of the SARSCoV nsp10/16 complex.
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Affiliation(s)
- Sultan F Alnomasy
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
| | - Bader S Alotaibi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
| | - Ziyad M Aldosari
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
| | - Ahmed H Mujamammi
- Department of Pathology, Clinical Biochemistry Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Alzamami
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
| | - Pragya Anand
- Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow, India
| | - Yusuf Akhter
- Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow, India
| | - Farhan R Khan
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
| | - Mohammad R Hasan
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences in Al-Quwayiyah, Shaqra University, Saudi Arabia
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Chemaitelly H, Nagelkerke N, Ayoub HH, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Duration of immune protection of SARS-CoV-2 natural infection against reinfection. J Travel Med 2022; 29:6731972. [PMID: 36179099 PMCID: PMC9619565 DOI: 10.1093/jtm/taac109] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The future of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic hinges on virus evolution and duration of immune protection of natural infection against reinfection. We investigated the duration of protection afforded by natural infection, the effect of viral immune evasion on duration of protection and protection against severe reinfection, in Qatar, between 28 February 2020 and 5 June 2022. METHODS Three national, matched, retrospective cohort studies were conducted to compare the incidence of SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) severity among unvaccinated persons with a documented SARS-CoV-2 primary infection, to incidence among those infection-naïve and unvaccinated. Associations were estimated using Cox proportional hazard regression models. RESULTS Effectiveness of pre-Omicron primary infection against pre-Omicron reinfection was 85.5% [95% confidence interval (CI): 84.8-86.2%]. Effectiveness peaked at 90.5% (95% CI: 88.4-92.3%) in the 7th month after the primary infection, but waned to ~ 70% by the 16th month. Extrapolating this waning trend using a Gompertz curve suggested an effectiveness of 50% in the 22nd month and < 10% by the 32nd month. Effectiveness of pre-Omicron primary infection against Omicron reinfection was 38.1% (95% CI: 36.3-39.8%) and declined with time since primary infection. A Gompertz curve suggested an effectiveness of < 10% by the 15th month. Effectiveness of primary infection against severe, critical or fatal COVID-19 reinfection was 97.3% (95% CI: 94.9-98.6%), irrespective of the variant of primary infection or reinfection, and with no evidence for waning. Similar results were found in sub-group analyses for those ≥50 years of age. CONCLUSIONS Protection of natural infection against reinfection wanes and may diminish within a few years. Viral immune evasion accelerates this waning. Protection against severe reinfection remains very strong, with no evidence for waning, irrespective of variant, for over 14 months after primary infection.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Research Department, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Nico Nagelkerke
- Infectious Disease Epidemiology Group, Research Department, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar.,Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.,Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, Cornell University,New York, NY, USA
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Research Department, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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17
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Altarawneh HN, Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Yassine HM, Al-Khatib HA, Smatti MK, Coyle P, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al Khal AL, Bertollini R, Abu-Raddad LJ. 1966. Protection afforded by prior infection, vaccination, and hybrid immunity against symptomatic BA.1 and BA.2 Omicron infections. Open Forum Infect Dis 2022. [PMCID: PMC9752683 DOI: 10.1093/ofid/ofac492.1591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Protection offered by five different forms of immunity, combining natural and vaccine immunity, was investigated against symptomatic SARS-CoV-2 infection from Omicron BA.1 or BA.2, and severe, critical, or fatal COVID-19 from BA.1 or BA.2, in Qatar, between December 23, 2021 and February 21, 2022. Methods Six national, matched, test-negative case-control studies were conducted on a sample of 272,861 PCR-positive tests and 669,628 PCR-negative tests to estimate effectiveness of BNT162b2 (Pfizer-BioNTech) vaccine, mRNA-1273 (Moderna) vaccine, natural immunity due to prior infection with pre-Omicron variants, and hybrid immunity from prior infection and vaccination. Results Effectiveness of prior infection alone against symptomatic BA.2 infection was 46.1% (95% CI: 39.5-51.9%). Effectiveness of two-dose BNT162b2 vaccination alone was negligible at -1.1% (95% CI: -7.1-4.6), but nearly all individuals received their second dose >6 months earlier. Effectiveness of three-dose BNT162b2 vaccination alone was 52.2% (95% CI: 48.1-55.9%). Effectiveness of hybrid immunity of prior infection and two-dose BNT162b2 vaccination was 55.1% (95% CI: 50.9-58.9%). Effectiveness of hybrid immunity of prior infection and three-dose BNT162b2 vaccination was 77.3% (95% CI: 72.4-81.4%). Meanwhile, prior infection, BNT162b2 vaccination, and hybrid immunity all showed strong effectiveness ( >70%) against severe, critical, or fatal COVID-19 due to BA.2. Similar patterns of effectiveness were observed for BA.1 and for the mRNA-1273 vaccine.
Effectiveness of prior infection, vaccination, and hybrid immunity against symptomatic Omicron infection and against severe, critical, or fatal COVID-19 for the BA.1 (panels A and B, respectively) and BA.2 (panels C and D, respectively) subvariants in the BNT162b2-vaccine study. ![]() Effectiveness of prior infection, vaccination, and hybrid immunity against symptomatic Omicron infection and against severe, critical, or fatal COVID-19 for the BA.1 (panels A and B, respectively) and BA.2 (panels C and D, respectively) subvariants in the mRNA-1273-vaccine study. ![]() Conclusion There are no discernable differences between BA.1 and BA.2 in the effects of prior infection, vaccination, and hybrid immunity. Vaccination enhances the protection of those with a prior infection. Hybrid immunity resulting from prior infection and recent booster vaccination conferred the strongest protection. Disclosures Adeel A. Butt, MBBS, Gilead Sciences: Grant/Research Support.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Peter Coyle
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | | | | | | | | | | | | | | | | | | | - Adeel A Butt
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
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Chemaitelly H, Ayoub HH, AlMukdad S, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Protection from previous natural infection compared with mRNA vaccination against SARS-CoV-2 infection and severe COVID-19 in Qatar: a retrospective cohort study. Lancet Microbe 2022; 3:e944-e955. [PMID: 36375482 PMCID: PMC9651957 DOI: 10.1016/s2666-5247(22)00287-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/24/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Understanding protection conferred by natural SARS-CoV-2 infection versus COVID-19 vaccination is important for informing vaccine mandate decisions. We compared protection conferred by natural infection versus that from the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar. METHODS We conducted two matched retrospective cohort studies that emulated target trials. Data were obtained from the national federated databases for COVID-19 vaccination, SARS-CoV-2 testing, and COVID-19-related hospitalisation and death between Feb 28, 2020 (pandemic onset in Qatar) and May 12, 2022. We matched individuals with a documented primary infection and no vaccination record (natural infection cohort) with individuals who had received two doses (primary series) of the same vaccine (BNT162b2-vaccinated or mRNA-1273-vaccinated cohorts) at the start of follow-up (90 days after the primary infection). Individuals were exact matched (1:1) by sex, 10-year age group, nationality, comorbidity count, and timing of primary infection or first-dose vaccination. Incidence of SARS-CoV-2 infection and COVID-19-related hospitalisation and death in the natural infection cohorts was compared with incidence in the vaccinated cohorts, using Cox proportional hazards regression models with adjustment for matching factors. FINDINGS Between Jan 5, 2021 (date of second-dose vaccine roll-out) and May 12, 2022, 104 500 individuals vaccinated with BNT162b2 and 61 955 individuals vaccinated with mRNA-1273 were matched to unvaccinated individuals with a documented primary infection. During follow-up, 7123 SARS-CoV-2 infections were recorded in the BNT162b2-vaccinated cohort and 3583 reinfections were recorded in the matched natural infection cohort. 4282 SARS-CoV-2 infections were recorded in the mRNA-1273-vaccinated cohort and 2301 reinfections were recorded in the matched natural infection cohort. The overall adjusted hazard ratio (HR) for SARS-CoV-2 infection was 0·47 (95% CI 0·45-0·48) after previous natural infection versus BNT162b2 vaccination, and 0·51 (0·49-0·54) after previous natural infection versus mRNA-1273 vaccination. The overall adjusted HR for severe (acute care hospitalisations), critical (intensive care unit hospitalisations), or fatal COVID-19 cases was 0·24 (0·08-0·72) after previous natural infection versus BNT162b2 vaccination, and 0·24 (0·05-1·19) after previous natural infection versus mRNA-1273 vaccination. Severe, critical, or fatal COVID-19 was rare in both the natural infection and vaccinated cohorts. INTERPRETATION Previous natural infection was associated with lower incidence of SARS-CoV-2 infection, regardless of the variant, than mRNA primary-series vaccination. Vaccination remains the safest and most optimal tool for protecting against infection and COVID-19-related hospitalisation and death, irrespective of previous infection status. FUNDING The Biomedical Research Program and the Biostatistics, Epidemiology, and Biomathematics Research Core, Weill Cornell Medicine-Qatar; Qatar Ministry of Public Health; Hamad Medical Corporation; Sidra Medicine; Qatar Genome Programme; and Qatar University Biomedical Research Center.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar,WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA,Correspondence to: Dr Hiam Chemaitelly, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha 24144, Qatar
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar,WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar,Biomedical Research Center, QU Health, Qatar University, Doha, Qatar,Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA,Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA,Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar,WHO Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar,Professor Laith J Abu-Raddad, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, Doha 24144, Qatar
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19
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Chemaitelly H, AlMukdad S, Ayoub HH, Altarawneh HN, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Romaihi HE, Butt AA, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Covid-19 Vaccine Protection among Children and Adolescents in Qatar. N Engl J Med 2022; 387:1865-1876. [PMID: 36322837 PMCID: PMC9644642 DOI: 10.1056/nejmoa2210058] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The BNT162b2 vaccine against coronavirus disease 2019 (Covid-19) has been authorized for use in children 5 to 11 years of age and adolescents 12 to 17 years of age but in different antigen doses. METHODS We assessed the real-world effectiveness of the BNT162b2 vaccine against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and adolescents in Qatar. To compare the incidence of SARS-CoV-2 infection in the national cohort of vaccinated participants with the incidence in the national cohort of unvaccinated participants, we conducted three matched, retrospective, target-trial, cohort studies - one assessing data obtained from children 5 to 11 years of age after the B.1.1.529 (omicron) variant became prevalent and two assessing data from adolescents 12 to 17 years of age before the emergence of the omicron variant (pre-omicron study) and after the omicron variant became prevalent. Associations were estimated with the use of Cox proportional-hazards regression models. RESULTS Among children, the overall effectiveness of the 10-μg primary vaccine series against infection with the omicron variant was 25.7% (95% confidence interval [CI], 10.0 to 38.6). Effectiveness was highest (49.6%; 95% CI, 28.5 to 64.5) right after receipt of the second dose but waned rapidly thereafter and was negligible after 3 months. Effectiveness was 46.3% (95% CI, 21.5 to 63.3) among children 5 to 7 years of age and 16.6% (95% CI, -4.2 to 33.2) among those 8 to 11 years of age. Among adolescents, the overall effectiveness of the 30-μg primary vaccine series against infection with the omicron variant was 30.6% (95% CI, 26.9 to 34.1), but many adolescents had been vaccinated months earlier. Effectiveness waned over time since receipt of the second dose. Effectiveness was 35.6% (95% CI, 31.2 to 39.6) among adolescents 12 to 14 years of age and 20.9% (95% CI, 13.8 to 27.4) among those 15 to 17 years of age. In the pre-omicron study, the overall effectiveness of the 30-μg primary vaccine series against SARS-CoV-2 infection among adolescents was 87.6% (95% CI, 84.0 to 90.4) and waned relatively slowly after receipt of the second dose. CONCLUSIONS Vaccination in children was associated with modest, rapidly waning protection against omicron infection. Vaccination in adolescents was associated with stronger, more durable protection, perhaps because of the larger antigen dose. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Sawsan AlMukdad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Heba N Altarawneh
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hebah A Al-Khatib
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Maria K Smatti
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Zaina Al-Kanaani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Einas Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hanan F Abdul-Rahim
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed G Al-Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Hamad E Al-Romaihi
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Abdullatif Al-Khal
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
| | - Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group (H.C., S.A., H.N.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., H.N.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University (H.H.A.), and the Biomedical Research Center (P.C., H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.C., H.N.A., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, United Kingdom (P.C.)
