Reactogenicity of homologous and heterologous prime-boost immunization with BNT162b2 and ChAdOx1-nCoV19: a prospective cohort study

Heterologous prime-boost vaccination is of increasing interest for COVID-19 vaccines. Evidence of rare thrombotic events associated with ChAdOx1-nCoV19 (Vaxzevria, ChAdOx) has lead several European countries to recommend a heterologous booster with mRNA vaccines for certain age groups (e.g. persons <60years in Germany), who have already received one dose of ChAdOx, although data on reactogenicity and safety of this vaccination regimen are still missing. Here we report reactogenicity data of homologous BNT162b2 (Comirnaty, BNT) or heterologous ChAdOx/BNT prime-boost immunisations in a prospective observational cohort study of 326 healthcare workers. Reactogenicity of heterologous ChAdOx/BNT booster vaccination was largely comparable to homologous BNT/BNT vaccination and overall well-tolerated. No major differences were observed in the frequency or severity of local reactions after either of the vaccinations. In contrast, notable differences between the regimens were observed for systemic reactions, which were most frequent after prime immunisation with ChAdOx (86%, 95CI: 79-91), and less frequent after homologous BNT/BNT (65%, 95CI: 56-72), or heterologous ChAdOx/BNT boosters (48%, 95CI: 36-59). This interim analysis supports the safety of currently recommended heterologous ChAdOx/BNT prime-boost immunisations with 12-week intervals.

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Prevalence and Course of IgA and IgG Antibodies against SARS-CoV-2 in Healthcare Workers during the First Wave of the COVID-19 Outbreak in Germany: Interim Results from an Ongoing Observational Cohort Study

Healthcare ◽

10.3390/healthcare9050498 ◽

2021 ◽

Vol 9 (5) ◽

pp. 498

Author(s):

Mark Reinwald ◽

Peter Markus Deckert ◽

Oliver Ritter ◽

Henrike Andresen ◽

Andreas G. Schreyer ◽

...

Keyword(s):

Cohort Study ◽

Healthcare Workers ◽

Significant Proportion ◽

Clinical Signs ◽

Signs And Symptoms ◽

Observational Cohort Study ◽

Igg Antibodies ◽

University Hospitals ◽

Observational Cohort

(1) Background: Healthcare workers (HCWs) are prone to intensified exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the ongoing pandemic. We prospectively analyzed the prevalence of antibodies against SARS-CoV-2 in HCWs at baseline and follow up with regard to clinical signs and symptoms in two university hospitals in Brandenburg, Germany. (2) Methods: Screening for anti-SARS-CoV-2 IgA and IgG antibodies was offered to HCWs at baseline and follow up two months thereafter in two hospitals of Brandenburg Medical School during the first wave of the COVID-19 pandemic in Germany in an ongoing observational cohort study. Medical history and signs and symptoms were recorded by questionnaires and analyzed. (3) Results: Baseline seroprevalence of anti-SARS-CoV-2 IgA was 11.7% and increased to 15% at follow up, whereas IgG seropositivity was 2.1% at baseline and 2.2% at follow up. The rate of asymptomatic seropositive cases was 39.5%. Symptoms were not associated with general seropositivity for anti-SARS-CoV-2; however, class switch from IgA to IgG was associated with increased symptom burden. (4) Conclusions: The seroprevalence of antibodies against SARS-CoV-2 was low in HCWs but higher compared to population data and increased over time. Screening for antibodies detected a significant proportion of seropositive participants cases without symptoms.

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Evaluation of N95 respirators, modified snorkel masks and low‐cost powered air‐purifying respirators: a prospective observational cohort study in healthcare workers

Anaesthesia ◽

10.1111/anae.15392 ◽

2021 ◽

Author(s):

D. Clinkard ◽

A. Mashari ◽

K. Karkouti ◽

L. Fedorko

Keyword(s):

Cohort Study ◽

Healthcare Workers ◽

Low Cost ◽

Observational Cohort Study ◽

Prospective Observational Cohort Study ◽

Observational Cohort ◽

N95 Respirators

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COVID-19 hospital outbreaks: Protecting healthcare workers to protect frail patients. An Italian observational cohort study

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.10.098 ◽

2021 ◽

Vol 102 ◽

pp. 532-537

Author(s):

Luigi Vimercati ◽

Luigi De Maria ◽

Marco Quarato ◽

Antonio Caputi ◽

Pasquale Stefanizzi ◽

...

Keyword(s):

Cohort Study ◽

Healthcare Workers ◽

Observational Cohort Study ◽

Frail Patients ◽

Observational Cohort

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Death in delirious palliative-care patients occurs irrespective of age: A prospective, observational cohort study of 229 delirious palliative-care patients

Palliative & Supportive Care ◽

10.1017/s1478951520000887 ◽

2020 ◽

pp. 1-9

Author(s):

Annina Seiler ◽

David Blum ◽

Caroline Hertler ◽

Markus Schettle ◽

Carl Moritz Zipser ◽

...

Keyword(s):

Palliative Care ◽

Cohort Study ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

Observational Cohort Study ◽

Adverse Outcomes ◽

Prospective Observational Cohort Study ◽

Precipitating Factors ◽

Observational Cohort

Abstract Objectives Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients. Methods In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age: <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors. Results In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No inter-group differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.64; confidence interval (CI) 1.90–6.99; P < 0.001], hypertonia (OR 3.57; CI 1.84–6.92; P < 0.001), and chronic kidney disease (OR 4.84; CI 1.19–19.72; P = 0.028). In contrast, in patients <65 years, only precipitating factors were relevant for delirium, including cerebral edema (OR 0.02; CI 0.01–0.43; P = 0.012). Significance of results The results of this study demonstrate that death in delirious palliative-care patients occurs irrespective of age. The multifactorial nature and adverse outcomes of delirium across all age in these patients require clinical recognition. Potentially reversible factors should be detected early to prevent or mitigate delirium and its poor survival outcomes.

