Immunogenicity of BNT162b2 vaccine after two and three doses in health personnel and institutionalized elderly people not infected with SARS-CoV-2

OBJECTIVE

The aim of our research was to compare the evolution of the immune response induced by the BNT162b2 vaccine after the administration of two and three doses in healthcare personnel and in institutionalized elderly people (>65 years of age) without previous SARS-CoV-2 infection.

MATERIAL AND METHODS

A prospective observational study was carried out on a convenience sample made up of health workers and institutionalized elderly people, measuring antibodies against S and N proteins of SARS-CoV-2 two and six months after receiving the second vaccine dose, as well as two months after receiving the third dose.

RESULTS

A significant reduction of the anti-S humoral immune response was reported six months after the second dose of vaccine in both health workers and residents. The administration of a third dose of vaccine induced a significant increase in this antibody response in both investigated groups reaching a similar proportion of responders two months after this third dose.

CONCLUSIONS

Humoral immunity induced by two doses of the BNT162b2 vaccine in persons without prior SARS-CoV-2 infection wanes over time. The administration of a third dose significantly increases anti-S antibodies being highly recommended, especially in people over 65 years of age.

[Internal validity of a rapid test for COVID-19 antigens in a nursing home]

Introducción

La RT-qPCR es la prueba de referencia para la detección de la infección por SARS-CoV-2; sin embargo, en la actualidad se dispone de pruebas rápidas de detección de antígenos (PRDA). En este trabajo se evaluó la validez interna de la PRDA en el contexto de un brote en una residencia de mayores.

Métodos

Se analizaron muestras de exudado nasofaríngeo mediante PRDA y RT-qPCR de 61 residentes de una residencia de mayores. Se calculó la sensibilidad y especificidad de la PRDA con respecto a la RT-qPCR.

Resultados

La especificidad fue del 100% (IC 95% 54,1-100,0), mientras que la sensibilidad en asintomáticos fue del 70,3% (IC 95% 53,0-84,1) y en los sintomáticos del 83,3% (IC 95% 51,6-97,9).

Conclusiones

Las PRDA son lo suficientemente sensibles y específicas para ser utilizadas como pruebas de cribado en las residencias de mayores, especialmente es situación de brotes o sospecha del mismo por la presencia de sintomáticos.

Social mobility and healthy behaviours from a gender perspective in the Spanish multicase-control study (MCC-Spain)

There is evidence for the influence of socioeconomic status (SES) on healthy behaviours but the effect of social mobility (SM) is not yet well known. This study aims to analyse the influence of origin and destination SES (O-SES and D-SES) and SM on healthy behaviours and co-occurrence, from an integrated gender and age perspective. Data were obtained from the controls of MCC-Spain between 2008-2013 (3,606 participants). Healthy behaviours considered: healthy diet, moderate alcohol consumption, non-smoking and physical activity. SM was categorized as stable high, upward, stable medium, downward or stable low. Binary and multinomial logistic regression models were adjusted. Those aged <65, with a low O-SES, D-SES and stable low SM are less likely to have healthy behaviours in the case of both women (physically active: OR = 0.65 CI = 0.45-0.94, OR = 0.71 CI = 0.52-0.98, OR = 0.61 CI = 0.41-0.91) and men (non-smokers: OR = 0.44 CI = 0.26-0.76, OR = 0.54 CI = 0.35-0.83, OR = 0.41 CI 0.24-0.72; physically active: OR = 0.57 CI = 0.35-0.92, OR = 0.64 CI = 0.44-0.95, OR = 0.53 CI = 0.23-0.87). However, for those aged ≥65, this probability is higher in women with a low O-SES and D-SES (non-smoker: OR = 8.09 CI = 4.18-15.67, OR = 4.14 CI = 2.28-7.52; moderate alcohol consumption: OR = 3.00 CI = 1.45-6.24, OR = 2.83 CI = 1.49-5.37) and in men with a stable low SM (physically active: OR = 1.52 CI = 1.02-1.26). In the case of men, the same behaviour pattern is observed in those with a low O-SES as those with upward mobility, with a higher probability of co-occurring behaviours (three-to-four behaviours: OR = 2.00 CI = 1.22-3.29; OR = 3.13 CI = 1.31-7.48). The relationship of O-SES, D-SES and SM with healthy behaviours is complex and differs according to age and gender.

Predictive factors of COVID-19 in patients with negative RT-qPCR

OBJECTIVE

To evaluate the factors associated with false negatives in RT-qPCR in patients with mild-moderate symptoms of COVID-19.

MATERIALS AND METHODS

This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-qPCR-positive cases and 52 RT-qPCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two rapid diagnostic tests - RDTs (Combined - cRDT and Differentiated - dRDT). The association between symptoms and SARS-CoV-2 infection was evaluated by non-conditional logistic regression, with estimation of Odds Ratio.

RESULTS

A total of 110 subjects were studied, 52% of whom were women (mean age: 48.2±11.0 years). There were 42.3% of negative RT-qPCRs that were positive in some RDTs. Fever over 38°C (present in 35.5% of cases) and anosmia (present in 41.8%) were the symptoms most associated with SARS-CoV-2 infection, a relationship that remained statistically significant in patients with negative RT-qPCR and some positive RDT (aOR=6.64; 95%CI=1.33-33.13 and aOR=19.38; 95% CI=3.69-101.89, respectively).