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Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Coyle P, Yassine HM, Al-Khatib HA, Smatti MK, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Immune Imprinting and Protection against Repeat Reinfection with SARS-CoV-2. N Engl J Med 2022; 387:1716-1718. [PMID: 36223534 PMCID: PMC9634858 DOI: 10.1056/nejmc2211055] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Altarawneh HN, Chemaitelly H, Ayoub HH, Hasan MR, Coyle P, Yassine HM, Al-Khatib HA, Smatti MK, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Tang P, Abu-Raddad LJ. Protective Effect of Previous SARS-CoV-2 Infection against Omicron BA.4 and BA.5 Subvariants. N Engl J Med 2022; 387:1620-1622. [PMID: 36198139 PMCID: PMC9559315 DOI: 10.1056/nejmc2209306] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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22
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Qassim SH, Chemaitelly H, Ayoub HH, AlMukdad S, Tang P, Hasan MR, Yassine HM, Al-Khatib HA, Smatti MK, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Khal A, Coyle P, Kaleeckal AH, Shaik RM, Latif AN, Al-Kuwari E, Jeremijenko A, Butt AA, Bertollini R, Al-Romaihi HE, Al-Thani MH, Abu-Raddad LJ. Effects of BA.1/BA.2 subvariant, vaccination and prior infection on infectiousness of SARS-CoV-2 omicron infections. J Travel Med 2022; 29:6594077. [PMID: 35639932 PMCID: PMC9213851 DOI: 10.1093/jtm/taac068] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Suelen H Qassim
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | - Peter Coyle
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Hamad Medical Corporation, Doha, Qatar.,Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | | | | | | | | | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.,Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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23
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Qassim SH, Hasan MR, Tang P, Chemaitelly H, Ayoub HH, Yassine HM, Al-Khatib HA, Smatti MK, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Al-Khal A, Coyle P, Gillani I, Kaleeckal AH, Shaik RM, Latif AN, Al-Kuwari E, Jeremijenko A, Butt AA, Bertollini R, Al-Romaihi HE, Al-Thani MH, Abu-Raddad LJ. Effects of SARS-CoV-2 Alpha, Beta, and Delta variants, age, vaccination, and prior infection on infectiousness of SARS-CoV-2 infections. Front Immunol 2022; 13:984784. [PMID: 36177014 PMCID: PMC9513583 DOI: 10.3389/fimmu.2022.984784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
In 2021, Qatar experienced considerable incidence of SARS-CoV-2 infection that was dominated sequentially by the Alpha, Beta, and Delta variants. Using the cycle threshold (Ct) value of an RT-qPCR-positive test to proxy the inverse of infectiousness, we investigated infectiousness of SARS-CoV-2 infections by variant, age, sex, vaccination status, prior infection status, and reason for testing in a random sample of 18,355 RT-qPCR-genotyped infections. Regression analyses were conducted to estimate associations with the Ct value of RT-qPCR-positive tests. Compared to Beta infections, Alpha and Delta infections demonstrated 2.56 higher Ct cycles (95% CI: 2.35-2.78), and 4.92 fewer cycles (95% CI: 4.67- 5.16), respectively. The Ct value declined gradually with age and was especially high for children <10 years of age, signifying lower infectiousness in small children. Children <10 years of age had 2.18 higher Ct cycles (95% CI: 1.88-2.48) than those 10-19 years of age. Compared to unvaccinated individuals, the Ct value was higher among individuals who had received one or two vaccine doses, but the Ct value decreased gradually with time since the second-dose vaccination. Ct value was 2.07 cycles higher (95% CI: 1.42-2.72) for those with a prior infection than those without prior infection. The Ct value was lowest among individuals tested because of symptoms and was highest among individuals tested as a travel requirement. Delta was substantially more infectious than Beta. Prior immunity, whether due to vaccination or prior infection, is associated with lower infectiousness of breakthrough infections, but infectiousness increases gradually with time since the second-dose vaccination.
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Affiliation(s)
- Suelen H. Qassim
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | | | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A. Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maria K. Smatti
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hanan F. Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K. Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | - Peter Coyle
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar
- Hamad Medical Corporation, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | | | | | | | | | | | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
- Hamad Medical Corporation, Doha, Qatar
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | | | | | | | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- *Correspondence: Laith J. Abu-Raddad,
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24
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Altarawneh HN, Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Yassine HM, Al-Khatib HA, Smatti MK, Coyle P, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections. N Engl J Med 2022; 387:21-34. [PMID: 35704396 PMCID: PMC9258753 DOI: 10.1056/nejmoa2203965] [Citation(s) in RCA: 279] [Impact Index Per Article: 139.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The protection conferred by natural immunity, vaccination, and both against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the BA.1 or BA.2 sublineages of the omicron (B.1.1.529) variant is unclear. METHODS We conducted a national, matched, test-negative, case-control study in Qatar from December 23, 2021, through February 21, 2022, to evaluate the effectiveness of vaccination with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna), natural immunity due to previous infection with variants other than omicron, and hybrid immunity (previous infection and vaccination) against symptomatic omicron infection and against severe, critical, or fatal coronavirus disease 2019 (Covid-19). RESULTS The effectiveness of previous infection alone against symptomatic BA.2 infection was 46.1% (95% confidence interval [CI], 39.5 to 51.9). The effectiveness of vaccination with two doses of BNT162b2 and no previous infection was negligible (-1.1%; 95% CI, -7.1 to 4.6), but nearly all persons had received their second dose more than 6 months earlier. The effectiveness of three doses of BNT162b2 and no previous infection was 52.2% (95% CI, 48.1 to 55.9). The effectiveness of previous infection and two doses of BNT162b2 was 55.1% (95% CI, 50.9 to 58.9), and the effectiveness of previous infection and three doses of BNT162b2 was 77.3% (95% CI, 72.4 to 81.4). Previous infection alone, BNT162b2 vaccination alone, and hybrid immunity all showed strong effectiveness (>70%) against severe, critical, or fatal Covid-19 due to BA.2 infection. Similar results were observed in analyses of effectiveness against BA.1 infection and of vaccination with mRNA-1273. CONCLUSIONS No discernable differences in protection against symptomatic BA.1 and BA.2 infection were seen with previous infection, vaccination, and hybrid immunity. Vaccination enhanced protection among persons who had had a previous infection. Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Heba N Altarawneh
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hebah A Al-Khatib
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Maria K Smatti
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Zaina Al-Kanaani
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Einas Al-Kuwari
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hanan F Abdul-Rahim
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohamed G Al-Kuwari
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hamad E Al-Romaihi
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Abdullatif Al-Khal
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Education City (H.N.A., H.C., L.J.A.-R.), the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), and the Departments of Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.) and Public Health (H.F.A.-R., L.J.A.-R.), College of Health Sciences, QU Health, Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (H.N.A., H.C., A.A.B., L.J.A.-R.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
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Butt AA, Dargham SR, Tang P, Chemaitelly H, Hasan MR, Coyle PV, Kaleeckal AH, Latif AN, Loka S, Shaik RM, Zaqout A, Almaslamani MA, Al Khal A, Bertollini R, Abou-Samra AB, Abu-Raddad LJ. COVID-19 disease severity in persons infected with the Omicron variant compared with the Delta variant in Qatar. J Glob Health 2022; 12:05032. [PMID: 35788085 PMCID: PMC9253930 DOI: 10.7189/jogh.12.05032] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Understanding the disease severity associated with the Omicron variant of the SARS-CoV-2 virus is important in determining appropriate management strategies at the individual and population levels. We determined the severity of SARS-CoV-2 infection in persons infected with the Omicron vs the Delta variant. Methods We identified individuals with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. We excluded temporary visitors to Qatar, those with a prior documented infection, those ≤18 years old, and those with <14 days of follow up after the index test positive date. We determined the rates of admission to the hospital, admission to intensive care unit, mechanical ventilation, or death among those infected with the Delta or Omicron variants. Results Among 9763 cases infected with the Delta variant and 11 310 cases infected with the Omicron variant, we identified 3926 propensity-score matched pairs. Among 3926 Delta infected, 3259 (83.0%) had mild, 633 (16.1%) had moderate and 34 (0.9%) had severe/critical disease. Among 3926 Omicron infected, 3866 (98.5%) had mild, 59 (1.5%) had moderate, and only 1 had severe/critical disease (overall P < 0.001). Factors associated with less moderate or severe/critical disease included infection with Omicron variant (aOR = 0.06; confidence interval (CI) = 0.05-0.09) and vaccination including a booster (aOR = 0.30; 95% CI = 0.09-0.99). Conclusions Omicron variant infection is associated with significantly lower severity of disease compared with the Delta variant. Vaccination continues to offer strong protection against severe/critical disease.