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Association Between Severity of Leptospirosis and Subsequent Major Autoimmune Diseases: A Nationwide Observational Cohort Study

Frontiers in Immunology ◽

10.3389/fimmu.2021.721752 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chih-Chung Chen ◽

Yao-Min Hung ◽

Lu-Ting Chiu ◽

Mei-Chia Chou ◽

Renin Chang ◽

...

Keyword(s):

Sensitivity Analysis ◽

Cohort Study ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Proportional Hazards ◽

Age Groups ◽

Cox Proportional Hazards ◽

Observational Cohort Study ◽

Research Database ◽

Observational Cohort

IntroductionInfections play a role in autoimmune diseases (AD). Leptospirosis has been linked to the trigger of systemic lupus erythematosus.ObjectiveTo investigate subsequent risk of major AD in hospitalized Taiwanese for Leptospirosis.MethodsRetrospective observational cohort study was employed. The enrolled period was from 2000 to 2012. In the main model, we extracted 4026 inpatients with leptospirosis from the Taiwan National Health Insurance Research Database (NHIRD) and 16,104 participants without leptospirosis at a 1:4 ratio propensity-score matched (PSM) by age, gender, index year, and comorbidities. The follow-up period was defined as the time from the initial diagnosis of leptospirosis to major AD occurrence or 2013. This study was re-analyzed by frequency-matching as a sensitivity analysis for cross-validation. Univariable and multivariable Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsThe adjusted HR (95% CI) of major ADs for the leptospirosis group was 4.45 (3.25–6.79) (p < 0.001) compared to the controls after full adjustment. The risk of major ADs was 5.52-fold (95% CI, 3.82–7.99) higher in leptospirosis patients hospitalized for seven days and above than the controls, while 2.80-fold (95% CI, 1.68–5.61) in those hospitalized less than seven days. The sensitivity analysis yields consistent findings. Stratified analysis revealed that the association between leptospirosis and major ADs was generalized in both genders, and all age groups.ConclusionsSymptomatic leptospirosis is associated with increased rate of subsequent major ADs, and the risk seems to be higher in severe cases.

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T-Cell and Antibody Responses to First BNT162b2 Vaccine Dose in Previously SARS-CoV-2-Infected and Infection-Naive UK Healthcare Workers: A Multicentre, Prospective, Observational Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3812375 ◽

2021 ◽

Author(s):

Adrienn Angyal ◽

Stephanie Longet ◽

Shona Moore ◽

Rebecca P. Payne ◽

Adam Harding ◽

...

Keyword(s):

Cohort Study ◽

T Cell ◽

Healthcare Workers ◽

Vaccine Dose ◽

Observational Cohort Study ◽

Antibody Responses ◽

Prospective Observational Cohort Study ◽

Observational Cohort

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Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: an observational cohort study.

10.1101/2021.04.23.21255964 ◽

2021 ◽

Author(s):

Naomi F Walker ◽

Rachel Louise Byrne ◽

Ashleigh Howard ◽

Elissavet Nikolaou ◽

Madlen Farrar ◽

...

Keyword(s):

Cohort Study ◽

Healthcare Workers ◽

Asymptomatic Infection ◽

Observational Cohort Study ◽

Symptom Profiles ◽

Symptom Screening ◽

Observational Cohort ◽

Uk National Health Service ◽

The Uk ◽

Frontline Healthcare Workers

Background The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the UK National Health Service (NHS). During the first wave of SARS-CoV-2 transmission in UK, SARS-CoV-2 NHS diagnostic test availability was limited to self-isolating symptomatic staff. The burden of symptomatic and asymptomatic infection in healthcare workers (HCW) attending work was unknown. Methods We conducted an observational cohort study of SARS-CoV-2 infection in HCW working in an acute NHS Trust during the first wave of the COVID-19 pandemic, using serial self-collected saliva and nasopharyngeal (NP) samples. We also collected self-assessed symptom profiles and isolation behaviours. We retrospectively compared SARS-CoV-2 detection by RT-PCR from saliva (weekly) and NP swabs (twice weekly) from 85 individuals in this cohort and evaluated the association with symptoms. Findings Over a 12-week period from 30th March 2020, 40% (n=34/85, CI95% 31.3-51.8%) HCWs had evidence of SARS-CoV-2 infection by surveillance NP swab and/or saliva RT-qPCR. Agreement between paired saliva and NP swabs was poor (28.6%, CI95% 13.2-48.7%) with both methods detecting symptomatic and asymptomatic infections. Symptoms were reported by 47.1% (n=40) and self-isolation by 25.9% participants (n=22). Only 41.2% (n=14/34) participants with SARS-CoV-2 infection reported any symptoms within 14 days of the infection. Interpretation HCWs are a potential source of SARS-CoV-2 transmission in hospitals and symptom screening will identify the minority of infections in HCW. Saliva is an easily accessible fluid sample for screening for SARS-CoV-2 infection and in addition to NP swab, facilitated ascertainment of symptomatic and asymptomatic cases in this setting. Combined saliva and NP testing would improve detection of SARS-CoV-2 for surveillance. Better understanding of transmissibility from asymptomatic staff using transmission-based infection precautions, is required to inform policy.

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