Efficacy of Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases, hospital admissions, type of variants, and deaths

OBJECTIVE

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) epidemic has instigated enormous damage to the global healthcare system and economies. A large number of vaccines have been developed. However, confidence in any COVID-19 vaccine is essential for its sustainable success. The present study aimed to investigate the efficacy of the Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against SARS-COV-2 cases, hospital admissions, type of variants and deaths.

MATERIALS AND METHODS

This study recorded data using electronic platforms PubMed, Web of Science, World Health Organization, US-Food and Drug Authorities-FDA, Facts sheets, and Pharmaceutical Websites. Initially, 278 articles and reports were identified, and after revising the abstracts, 39 studies, clinical trials and organizations, reports were selected for a detailed analysis.

RESULTS

The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases after the first dose was 60.59% (p=0.00001) and after the second dose was 66.84% (p=0.00001). The highest efficacy was against the Alpha variant 58.80% (p=0.00001) and the lowest efficacy was against the Beta variant 30.83% (p=0.00001). However, the overall efficacy against the SARS-CoV-2 variants after the first dose was 49.20%. The highest efficiency of SARS-CoV-2 variants after the second dose against the Beta (B.1.351) variant was 90.34% (p=0.00001), while the lowest efficacy was against the Omicron (B.1.1.529) variant 46.46% (p=0.00001), with overall efficacy against SARS-CoV-2-2 variants after the second dose 73.73%. The highest efficacy against emergency admission was 94.42% (p=0.00001), while the lowest efficacy was 86.57% (p=0.00001), with overall efficacy against ICU, hospital, and emergency admissions after the second dose was 87.74%. Furthermore, the efficacy of the Oxford-AstraZeneca vaccine against deaths after the second dose was 87.44% (p=0.00001).

CONCLUSIONS

The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases, various variants, ICU, and emergency admissions, and against deaths was high. The present study results provide valuable insights for healthcare workers, policymakers, and researchers about the precise efficacy levels against symptomatic cases, hospitalization, and mortality across the diverse populations and age groups.

5 Cervical Spine Pedicle Screw Accuracy in Open Fluoroscopic, Navigated and Template Guided Systems- a Systematic Review

Aim

Pedicle screws provide excellent fixation for a wide range of indications; their adoption in the cervical spine has been slower than in the thoracic and lumbar spine, largely due to the smaller pedicle sizes and proximity to neurovascular structures in the neck. Recent years have seen the development of technology to improve accuracy and thereby safety in cervical pedicle screw placement over traditional fluoroscopic techniques, including intraoperative 3D navigation, computer assisted systems and physical templates with screw guides. We have performed a systematic review into the accuracy rates of the various systems.

Method

PubMed and Cochrane Library databases were searched; keywords "pedicle screw cervical spine" were searched; 9 valid papers involving 1427 screws were found.

Results

Accuracy rates were 80.6% for fluoroscopy, 91.4% for navigation methods, and 96.7% for templates.

Conclusions

Superior results for templates are complemented by reduced radiation exposure to patient and surgeon; however, the technology requires prolonged pre-operative planning to create the bespoke template, and the development of an infrastructure to allow for their rapid production and delivery is needed before they become more widely available.

Two broad methods of navigation currently exist: intraoperative CT scanning providing real-time 3D navigation and preoperative CT registration in relation to a fixed reference with intraoperative computer assistance. At present, these methods are more commonly used, due to their proven improved accuracy rates over fluoroscopy, availability in emergencies and alongside minimally invasive techniques.

Despite their novelty and limitations, templates provide promising accuracy scores, although practical considerations may inhibit their proliferation.