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Affiliation(s)
- Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, New York, New York; and Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; and Doha, Qatar
| | - Soha R Dargham
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; and Doha, Qatar
| | | | - Hiam Chemaitelly
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; and Doha, Qatar
| | - Mohammad R Hasan
- Department of Medicine, Weill Cornell Medicine, New York, New York; and Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; and Doha, Qatar
| | | | | | | | | | | | | | | | | | | | | | - Laith J Abu-Raddad
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; and Doha, Qatar
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26
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Chemaitelly H, Ayoub HH, AlMukdad S, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Duration of mRNA vaccine protection against SARS-CoV-2 Omicron BA.1 and BA.2 subvariants in Qatar. Nat Commun 2022; 13:3082. [PMID: 35654888 PMCID: PMC9163167 DOI: 10.1038/s41467-022-30895-3] [Citation(s) in RCA: 129] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/24/2022] [Indexed: 12/14/2022] Open
Abstract
SARS-CoV-2 Omicron BA.1 and BA.2 subvariants are genetically divergent. We conducted a matched, test-negative, case-control study to estimate duration of protection of the second and third/booster doses of mRNA COVID-19 vaccines against BA.1 and BA.2 infections in Qatar. BNT162b2 effectiveness was highest at 46.6% (95% CI: 33.4-57.2%) against symptomatic BA.1 and at 51.7% (95% CI: 43.2-58.9%) against symptomatic BA.2 infections in the first three months after the second dose, but declined to ~10% or below thereafter. Effectiveness rebounded to 59.9% (95% CI: 51.2-67.0%) and 43.7% (95% CI: 36.5-50.0%), respectively, in the first month after the booster dose, before declining again. Effectiveness against COVID-19 hospitalization and death was 70-80% after the second dose and >90% after the booster dose. mRNA-1273 vaccine protection showed similar patterns. mRNA vaccines provide comparable, moderate, and short-lived protection against symptomatic BA.1 and BA.2 Omicron infections, but strong and durable protection against COVID-19 hospitalization and death.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Qatar Foundation-Education City, Cornell University, Doha, Qatar.
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Qatar Foundation-Education City, Cornell University, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Hamad Medical Corporation, Doha, Qatar
- Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Qatar Foundation-Education City, Cornell University, Doha, Qatar.
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
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Jahan N, Khan MNI, Hasan MR, Bashar MS, Islam A, Alam MK, Hakim MA, Khandaker JI. Correlation among the structural, electric and magnetic properties of Al 3+ substituted Ni-Zn-Co ferrites. RSC Adv 2022; 12:15167-15179. [PMID: 35693236 PMCID: PMC9116189 DOI: 10.1039/d1ra09354a] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
This study explored the structural, electrical, and magnetic properties of diamagnetic aluminium (Al3+) substituted nickel-zinc-cobalt (Ni–Zn–Co) mixed spinel ferrites, though the research on this area is in the infancy stage. Single-phase cubic spinel structures with the Fd3̄m space group of the synthesized Ni0.4Zn0.35Co0.25Fe(2−x)AlxO4 (0 ≤ x ≤ 0.12) ferrite samples were confirmed by X-ray diffraction (XRD) analysis. The average particle size ranged from 0.67 to 0.39 μm. Selected area electron diffraction (SAED) patterns were indexed according to the space group Fd3m, representing the particle's crystallinity. The optical band gaps ranged from 4.784 eV to 4.766 eV. Frequency-dependent dielectric constants and ac conductivity measurement suggested that the prepared ferrites were highly resistive. Relaxation times were reduced to a low value from 45.45 μs to 1.54 μs with the composition x. The Curie temperatures (Tc) were 615–623 K for all samples. Real part permeabilities (μ/) were relatively stable up to an extended frequency range of 106 Hz with relative quality factors (RQF) of around 103. Tuning of the properties indicates that the fabricated ferrites may be promising for high-frequency electronic devices. This study explored the structural, electrical, and magnetic properties of diamagnetic aluminium (Al3+) substituted nickel–zinc–cobalt (Ni–Zn–Co) mixed spinel ferrites, though the research on this area is in the infancy stage.![]()
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Affiliation(s)
- Nusrat Jahan
- Department of Physics, Jahangirnagar University Savar Dhaka 1342 Bangladesh .,Department of Physics, American International University Bangladesh (AIUB) Dhaka 1229 Bangladesh
| | - M N I Khan
- Materials Science Division, Atomic Energy Centre Dhaka 1000 Bangladesh
| | - M R Hasan
- Materials Science Division, Atomic Energy Centre Dhaka 1000 Bangladesh
| | - M S Bashar
- Sustainable Energy Technology, Institute of Fuel Research & Development, BCSIR, Ministry of Science & Technology Bangladesh
| | - A Islam
- Department of Physics, Magura Govt. Mahila College Magura Bangladesh
| | - M K Alam
- Department of Physics, Materials Science Lab, Bangladesh University of Engineering & Technology Dhaka 1000 Bangladesh
| | - M A Hakim
- Department of Glass and Ceramic Engineering, Bangladesh University of Engineering and Technology (BUET) Dhaka 1000 Bangladesh
| | - J I Khandaker
- Department of Physics, Jahangirnagar University Savar Dhaka 1342 Bangladesh
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Abu-Raddad LJ, Chemaitelly H, Ayoub HH, AlMukdad S, Yassine HM, Al-Khatib HA, Smatti MK, Tang P, Hasan MR, Coyle P, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R. Effect of mRNA Vaccine Boosters against SARS-CoV-2 Omicron Infection in Qatar. N Engl J Med 2022; 386:1804-1816. [PMID: 35263534 PMCID: PMC8929389 DOI: 10.1056/nejmoa2200797] [Citation(s) in RCA: 233] [Impact Index Per Article: 116.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Waning of vaccine protection against coronavirus disease 2019 (Covid-19) and the emergence of the omicron (or B.1.1.529) variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to expedited efforts to scale up booster vaccination. Protection conferred by booster doses of the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar, as compared with protection conferred by the two-dose primary series, is unclear. METHODS We conducted two matched retrospective cohort studies to assess the effectiveness of booster vaccination, as compared with that of a two-dose primary series alone, against symptomatic SARS-CoV-2 infection and Covid-19-related hospitalization and death during a large wave of omicron infections from December 19, 2021, through January 26, 2022. The association of booster status with infection was estimated with the use of Cox proportional-hazards regression models. RESULTS In a population of 2,239,193 persons who had received at least two doses of BNT162b2 or mRNA-1273 vaccine, those who had also received a booster were matched with persons who had not received a booster. Among the BNT162b2-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 2.4% (95% confidence interval [CI], 2.3 to 2.5) in the booster cohort and 4.5% (95% CI, 4.3 to 4.6) in the nonbooster cohort after 35 days of follow-up. Booster effectiveness against symptomatic omicron infection, as compared with that of the primary series, was 49.4% (95% CI, 47.1 to 51.6). Booster effectiveness against Covid-19-related hospitalization and death due to omicron infection, as compared with the primary series, was 76.5% (95% CI, 55.9 to 87.5). BNT162b2 booster effectiveness against symptomatic infection with the delta (or B.1.617.2) variant, as compared with the primary series, was 86.1% (95% CI, 67.3 to 94.1). Among the mRNA-1273-vaccinated persons, the cumulative incidence of symptomatic omicron infection was 1.0% (95% CI, 0.9 to 1.2) in the booster cohort and 1.9% (95% CI, 1.8 to 2.1) in the nonbooster cohort after 35 days; booster effectiveness against symptomatic omicron infection, as compared with the primary series, was 47.3% (95% CI, 40.7 to 53.3). Few severe Covid-19 cases were noted in the mRNA-1273-vaccinated cohorts. CONCLUSIONS The messenger RNA (mRNA) boosters were highly effective against symptomatic delta infection, but they were less effective against symptomatic omicron infection. However, with both variants, mRNA boosters led to strong protection against Covid-19-related hospitalization and death. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Sawsan AlMukdad
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hebah A Al-Khatib
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Maria K Smatti
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Zaina Al-Kanaani
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Einas Al-Kuwari
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hanan F Abdul-Rahim
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohamed Ghaith Al-Kuwari
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Hamad Eid Al-Romaihi
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Abdullatif Al-Khal
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group (L.J.A.-R., H.C., S.A.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (L.J.A.-R., H.C., S.A.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Departments of Public Health (L.J.A.-R., H.F.A.-R.) and Biomedical Science (H.M.Y., H.A.A.-K., M.K.S., G.K.N.), College of Health Sciences, QU Health, the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), the Biomedical Research Center, QU Health (H.M.Y., H.A.A.-K., M.K.S., P.C., G.K.N.), Qatar University, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), Hamad Medical Corporation (P.C., Z.A.-K., E.A.-K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.-K.), Primary Health Care Corporation (M.G.A.-K.), and the Ministry of Public Health (H.E.A.-R., M.H.A.-T., R.B.) - all in Doha, Qatar; the Departments of Population Health Sciences (L.J.A.-R., H.C., A.A.B.) and Medicine (A.A.B.), Weill Cornell Medicine, Cornell University, New York; and the Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.)
