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Lunt R, Quinot C, Kirsebom F, Andrews N, Skarnes C, Letley L, Haskins D, Angel C, Firminger S, Ratcliffe K, Rajan S, Sherridan A, Ijaz S, Zambon M, Brown K, Ramsay M, Bernal JL. The impact of vaccination and SARS-CoV-2 variants on the virological response to SARS-CoV-2 infections during the Alpha, Delta, and Omicron waves in England. J Infect 2024; 88:21-29. [PMID: 37926118 DOI: 10.1016/j.jinf.2023.10.016] [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: 05/31/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
Vaccination status and the SARS-CoV-2 variant individuals are infected with are known to independently impact viral dynamics; however, little is known about the interaction of these two factors and how this impacts viral dynamics. Here we investigated how monovalent vaccination modified the time course and viral load of infections from different variants. Regression analyses were used to investigate the impact of vaccination on cycle threshold values and disease severity, and interval-censored survival analyses were used to investigate the impact of vaccination on duration of positivity. A range of covariates were adjusted for as potential confounders and investigated for their own effects in exploratory analyses. All analyses were done combining all variants and stratified by variant. For those infected with Alpha or Delta, vaccinated individuals were more likely to report mild disease than moderate/severe disease and had significantly shorter duration of positivity and lower viral loads compared to unvaccinated individuals. Vaccination had no impact on self-reported disease severity, viral load, or duration if positivity for those infected with Omicron. Overall, individuals who were immunosuppressed and clinically extremely vulnerable had longer duration of positivity and higher viral loads. This study adds to the evidence base on disease dynamics following COVID-19, demonstrating that vaccination mitigates severity of disease, the amount of detectable virus within infected individuals and reduces the time individuals are positive for. However, these effects have been significantly attenuated since the emergence of Omicron. Therefore, our findings strengthen the argument for using modified or multivalent vaccines that target emerging variants.
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Affiliation(s)
- Rachel Lunt
- UK Health Security Agency, London, United Kingdom.
| | | | | | - Nick Andrews
- UK Health Security Agency, London, United Kingdom; NIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | | | | | | | | | | | - Samreen Ijaz
- UK Health Security Agency, London, United Kingdom
| | - Maria Zambon
- UK Health Security Agency, London, United Kingdom; NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, United Kingdom
| | - Kevin Brown
- UK Health Security Agency, London, United Kingdom
| | - Mary Ramsay
- UK Health Security Agency, London, United Kingdom; NIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jamie Lopez Bernal
- UK Health Security Agency, London, United Kingdom; NIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene and Tropical Medicine, London, United Kingdom; NIHR Health Protection Research Unit in Respiratory Infections, Imperial College London, London, United Kingdom
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Eberly AR, Challener DW, Shweta FNU, Fida M, Boerger AC, Assi M, O'Horo JC, Binnicker MJ. Initial SARS-CoV-2 PCR crossing point does not predict hospitalization and duration of PCR positivity. J Microbiol Immunol Infect 2020; 54:77-80. [PMID: 33069621 PMCID: PMC7546960 DOI: 10.1016/j.jmii.2020.08.020] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Abstract
This study aimed to determine if the crossing point of the initial positive SARS-CoV-2 PCR test correlated with patient demographics, subsequent hospitalization, or duration of positivity. Seventy-three patients with two or more positive PCR tests had a median time of 23 days to two consecutive negative results.
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Affiliation(s)
- Allison R Eberly
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Douglas W Challener
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - F N U Shweta
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Madiha Fida
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Aimee C Boerger
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mariam Assi
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - John C O'Horo
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Matthew J Binnicker
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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