CONCLUSIONS

RT-qPCR is the technique of choice in the diagnosis of SARS-CoV-2 infection, but it is not exempt from false negatives. Our results show that patients who present mild or moderate symptoms with negative RT-qPCR, but with fever and/or anosmia, should be considered as suspicious cases and should be evaluated with other diagnostic methods.

Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors

Objective

To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centers and nursing homes in the Healthcare Area of León (Spain).

Materials and methods

Cross-sectional study in a convenience sample of professionals from 30 health centers and 30 nursing homes from the primary care management division of the Healthcare Area of Leon. The work center, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. The true prevalence of SARS-CoV-2 infection was calculated according to two scenarios for RDT (Sensitivity = 0.6 and Specificity = 0.985; Sensitivity = 0.8 and Specificity = 1).

Results

The true prevalence of SARS-CoV-2 infection was between 4.9% and 11.0%. The observed prevalence was 5.9% and was higher in nursing homes than in primary care centers (9.5% vs. 5.5%). No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures.

Conclusions

The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.

Social exclusion of the adolescent with overweight: study of sociocentric social networks in the classroom

BACKGROUND

Multiple studies have shown the social consequences of suffering overweight, with social exclusion or isolation as some of the most important. In order to study the social patterns among adolescents, we have set as objectives to analyse the position of the individual within their network from a sociocentric perspective, comparing the relational pattern of the adolescents suffering from overweight with those who are normal weight.

METHOD

This was a cross-sectional descriptive study using logistic regression and social network analysis. We analysed the contact patterns of 235 adolescents in 11 social networks, classifying contact into three levels of intensity: minimum, intermediate and maximum (friendship). The WHO reference was used for the variable of overweight.

RESULTS

The prevalence of overweight was 30.2% (25.5% overweight and 4.7% obesity). An analysis of the relational patterns of individuals with overweight showed that at the minimum contact level, they established fewer relationships and less closeness (odds ratio [OR]: 2.32; confidence interval [CI] 95%: 1.17-4.66; p-value: 0.016). This effect was more marked in female adolescents. At intermediate contact level, they had few relationships and low prestige (OR: 3.29; CI: 95%; 1.03-10.51; p-value: 0.045, OR: 3.18; CI: 95%; 1.00-10.04; p-value: 0.049, respectively). At maximum contact level (friendship), female adolescents related little with other adolescents (OR: 3.78; CI: 95%; 1.07-13.32; p-value: 0.038).

CONCLUSIONS

Adolescents with overweight take up peripheral positions within their social network, choosing by themselves not to establish contact with others. Social network analysis is crucial to detect adolescents with overweight at risk of exclusion and help alleviate psychological and social deficits.

Compositional analysis of dietary patterns

Instead of looking at individual nutrients or foods, dietary pattern analysis has emerged as a promising approach to examine the relationship between diet and health outcomes. Despite dietary patterns being compositional (i.e. usually a higher intake of some foods implies that less of other foods are being consumed), compositional data analysis has not yet been applied in this setting. We describe three compositional data analysis approaches (compositional principal component analysis, balances and principal balances) that enable the extraction of dietary patterns by using control subjects from the Spanish multicase-control (MCC-Spain) study. In particular, principal balances overcome the limitations of purely data-driven or investigator-driven methods and present dietary patterns as trade-offs between eating more of some foods and less of others.

Abstract P3-09-01: Withdrawn

This abstract was withdrawn by the authors.

Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-2010)

OBJECTIVE

Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León.

MATERIAL AND METHODS

the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one.

RESULTS

1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences.

CONCLUSIONS

bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed.

Retroperitoneal fibrosis: typical and atypical manifestations

Retroperitoneal fibrosis (RPF) is a well described clinical entity that is being diagnosed with increasing frequency. RPF is characterized by replacement of the normal tissue of the retroperitoneum with fibrosis and/or chronic inflammation. However, aetiology, clinical presentation and radiological appearance in many cases are protean. Up to 15% of patients have additional fibrotic processes outside the retroperitoneum. In the abdomen, RPF may spread contiguously to involve multiple structures in both the retroperitoneum and the peritoneal cavity or multiple non-contiguous sites may be involved. We retrospectively reviewed 30 patients (19 male, 11 female; age range 28-79 years) with biopsy proven RPF. Although we found RPF most commonly as an isolated fibrotic plaque in the lower lumbar region (18 patients), 12 patients (40%) presented with RPF in atypical locations (4 peripancreatic, 1 periduodenal, 7 pelvic). The RPF was non-malignant in 24 patients (21 idiopathic, 2 perianeurysmal, 1 ergot-derivative treatment) and malignant in six cases. We present a pictorial review of the varied appearances of RPF, concentrating on atypical sites. The radiological differential diagnosis and its appearance with various imaging modalities are discussed. Current concepts with respect to management, prognosis and treatment are summarized.