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29
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Butt AA, Dargham SR, Loka S, Shaik RM, Chemaitelly H, Tang P, Hasan MR, Coyle PV, Yassine HM, Al-Khatib HA, Smatti MK, Kaleeckal AH, Latif AN, Zaqout A, Almaslamani MA, Al Khal A, Bertollini R, Abou-Samra AB, Abu-Raddad LJ. COVID-19 Disease Severity in Children Infected with the Omicron Variant. Clin Infect Dis 2022; 75:e361-e367. [PMID: 35404391 PMCID: PMC9047187 DOI: 10.1093/cid/ciac275] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Indexed: 12/21/2022] Open
Abstract
Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.
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Affiliation(s)
- Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar
| | - Soha R Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | | | | | - Hiam Chemaitelly
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | | | | | | | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar.,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Laith J Abu-Raddad
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY and Doha, Qatar.,Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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30
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Akhter T, Nessa A, Hasan MR, Sharmin A, Yeasmin F, Afroz L, Rukunuzzaman M, Naznen F, Sharmin T. Study on Body Mass Index and Serum Calcium Level in Postmenopausal Women. Mymensingh Med J 2022; 31:367-371. [PMID: 35383752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Menopause is one of the natural parts of women's life when menstrual cycle stops due to lack of estrogen, which occurs in middle age. Various health problems occur in this period which hampers quality of life. This study was done to evaluate the changes of body mass index and serum calcium level in post-menopausal women in comparison to reproductive women. This cross-sectional analytical type of study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2021 to December 2021. A total number of 140 female subjects age ranged from 25-65 years were included in this study. Among them 70 (seventy) postmenopausal woman (45-65 years) were taken as study group (Group II) and 70 (seventy) reproductive women (25-45 years) were taken as control group (Group I). Body mass index was measured by Anthropometric measurements such as height and weight taken in meter and kilogram respectively and Serum calcium level was measured by colorimetric method with O-Cresolftalein-complexone (OCC). Data were expressed as mean (±SD) and statistical significance of difference among the group was calculated by unpaired Student's 't' test. The mean±SD of BMI of Group I and Group II were 23.05±4.43 kg/m² and 29.01±3.12 kg/m² respectively. The mean±SD of body mass index is significantly higher in study group in comparison with control group. Serum calcium of Group I and Group II were 10.95±0.77 mg/dl and 7.99±0.55 mg/dl respectively. The mean±SD of serum calcium level was significantly lower in study group in comparison with control group. Post-menopausal women with low serum calcium level have a chance of development of osteoporosis. So, assessment of this parameter is important for early detection and prevention of complication related to low serum calcium level for leading a sound life.
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Affiliation(s)
- T Akhter
- Dr Tania Akhter, M Phil (Physiology) Final Part, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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31
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Altarawneh HN, Chemaitelly H, Hasan MR, Ayoub HH, Qassim S, AlMukdad S, Coyle P, Yassine HM, Al-Khatib HA, Benslimane FM, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Tang P, Abu-Raddad LJ. Protection against the Omicron Variant from Previous SARS-CoV-2 Infection. N Engl J Med 2022; 386:1288-1290. [PMID: 35139269 PMCID: PMC8849180 DOI: 10.1056/nejmc2200133] [Citation(s) in RCA: 266] [Impact Index Per Article: 133.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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32
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Bsat R, Chemaitelly H, Coyle P, Tang P, Hasan MR, Al Kanaani Z, Al Kuwari E, Butt AA, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Nasrallah GK, Benslimane FM, Al Khatib HA, Yassine HM, Al Kuwari MG, Al Romaihi HE, Al-Thani MH, Al Khal A, Bertollini R, Abu-Raddad LJ, Ayoub HH. Characterizing the effective reproduction number during the COVID-19 pandemic: Insights from Qatar’s experience. J Glob Health 2022; 12:05004. [PMID: 35136602 PMCID: PMC8819337 DOI: 10.7189/jogh.12.05004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The effective reproduction number, Rt, is a tool to track and understand pandemic dynamics. This investigation of Rt estimations was conducted to guide the national COVID-19 response in Qatar, from the onset of the pandemic until August 18, 2021. Methods Real-time “empirical” RtEmpirical was estimated using five methods, including the Robert Koch Institute, Cislaghi, Systrom-Bettencourt and Ribeiro, Wallinga and Teunis, and Cori et al. methods. Rt was also estimated using a transmission dynamics model (RtModel-based). Uncertainty and sensitivity analyses were conducted. Correlations between different Rt estimates were assessed by calculating correlation coefficients, and agreements between these estimates were assessed through Bland-Altman plots. Results RtEmpirical captured the evolution of the pandemic through three waves, public health response landmarks, effects of major social events, transient fluctuations coinciding with significant clusters of infection, and introduction and expansion of the Alpha (B.1.1.7) variant. The various estimation methods produced consistent and overall comparable RtEmpirical estimates with generally large correlation coefficients. The Wallinga and Teunis method was the fastest at detecting changes in pandemic dynamics. RtEmpirical estimates were consistent whether using time series of symptomatic PCR-confirmed cases, all PCR-confirmed cases, acute-care hospital admissions, or ICU-care hospital admissions, to proxy trends in true infection incidence. RtModel-based correlated strongly with RtEmpirical and provided an average RtEmpirical. Conclusions Rt estimations were robust and generated consistent results regardless of the data source or the method of estimation. Findings affirmed an influential role for Rt estimations in guiding national responses to the COVID-19 pandemic, even in resource-limited settings.
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Affiliation(s)
- Raghid Bsat
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | | | | | - Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | | | | | | | | | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Fatiha M Benslimane
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Public Health, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
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33
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Butt AA, Dargham SR, Chemaitelly H, Al Khal A, Tang P, Hasan MR, Coyle PV, Thomas AG, Borham AM, Concepcion EG, Kaleeckal AH, Latif AN, Bertollini R, Abou-Samra AB, Abu-Raddad LJ. Severity of Illness in Persons Infected With the SARS-CoV-2 Delta Variant vs Beta Variant in Qatar. JAMA Intern Med 2022; 182:197-205. [PMID: 34935861 PMCID: PMC8696690 DOI: 10.1001/jamainternmed.2021.7949] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE The Delta variant is now the predominant circulating SARS-CoV-2 strain worldwide. Severity of illness in persons infected with the SARS-CoV-2 Delta variant compared with the Beta variant is not known. OBJECTIVE To directly compare clinical outcomes in persons infected with the SARS-CoV-2 Delta variant vs those infected with the Beta variant in Qatar. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the national COVID-19 database in Qatar, which includes information on all individuals who were ever tested for SARS-CoV-2 using a reverse transcriptase-polymerase chain reaction test and all individuals who received any SARS-CoV-2 vaccine in Qatar. Among persons with confirmed SARS-CoV-2 infection between March 22 and July 7, 2021, those infected with the Delta variant were identified and were propensity score matched with control individuals infected with the Beta variant. The variants were ascertained by variant genotyping of the positive samples. EXPOSURES SARS-CoV-2 infection with the Delta or Beta variant. MAIN OUTCOMES AND MEASURES The main outcomes were admission to the hospital, admission to the intensive care unit, use of supplemental oxygen, use of high-flow oxygen, receipt of mechanical ventilation, or death among those infected with the Delta or Beta variant overall and stratified by vaccination status. RESULTS Among 1427 persons infected with the Delta variant (252 [55.9%] male; median age, 34 years [IQR, 17-43 years]) and 5353 persons infected with the Beta variant (233 [51.7%] male; median age, 34 years [IQR, 17-45 years]), 451 propensity score-matched pairs were identified. Persons infected with the Delta variant were more likely to be hospitalized (27.3% [95% CI, 23.2%-31.6%] vs 20.0% [95% CI, 16.4-24.0]; P = .01) or to have mild-moderate or severe-critical disease outcomes (27.9% [95% CI, 23.8%-32.3%] vs 20.2% [95% CI, 16.6%-24.2%]; P = .01) compared with persons infected with the Beta variant. Infection with the Delta variant was independently associated with higher odds of experiencing any adverse outcome (adjusted odds ratio [aOR], 2.53; 95% CI, 1.72-3.72). Compared with being unvaccinated, being vaccinated with a second dose more than 3 months before infection was associated with lower odds of any adverse outcome among persons infected with the Delta variant (aOR, 0.11; 95% CI, 0.04-0.26) and among those infected with the Beta variant (aOR, 0.22; 95% CI, 0.05-0.98). Protection was similar among those who received a second vaccine dose less than 3 months before infection, but having received only a single dose was not associated with a lower odds of any severe outcome among those infected with the Delta variant (aOR, 1.12; 95% CI, 0.41-3.06) or those infected with the Beta variant (aOR, 0.74; 95% CI, 0.20-2.72). CONCLUSIONS AND RELEVANCE In this cohort study of persons with COVID-19 in Qatar, infection with the SARS-CoV-2 Delta variant was associated with more severe disease than was infection with the Beta variant. Being unvaccinated was associated with greater odds of severe-critical disease.
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Affiliation(s)
- Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, New York, New York.,Department of Population Health Sciences, Weill Cornell Medicine, Doha, Qatar
| | - Soha R Dargham
- Department of Population Health Sciences, Weill Cornell Medicine, Doha, Qatar
| | - Hiam Chemaitelly
- Department of Population Health Sciences, Weill Cornell Medicine, Doha, Qatar
| | | | - Patrick Tang
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, Doha, Qatar.,Sidra Medicine, Doha, Qatar
| | - Mohammad R Hasan
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, Doha, Qatar.,Sidra Medicine, Doha, Qatar
| | | | | | | | | | | | | | | | | | - Laith J Abu-Raddad
- Department of Population Health Sciences, Weill Cornell Medicine, Doha, Qatar
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34
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Abu-Raddad LJ, Chemaitelly H, Ayoub HH, Tang P, Coyle P, Hasan MR, Yassine HM, Benslimane FM, Al-Khatib HA, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Khal A, Al-Thani MH, Bertollini R. Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections. Nat Commun 2022; 13:532. [PMID: 35087035 PMCID: PMC8795418 DOI: 10.1038/s41467-022-28199-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/06/2022] [Indexed: 12/18/2022] Open
Abstract
SARS-CoV-2 breakthrough infections in vaccinated individuals and in those who had a prior infection have been observed globally, but the transmission potential of these infections is unknown. The RT-qPCR cycle threshold (Ct) value is inversely correlated with viral load and culturable virus. Here, we investigate differences in RT-qPCR Ct values across Qatar's national cohorts of primary infections, reinfections, BNT162b2 (Pfizer-BioNTech) breakthrough infections, and mRNA-1273 (Moderna) breakthrough infections. Our matched-cohort analyses of the randomly diagnosed infections show higher mean Ct value in all cohorts of breakthrough infections compared to the cohort of primary infections in unvaccinated individuals. The Ct value is 1.3 (95% CI: 0.9-1.8) cycles higher for BNT162b2 breakthrough infections, 3.2 (95% CI: 1.9-4.5) cycles higher for mRNA-1273 breakthrough infections, and 4.0 (95% CI: 3.5-4.5) cycles higher for reinfections in unvaccinated individuals. Since Ct value correlates inversely with SARS-CoV-2 infectiousness, these differences imply that vaccine breakthrough infections and reinfections are less infectious than primary infections in unvaccinated individuals. Public health benefits of vaccination may have been underestimated, as COVID-19 vaccines not only protect against acquisition of infection, but also appear to protect against transmission of infection.
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Affiliation(s)
- Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | | | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Fatiha M Benslimane
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Hamad Medical Corporation, Doha, Qatar
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35
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Chemaitelly H, Tang P, Hasan MR, AlMukdad S, Yassine HM, Benslimane FM, Al Khatib HA, Coyle P, Ayoub HH, Al Kanaani Z, Al Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul Rahim HF, Nasrallah GK, Al Kuwari MG, Al Romaihi HE, Butt AA, Al-Thani MH, Al Khal A, Bertollini R, Abu-Raddad LJ. Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar. N Engl J Med 2021; 385:e83. [PMID: 34614327 PMCID: PMC8522799 DOI: 10.1056/nejmoa2114114] [Citation(s) in RCA: 522] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Waning of vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (Covid-19) is a concern. The persistence of BNT162b2 (Pfizer-BioNTech) vaccine effectiveness against infection and disease in Qatar, where the B.1.351 (or beta) and B.1.617.2 (or delta) variants have dominated incidence and polymerase-chain-reaction testing is done on a mass scale, is unclear. METHODS We used a matched test-negative, case-control study design to estimate vaccine effectiveness against any SARS-CoV-2 infection and against any severe, critical, or fatal case of Covid-19, from January 1 to September 5, 2021. RESULTS Estimated BNT162b2 effectiveness against any SARS-CoV-2 infection was negligible in the first 2 weeks after the first dose. It increased to 36.8% (95% confidence interval [CI], 33.2 to 40.2) in the third week after the first dose and reached its peak at 77.5% (95% CI, 76.4 to 78.6) in the first month after the second dose. Effectiveness declined gradually thereafter, with the decline accelerating after the fourth month to reach approximately 20% in months 5 through 7 after the second dose. Effectiveness against symptomatic infection was higher than effectiveness against asymptomatic infection but waned similarly. Variant-specific effectiveness waned in the same pattern. Effectiveness against any severe, critical, or fatal case of Covid-19 increased rapidly to 66.1% (95% CI, 56.8 to 73.5) by the third week after the first dose and reached 96% or higher in the first 2 months after the second dose; effectiveness persisted at approximately this level for 6 months. CONCLUSIONS BNT162b2-induced protection against SARS-CoV-2 infection appeared to wane rapidly following its peak after the second dose, but protection against hospitalization and death persisted at a robust level for 6 months after the second dose. (Funded by Weill Cornell Medicine-Qatar and others.).
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Affiliation(s)
- Hiam Chemaitelly
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Patrick Tang
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Mohammad R Hasan
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Sawsan AlMukdad
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Hadi M Yassine
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Fatiha M Benslimane
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Hebah A Al Khatib
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Peter Coyle
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Houssein H Ayoub
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Zaina Al Kanaani
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Einas Al Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Andrew Jeremijenko
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Anvar H Kaleeckal
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Ali N Latif
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Riyazuddin M Shaik
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Hanan F Abdul Rahim
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Gheyath K Nasrallah
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Mohamed G Al Kuwari
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Hamad E Al Romaihi
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Adeel A Butt
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Mohamed H Al-Thani
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Abdullatif Al Khal
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Roberto Bertollini
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
| | - Laith J Abu-Raddad
- From the Infectious Disease Epidemiology Group (H.C., S.A., L.J.A.-R.) and the World Health Organization Collaborating Center for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis (H.C., S.A., L.J.A.-R.), Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation-Education City, the Department of Pathology, Sidra Medicine (P.T., M.R.H.), the Biomedical Research Center, Member of QU Health (H.M.Y., F.M.B., H.A.A.K., P.C., G.K.N.), the Departments of Biomedical Science (H.M.Y., F.M.B., H.A.A.K., G.K.N.) and Public Health (H.F.A.R., L.J.A.-R.), College of Health Sciences, and the Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences (H.H.A.), Qatar University, Hamad Medical Corporation (P.C., Z.A.K., E.A.K., A.J., A.H.K., A.N.L., R.M.S., A.A.B., A.A.K.), Primary Health Care Corporation (M.G.A.K.), and the Ministry of Public Health (H.E.A.R., M.H.A.-T., R.B.) - all in Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom (P.C.); and the Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York (A.A.B., L.J.A.-R.)
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Abu-Raddad LJ, Chemaitelly H, Ayoub HH, Yassine HM, Benslimane FM, Al Khatib HA, Tang P, Hasan MR, Coyle P, Al Kanaani Z, Al Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul Rahim HF, Nasrallah GK, Al Kuwari MG, Butt AA, Al Romaihi HE, Al-Thani MH, Al Khal A, Bertollini R. Association of Prior SARS-CoV-2 Infection With Risk of Breakthrough Infection Following mRNA Vaccination in Qatar. JAMA 2021; 326:1930-1939. [PMID: 34724027 PMCID: PMC8561432 DOI: 10.1001/jama.2021.19623] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/15/2021] [Indexed: 12/19/2022]
Abstract
Importance The effect of prior SARS-CoV-2 infection on vaccine protection remains poorly understood. Objective To assess protection from SARS-CoV-2 breakthrough infection after mRNA vaccination among persons with vs without prior SARS-CoV-2 infection. Design, Setting, and Participants Matched-cohort studies in Qatar for the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines. A total of 1 531 736 individuals vaccinated with either vaccine between December 21, 2020, and September 19, 2021, were followed up beginning 14 days after receiving the second dose until September 19, 2021. Exposures Prior SARS-CoV-2 infection and COVID-19 vaccination. Main Outcomes and Measures Incident SARS-CoV-2 infection, defined as a polymerase chain reaction (PCR)-positive nasopharyngeal swab regardless of reason for PCR testing or presence of symptoms. Cumulative incidence was calculated using the Kaplan-Meier estimator method. Results The BNT162b2-vaccinated cohort comprised 99 226 individuals with and 290 432 matched individuals without prior PCR-confirmed infection (median age, 37 years; 68% male). The mRNA-1273-vaccinated cohort comprised 58 096 individuals with and 169 514 matched individuals without prior PCR-confirmed infection (median age, 36 years; 73% male). Among BNT162b2-vaccinated persons, 159 reinfections occurred in those with and 2509 in those without prior infection 14 days or more after dose 2. Among mRNA-1273-vaccinated persons, 43 reinfections occurred in those with and 368 infections in those without prior infection. Cumulative infection incidence among BNT162b2-vaccinated individuals was an estimated 0.15% (95% CI, 0.12%-0.18%) in those with and 0.83% (95% CI, 0.79%-0.87%) in those without prior infection at 120 days of follow-up (adjusted hazard ratio for breakthrough infection with prior infection, 0.18 [95% CI, 0.15-0.21]; P < .001). Cumulative infection incidence among mRNA-1273-vaccinated individuals was an estimated 0.11% (95% CI, 0.08%-0.15%) in those with and 0.35% (95% CI, 0.32%-0.40%) in those without prior infection at 120 days of follow-up (adjusted hazard ratio, 0.35 [95% CI, 0.25-0.48]; P < .001). Vaccinated individuals with prior infection 6 months or more before dose 1 had statistically significantly lower risk for breakthrough infection than those vaccinated less than 6 months before dose 1 (adjusted hazard ratio, 0.62 [95% CI, 0.42-0.92]; P = .02 for BNT162b2 and 0.40 [95% CI, 0.18-0.91]; P = .03 for mRNA-1273 vaccination). Conclusions and Relevance Prior SARS-CoV-2 infection was associated with a statistically significantly lower risk for breakthrough infection among individuals receiving the BNT162b2 or mRNA-1273 vaccines in Qatar between December 21, 2020, and September 19, 2021. The observational study design precludes direct comparisons of infection risk between the 2 vaccines.
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Affiliation(s)
- Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation–Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York
- Department of Public Health, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation–Education City, Doha, Qatar
| | - Houssein H. Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Fatiha M. Benslimane
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A. Al Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | - Peter Coyle
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Hamad Medical Corporation, Doha, Qatar
- Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | | | | | | | | | | | | | | | - Gheyath K. Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A. Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York
- Hamad Medical Corporation, Doha, Qatar
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37
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Abu-Raddad LJ, Chemaitelly H, Ayoub HH, Yassine HM, Benslimane FM, Al Khatib HA, Tang P, Hasan MR, Coyle P, AlMukdad S, Al Kanaani Z, Al Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul Rahim HF, Nasrallah GK, Al Kuwari MG, Butt AA, Al Romaihi HE, Al-Thani MH, Al Khal A, Bertollini R. Severity, Criticality, and Fatality of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Beta Variant. Clin Infect Dis 2021; 75:e1188-e1191. [PMID: 34657152 PMCID: PMC9402694 DOI: 10.1093/cid/ciab909] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Indexed: 01/19/2023] Open
Abstract
Beta (B.1.351)-variant coronavirus disease 2019 (COVID-19) disease was investigated in Qatar. Compared with the Alpha (B.1.1.7) variant, odds (95% confidence interval) of progressing to severe disease, critical disease, and COVID-19-related death were 1.24-fold (1.11-1.39), 1.49-fold (1.13-1.97), and 1.57-fold (1.03-2.43) higher, respectively, for the Beta variant.
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Affiliation(s)
- Laith J Abu-Raddad
- Correspondence: L. J. Abu-Raddad, Infectious Disease Epidemiology Group, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Qatar Foundation– Education City, P.O. Box 24144, Doha, Qatar ()
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hadi M Yassine
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Fatiha M Benslimane
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al Khatib
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | - Peter Coyle
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar,Hamad Medical Corporation, Doha, Qatar,Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, United Kingdom
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation—Education City, Doha, Qatar
| | | | | | | | | | | | | | - Hanan F Abdul Rahim
- Department of Public Health, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, Member of QU Health, Qatar University, Doha, Qatar,Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA,Hamad Medical Corporation, Doha, Qatar
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38
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Haque AN, Uzzaman KS, Hasan MM, Hasan KR, Hasan MR, Hussain M, Saha MK, Islam MS, Rahman MM, Roy MK, Kamruzzaman M, Minto MR, Alam MT, Hossain MZ, Islam MN, Islam MS. Outcome of Danis-Weber Type-B ankle fracture treated by Pre-contoured Distal Fibular Locking Plate. Mymensingh Med J 2021; 30:644-650. [PMID: 34226450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Danis-Weber type-B ankle fracture is one of the most common injuries in young and active individual. This fracture offers a considerable challenge to orthopedic surgeon. Though there are several options for treating such type of fracture, ORIF by Pre-contoured Distal Fibular Locking Plate is the preferred option in the recent years. This descriptive type of observational study was performed from July 2017 to June 2019 in NITOR. Thirty (30) patients, 22 male and 8 female with an average age of 39 years with Danis-Weber type-B ankle fracture underwent ORIF by Pre-contoured Distal Fibular Locking Plate for fractured fibula and ORIF by 4.0mm cannulated cancellous screw for fractured medial malleolus. All the patients were initially managed by analgesic and short leg posterior slab. Average follow up was 24 weeks. Final outcome was assessed by AOFAS score. The main cause of injury was RTA (56.67%). Mean operation time was 1.2 hours. Mean duration of Hospital stay was 16.43±1.73 days. Superficial infection was in 3.33% and skin necrosis in 3.33% patient. Mean duration of radiological healing was 12.73±0.39 weeks. At final follow up, mean dorsi flexion was 10.93°±0.357° and plantar flexion was 50.93°±0.357°. Ninety percent (90%) patient had no difficulties in walking on any surface; 96.67% patient had stable ankle hind foot; 86.67% patient had good. Ten percent (10%) had fair and 3.33% patient had poor alignment of foot. The mean score in this study was 88.67±2.31. Satisfactory outcome was observed in 86.67% patients and 13.33% had unsatisfactory results. On the basis of results in the present study, it can be concluded that treatment of Danis-Weber type-B ankle fracture by Pre-contoured Distal Fibular Locking Plate is an effective and reliable method.
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Affiliation(s)
- A N Haque
- Dr AKM Nazmul Haque, Junior Consultant (Orthopedics), Department of Orthopedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
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39
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Khan T, Rahman M, Ali FA, Huang SSY, Ata M, Zhang Q, Bastard P, Liu Z, Jouanguy E, Béziat V, Cobat A, Nasrallah GK, Yassine HM, Smatti MK, Saeed A, Vandernoot I, Goffard JC, Smits G, Migeotte I, Haerynck F, Meyts I, Abel L, Casanova JL, Hasan MR, Marr N. Distinct antibody repertoires against endemic human coronaviruses in children and adults. JCI Insight 2021; 6:144499. [PMID: 33497357 PMCID: PMC7934927 DOI: 10.1172/jci.insight.144499] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Four endemic human coronaviruses (HCoVs) are commonly associated with acute respiratory infection in humans. B cell responses to these “common cold” viruses remain incompletely understood. Here we report a comprehensive analysis of CoV-specific antibody repertoires in 231 children and 1168 adults using phage immunoprecipitation sequencing. Seroprevalence of antibodies against endemic HCoVs ranged between approximately 4% and 27% depending on the species and cohort. We identified at least 136 novel linear B cell epitopes. Antibody repertoires against endemic HCoVs were qualitatively different between children and adults in that anti-HCoV IgG specificities more frequently found among children targeted functionally important and structurally conserved regions of the spike, nucleocapsid, and matrix proteins. Moreover, antibody specificities targeting the highly conserved fusion peptide region and S2′ cleavage site of the spike protein were broadly cross-reactive with peptides of epidemic human and nonhuman coronaviruses. In contrast, an acidic tandem repeat in the N-terminal region of the Nsp3 subdomain of the HCoV-HKU1 polyprotein was the predominant target of antibody responses in adult donors. Our findings shed light on the dominant species-specific and pan-CoV target sites of human antibody responses to coronavirus infection, thereby providing important insights for the development of prophylactic or therapeutic monoclonal antibodies and vaccine design.
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Affiliation(s)
| | | | | | | | - Manar Ata
- Research Branch, Sidra Medicine, Doha, Qatar
| | - Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA
| | - Paul Bastard
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France
| | - Zhiyong Liu
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France
| | - Vivien Béziat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France
| | - Aurélie Cobat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France
| | - Gheyath K Nasrallah
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar.,Biomedical Research Center, Qatar University, Doha, Qatar
| | - Hadi M Yassine
- College of Health Sciences, QU Health, Qatar University, Doha, Qatar.,Biomedical Research Center, Qatar University, Doha, Qatar
| | - Maria K Smatti
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Amira Saeed
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | | | | | - Isabelle Migeotte
- Fonds de la Recherche Scientifique (FNRS) and Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Filomeen Haerynck
- Department of Pediatric Pulmonology and Immunology, Department of Pediatrics and Internal Medicine, Center for Primary Immunodeficiencies Ghent, Jeffrey Modell Foundation Diagnostic and Research Center, Ghent University Hospital, Belgium
| | - Isabelle Meyts
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, and Department of Pediatrics, University Hospitals Leuven, KU Leuven, Belgium.,Department of Pediatrics, University Hospitals Leuven, KU Leuven, Belgium
| | - Laurent Abel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA.,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France.,Howard Hughes Medical Institute, New York, New York, USA
| | - Mohammad R Hasan
- Department of Pathology, Sidra Medicine, Doha, Qatar.,Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Nico Marr
- Research Branch, Sidra Medicine, Doha, Qatar.,College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
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40
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Ali MH, Kabir MA, Islam MS, Rahim CM, Hasan MK, Islam MK, Hasan MR, Alam MS. Study on Precipitating Factor of Chronic Hepatic Encephalopathy. Mymensingh Med J 2020; 29:800-806. [PMID: 33116080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Hepatic encephalopathy (HE) is a neuro-psychiatric manifestation of chronic liver disease causing significant morbidity and mortality worldwide. Though the exact mechanism is unknown but it is well accepted that various precipitating factors are involved in hepatic encephalopathy. Aim of the study was explore the precipitating factors of chronic hepatic encephalopathy. This cross sectional descriptive study was conducted in the Department of Medicine and Department of Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period from April 2016 to October 2016. One hundred patients with hepatic encephalopathy fulfilling the inclusion and exclusion criteria were enrolled. Inclusion criteria were designed for all diagnosed cases of hepatic encephalopathy associated with cirrhosis of liver aged 18 years or above irrespective of sex. Patients with acute fulminant hepatitis and non-cirrhotic hepatic encephalopathy were excluded. The result of the study was mean age of hepatic encephalopathy was 52.81±8.15 years and 94.0% patients were above 40 years. Male (66.0%) were predominant over female (34.0%). HBsAg and Anti HCV were positive in 49.0% and 11.0% patients respectively. Stage of hepatic encephalopathy was stage-I in 8.0%, stage-II in 37.0%, stage-III in 39.0% and stage-IV in 16.0% patients. Changes of biochemical parameters were low haemoglobin level (70.0%), raised total count of leukocyte (25.0%), low platelet count (68.0%), low serum albumin (98.0%) raised prothrombin time (60.0%), low serum sodium (34.0%) and low serum potassium (63.0%). The recoded precipitating factors were gastrointestinal bleeding (14.0%), constipation (37.0%), hyponatremia (34.0%), hypokalemia (28.0%) infections (20.0%), use of diruretics (8.0%), use of sedatives (4.0%) and excess intake of protein (6.0%). While precipitating factor was absent in 11.0% of cases. In conclusion there are different factors which play a key role in precipitating hepatic encephalopathy but electrolytes imbalance, constipation, infections, Upper GI bleed, diuretics are the most common precipitating factors.
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Affiliation(s)
- M H Ali
- Dr Md Haidar Ali, Registrar, Department of Medical Oncology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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MacLeod MJ, Hasan MR, Robb DHF, Mamun-Ur-Rashid M. Quantifying greenhouse gas emissions from global aquaculture. Sci Rep 2020; 10:11679. [PMID: 32669630 PMCID: PMC7363927 DOI: 10.1038/s41598-020-68231-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/15/2020] [Indexed: 12/03/2022] Open
Abstract
Global aquaculture makes an important contribution to food security directly (by increasing food availability and accessibility) and indirectly (as a driver of economic development). In order to enable sustainable expansion of aquaculture, we need to understand aquaculture’s contribution to global greenhouse gas (GHG) emissions and how it can be mitigated. This study quantifies the global GHG emissions from aquaculture (excluding the farming of aquatic plants), with a focus on using modern, commercial feed formulations for the main species groups and geographic regions. Here we show that global aquaculture accounted for approximately 0.49% of anthropogenic GHG emissions in 2017, which is similar in magnitude to the emissions from sheep production. The modest emissions reflect the low emissions intensity of aquaculture, compared to terrestrial livestock (in particular cattle, sheep and goats), which is due largely to the absence of enteric CH4 in aquaculture, combined with the high fertility and low feed conversion ratios of finfish and shellfish.
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Affiliation(s)
| | - Mohammad R Hasan
- Aquaculture Branch, FAO Fisheries and Aquaculture Department, Rome, Italy
| | - David H F Robb
- Cargill Animal Nutrition and Health, Aquaculture Business, Surrey, UK
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Sharmin T, Mirza TT, Hasan MR, Sarker K, Shamsi S, Shikha SS, Panna LK. Clinical Study on Rupture Uterus in Mymensingh Medical College Hospital. Mymensingh Med J 2019; 28:520-526. [PMID: 31391421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Uterine rupture is a devastating situation, has claimed innumerable lives of both the mother and the fetus. Even today, it is one of the common obstetric complications and a significant cause of maternal and fetal death. Several factors are responsible for this including-inadequate antenatal and intra partum care, poor communications and inadequate logistic support, above all, illiteracy and lack of knowledge of the people. To evaluate the patients with rupture uterus A cross sectional descriptive study was carried out in the department of Obstetrics & Gynaecology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2012 to June 2013. Total 100 cases of rupture uterus were included in this study within this period. Data were processed and analyzed by Computer software SPSS-16 version (Statistical Package for Social Science) & cases were selected purposively. Incidence of rupture uterus was 1.43%, common age group was 20-30 years, majority (67%) came from rural areas, multi-gravid patients were mainly affected (98%). Most of the patients (68%) had no antenatal check-up and 46% were handled by untrained Dai at home during labour pain and 56% exposed to oxytocic drugs. Unscarred uterus was more common (61%) & common clinical presentation was hypo-volumic shock (64%). Subtotal hysterectomy (51%) had done as surgical procedure in 51% patients and average duration of hospital stay was 11±4 days. The common post operative complications were sepsis (20%), wound infection (13%), shock (10%) and urinary fistula (8%). Incidence of peri-natal mortality was 89% and maternal mortality 14%.This study suggests maternal and perinatal morbidity and mortality is high due to rupture uterus. So prevention and proper management is necessary to overcome this problem. This study will hopefully give us some guide to take the strategies in improving the care of rupture uterus.
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Affiliation(s)
- T Sharmin
- Dr Tahmina Sharmin, Registrar, Department Obs and Gynae, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Khan AK, Quddus SR, Khan HK, Ali MS, Kamruzzaman M, Hasan MR, Hasan M, Moon RH. Complications Following General Anaesthesia in Paediatric Patients. Mymensingh Med J 2018; 27:429-436. [PMID: 29769515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Complications in paediatric anaesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with smell patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of cases malpractice claims. Both minor & major complication occurs most commonly in infants and children under three especially those with severe co-morbidities. Knowledge of risk profiles in paediatric anaesthesia is a starting point for the reduction of risk complication.
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Affiliation(s)
- A K Khan
- Dr Md Abul Kalam Azad Khan, Assistant Professor & Head, Department of Anaesthesiology, Community Based Medical College Bangladesh (CBMCB), Mymensingh, Bangladesh
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Hasan MR, Hassan N, Khan R, Kim YT, Iqbal SM. Classification of cancer cells using computational analysis of dynamic morphology. Comput Methods Programs Biomed 2018; 156:105-112. [PMID: 29428061 DOI: 10.1016/j.cmpb.2017.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/09/2017] [Accepted: 12/05/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Detection of metastatic tumor cells is important for early diagnosis and staging of cancer. However, such cells are exceedingly difficult to detect from blood or biopsy samples at the disease onset. It is reported that cancer cells, and especially metastatic tumor cells, show very distinctive morphological behavior compared to their healthy counterparts on aptamer functionalized substrates. The ability to quickly analyze the data and quantify the cell morphology for an instant real-time feedback can certainly contribute to early cancer diagnosis. A supervised machine learning approach is presented for identification and classification of cancer cell gestures for early diagnosis. METHODS We quantified the morphologically distinct behavior of metastatic cells and their healthy counterparts captured on aptamer-functionalized glass substrates from time-lapse optical micrographs. As a proof of concept, the morphologies of human glioblastoma (hGBM) and astrocyte cells were used. The cells were captured and imaged with an optical microscope. Multiple feature vectors were extracted to quantify and differentiate the complex physical gestures of cancerous and non-cancerous cells. Three different classifier models, Support Vector Machine (SVM), Random Forest Tree (RFT), and Naïve Bayes Classifier (NBC) were trained with the known dataset using machine learning algorithms. The performances of the classifiers were compared for accuracy, precision, and recall measurements using five-fold cross-validation technique. RESULTS All the classifier models detected the cancer cells with an average accuracy of at least 82%. The NBC performed the best among the three classifiers in terms of Precision (0.91), Recall (0.9), and F1-score (0.89) for the existing dataset. CONCLUSIONS This paper presents a standalone system built on machine learning techniques for cancer screening based on cell gestures. The system offers rapid, efficient, and novel identification of hGBM brain tumor cells and can be extended to define single cell analysis metrics for many other types of tumor cells.
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Affiliation(s)
- Mohammad R Hasan
- Nano-Bio Lab, University of Texas at Arlington, Arlington, TX 76019, USA; Nanotechnology Research Center, University of Texas at Arlington, Arlington, TX 76019, USA; Department of Electrical Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Naeemul Hassan
- Department of Computer and Information Science, University of Mississippi, University, MS 38677, USA
| | - Rayan Khan
- Nano-Bio Lab, University of Texas at Arlington, Arlington, TX 76019, USA; Nanotechnology Research Center, University of Texas at Arlington, Arlington, TX 76019, USA; Department of Electrical Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Young-Tae Kim
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX 76019, USA; Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75235, USA
| | - Samir M Iqbal
- Nano-Bio Lab, University of Texas at Arlington, Arlington, TX 76019, USA; Department of Electrical Engineering, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA; School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA.
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Hasan MR, Peri SSS, Sabane VP, Mansur N, Gao JX, Nguyen KT, Weidanz JA, Iqbal SM, Abhyankar VV. One-step fabrication of flexible nanotextured PDMS as a substrate for selective cell capture. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aa89a6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Weiswald LB, Hasan MR, Wong JCT, Pasiliao CC, Rahman M, Ren J, Yin Y, Gusscott S, Vacher S, Weng AP, Kennecke HF, Bièche I, Schaeffer DF, Yapp DT, Tai IT. Inactivation of the Kinase Domain of CDK10 Prevents Tumor Growth in a Preclinical Model of Colorectal Cancer, and Is Accompanied by Downregulation of Bcl-2. Mol Cancer Ther 2017; 16:2292-2303. [PMID: 28663269 DOI: 10.1158/1535-7163.mct-16-0666] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/15/2017] [Accepted: 06/23/2017] [Indexed: 11/16/2022]
Abstract
Cyclin-dependent kinase 10 (CDK10), a CDC2-related kinase, is highly expressed in colorectal cancer. Its role in the pathogenesis of colorectal cancer is unknown. This study examines the function of CDK10 in colorectal cancer, and demonstrates its role in suppressing apoptosis and in promoting tumor growth in vitro and in vivo Modulation of CDK10 expression in colorectal cancer cell lines demonstrates that CDK10 promotes cell growth, reduces chemosensitivity and inhibits apoptosis by upregulating the expression of Bcl-2. This effect appears to depend on its kinase activity, as kinase-defective mutant colorectal cancer cell lines have an exaggerated apoptotic response and reduced proliferative capacity. In vivo, inhibiting CDK10 in colorectal cancer following intratumoral injections of lentivirus-mediated CDK10 siRNA in a patient-derived xenograft mouse model demonstrated its efficacy in suppressing tumor growth. Furthermore, using a tissue microarray of human colorectal cancer tissues, the potential for CDK10 to be a prognostic biomarker in colorectal cancer was explored. In tumors of individuals with colorectal cancer, high expression of CDK10 correlates with earlier relapse and shorter overall survival. The findings of this study indicate that CDK10 plays a role in the pathogenesis in colorectal cancer and may be a potential therapeutic target for treatment. Mol Cancer Ther; 16(10); 2292-303. ©2017 AACR.
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Affiliation(s)
- Louis-Bastien Weiswald
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Mohammad R Hasan
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - John C T Wong
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Clarissa C Pasiliao
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Mahbuba Rahman
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Jianhua Ren
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Yaling Yin
- Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.,Cancer Surveillance & Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Samuel Gusscott
- Terry Fox Laboratory, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Sophie Vacher
- Department of Genetics, Institute Curie, Paris, France
| | - Andrew P Weng
- Terry Fox Laboratory, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Hagen F Kennecke
- Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Ivan Bièche
- Department of Genetics, Institute Curie, Paris, France
| | - David F Schaeffer
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald T Yapp
- Experimental Therapeutics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Isabella T Tai
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. .,Michael Smith Genome Sciences Center, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Hasan MR, Tan R, Al-Rawahi G, Thomas E, Tilley P. Comparative evaluation of laboratory developed real-time PCR assays and RealStar(®) BKV PCR Kit for quantitative detection of BK polyomavirus. J Virol Methods 2016; 234:80-6. [PMID: 27091098 DOI: 10.1016/j.jviromet.2016.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 02/25/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Quantitative, viral load monitoring for BK virus (BKV) by real-time PCR is an important tool in the management of polyomavirus associated nephropathy in renal transplant patients. However, variability in PCR results has been reported because of polymorphisms in viral genes among different subtypes of BKV, and lack of standardization of the PCR assays among different laboratories. In this study we have compared the performance of several laboratory developed PCR assays that target highly conserved regions of BKV genome with a commercially available, RealStar(®) BKV PCR Kit. METHOD Three real-time PCR assays (i) VP1 assay: selected from the literature that targets the major capsid protein (VP1) gene (ii) VP1MOD assay: VP1 assay with a modified probe, and (iii) BKLTA assay: newly designed assay that targets the large T antigen gene were assessed in parallel, using controls and clinical specimens that were previously tested using RealStar(®) BKV PCR Kit (Altona Diagnostics GmbH, Hamburg, Germany). Nucleic acid from all samples were extracted using the QIA symphony virus/bacteria kit on an automated DNA extraction platform QIA symphony SP (Qiagen). Primer and probe concentration, and reaction conditions for laboratory developed assays were optimized and the limit of detection of different assays was determined. Positive control for laboratory developed BK assays was prepared through construction of a plasmid carrying respective amplicon sequences. RESULTS The 95% detection limit of VP1, VP1MOD and BKLTA assays were 1.8×10(2), 3×10(3) and 3.5×10(2) genomic copies/ml, respectively, as determined by Probit regression analysis of data obtained by testing a dilution series of a titered patient specimen, using RealStar(®) BKV PCR Kit. The inter-assay and intra-assay, coefficient of variations of these assays using calibrated, plasmid standards were <1%. All assays, including the RealStar(®) BKV PCR assay, were highly specific when tested against a panel of external proficiency specimens containing both BK and JC viruses. All assays, except the VP1MOD assay determined BK viral load in proficiency specimens within the same log values. With reference to results obtained by RealStar(®) BKV PCR assay, the sensitivity and specificity of different assays tested in 116 serum specimens submitted for BK viral load assay were 91% and 97% for VP1 assay, 88% and 97% for VP1MOD assay, and 97% and 98% for BKLTA assay, respectively. BK Viral load in positive specimens determined by various assays was highly correlated (R(2)>0.97), based on linear regression analysis. CONCLUSIONS The performance characteristics of the newly designed, BKLTA assay were highly comparable to RealStar(®) BKV PCR assay, and can be used for routine detection and viral load monitoring of BKV in a cost-effective manner.
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Affiliation(s)
- Mohammad R Hasan
- Department of Pathology, Sidra Medical & Research Center, Doha, Qatar; Weill Cornell Medical College in Qatar, Doha, Qatar.
| | - Rusung Tan
- Department of Pathology, Sidra Medical & Research Center, Doha, Qatar; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ghada Al-Rawahi
- Children's and Women's Health Centre of BC, PHSA, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eva Thomas
- Department of Pathology, Sidra Medical & Research Center, Doha, Qatar
| | - Peter Tilley
- Children's and Women's Health Centre of BC, PHSA, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Ghosh A, Kushwaha HR, Hasan MR, Pareek A, Sopory SK, Singla-Pareek SL. Presence of unique glyoxalase III proteins in plants indicates the existence of shorter route for methylglyoxal detoxification. Sci Rep 2016; 6:18358. [PMID: 26732528 PMCID: PMC4702089 DOI: 10.1038/srep18358] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/03/2015] [Indexed: 11/16/2022] Open
Abstract
Glyoxalase pathway, comprising glyoxalase I (GLY I) and glyoxalase II (GLY II) enzymes, is the major pathway for detoxification of methylglyoxal (MG) into D-lactate involving reduced glutathione (GSH). However, in bacteria, glyoxalase III (GLY III) with DJ-1/PfpI domain(s) can do the same conversion in a single step without GSH. Our investigations for the presence of DJ-1/PfpI domain containing proteins in plants have indicated the existence of GLY III-like proteins in monocots, dicots, lycopods, gymnosperm and bryophytes. A deeper in silico analysis of rice genome identified twelve DJ-1 proteins encoded by six genes. Detailed analysis has been carried out including their chromosomal distribution, genomic architecture and localization. Transcript profiling under multiple stress conditions indicated strong induction of OsDJ-1 in response to exogenous MG. A member of OsDJ-1 family, OsDJ-1C, showed high constitutive expression at all developmental stages and tissues of rice. MG depletion study complemented by simultaneous formation of D-lactate proved OsDJ-1C to be a GLY III enzyme that converts MG directly into D-lactate in a GSH-independent manner. Site directed mutagenesis of Cys-119 to Alanine significantly reduces its GLY III activity indicating towards the existence of functional GLY III enzyme in rice—a shorter route for MG detoxification.
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Affiliation(s)
- Ajit Ghosh
- Plant Molecular Biology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi-110067, India.,Present address: Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Hemant R Kushwaha
- Plant Molecular Biology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi-110067, India
| | - Mohammad R Hasan
- Plant Molecular Biology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi-110067, India
| | - Ashwani Pareek
- Stress Physiology and Molecular Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi-110067, India
| | - Sudhir K Sopory
- Plant Molecular Biology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi-110067, India
| | - Sneh L Singla-Pareek
- Plant Molecular Biology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi-110067, India
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Weiswald LB, Hasan MR, Rahman M, Pasiliao C, Tai IT. Abstract 2047: CDK10 promotes tumour growth and chemoresistance in colorectal cancer, and is a potential target for treatment. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-2047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
CDK10 is a novel and relatively poorly characterized member of the CDC2 family of kinases. CDK10 has been reported to be involved in the regulation of the G2/M phase of the cell cycle. Its role in cancer is unclear. A meta-analysis of gene expression profiling studies has consistently demonstrated higher expression of this protein in colorectal cancer (CRC) but its role is unknown.
In this study, we were interested in examining the role of CDK10 in growth, apoptosis, chemoresistance, and as a therapeutic target in CRC.
CRC cell lines stably overexpressing CDK10 wild type (WT) as well as a kinase defective/dominant negative (DN) form of CDK10 were established in CRC cell lines RKO, HCT-15 and MIP101. Knockdown of CDK10 was achieved via siRNA. MTS and colony-forming assays were used to examine the response to 5-Fluorouracil (5-FU); TUNEL, caspase 3/7 assays, for apoptosis; and signaling events by immunoblotting. Cell growth in vivo was monitored after injection of cell lines into the flanks of Nude mice. To examine CDK10's role as a potential target, SCID mice implanted SC with patient-derived CRC were injected with lentiviral siRNA targeting CDK10 and tumor growth was examined.
Overexpression of CDK10 WT in RKO cells resulted in greater in vitro cell proliferation in comparison to either the DN or the control cells. It also inhibited apoptosis by 32%, while overexpression of the CDK10 DN protein was associated with an augmentation of apoptosis (>50%). Knockdown of CDK10 via siRNA confirmed a significant decrease in cell viability (20-60%) and a significant increase in apoptosis (>80%). This was associated with a downregulation of Bcl-2 and Bcl-xL expression. Interestingly, inhibition of apoptosis in CDK10 WT RKO cells could be achieved by inhibiting the expression of Bcl-2 and Bcl-xL by siRNA. The sensitivity of CRC cells to 5-FU was also dramatically reduced in cells overexpressing CDK10, as demonstrated by the significant higher IC50 in these cells. Colony-forming assay showed involvement of the kinase activity in 5-FU resistance since CDK10 DN HCT-15 cells displayed higher sensitivity and the CDK10 WT HCT-15 higher resistance to 5-FU. In line with the in vitro results, in vivo studies revealed that HCT-15 tumor xenografts expressing CDK10 WT have a significantly greater rate of growth than tumors expressing basal levels of CDK10. Interestingly, tumors of CDK10 DN cells had the slowest rate of growth. Furthermore, in vivo knockdown of CDK10 significantly impaired the growth of human SC implanted CRC tumors, as compared to control, with a ΔT/ΔC close to 0% by 26 days of treatment.
CDK10 appears to be involved in the pathogenesis of CRC by influencing cell growth, apoptosis and chemotherapy resistance, in part, through its kinase active site. In addition, in vivo results using patient-derived tumors showed a significant reduction in tumor growth, following siRNA knockdown of CDK10, thereby demonstrating it to be a potential target for therapy in CRC.
Citation Format: Louis-Bastien Weiswald, Mohammad R. Hasan, Mahbuba Rahman, Clarissa Pasiliao, Isabella T. Tai. CDK10 promotes tumour growth and chemoresistance in colorectal cancer, and is a potential target for treatment. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2047. doi:10.1158/1538-7445.AM2015-2047
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Zechariah A, ElAli A, Doeppner TR, Jin F, Hasan MR, Helfrich I, Mies G, Hermann DM. Vascular endothelial growth factor promotes pericyte coverage of brain capillaries, improves cerebral blood flow during subsequent focal cerebral ischemia, and preserves the metabolic penumbra. Stroke 2013; 44:1690-7. [PMID: 23632977 DOI: 10.1161/strokeaha.111.000240] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Therapeutic angiogenesis aims at improving cerebral blood flow by amplification of vascular sprouting, thus promoting tissue survival under conditions of subsequent ischemia. It remains unknown whether induced angiogenesis leads to the formation of functional vessels that indeed result in hemodynamic improvements. Observations of hemodynamic steal phenomena and disturbed neurovascular integrity after vascular endothelial growth factor delivery questioned the concept of therapeutic angiogenesis. METHODS Mice were treated with recombinant human vascular endothelial growth factor (0.02 μg/d; intracerebroventricular) for 3 to 21 days and subsequently exposed to 90-minute middle cerebral artery occlusion. Angiogenesis, histological brain injury, IgG extravasation, cerebral blood flow, protein synthesis and energy state, and pericyte coverage on brain capillaries were evaluated in a multiparametric approach combining histochemical, autoradiographic, and regional bioluminescence techniques. RESULTS Vascular endothelial growth factor increased brain capillary density within 10 days and reduced infarct volume and inflammation after subsequent middle cerebral artery occlusion, and, when delivered for prolonged periods of 21 days, enhanced postischemic blood-brain barrier integrity. Increased cerebral blood flow was noted in ischemic brain areas exhibiting enhanced angiogenesis and was associated with preservation of the metabolic penumbra, defined as brain tissue in which protein synthesis has been suppressed but ATP preserved. Vascular endothelial growth factor enhanced pericyte coverage of brain endothelial cells via mechanisms involving increased N-cadherin expression on cerebral microvessels. CONCLUSIONS That cerebral blood flow is increased during subsequent ischemic episodes, leading to the stabilization of cerebral energy state, fosters hope that by promoting new vessel formation brain tissue survival may be improved.
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Affiliation(s)
- Anil Zechariah
- Department of Neurology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany
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