scholarly journals Comprehensive genomic, immunological and clinical analysis of COVID-19 vaccine breakthrough infections: a prospective, comparative cohort study

2021 ◽  
Author(s):  
Di Tian ◽  
Yang Song ◽  
Man Zhang ◽  
Yang Pan ◽  
Ziruo Ge ◽  
...  
Keyword(s):  
Cohort Study ◽  
T Lymphocyte ◽  
Severe Disease ◽  
Clinical Analysis ◽  
Viral Loads ◽  
Viral Shedding ◽  
Significant Difference ◽  
Whole Genomes ◽  
Increasing Trend ◽  
Comparative Cohort Study

AbstractObjectivesAs the COVID-19 pandemic is still ongoing and SARS-CoV-2 variants are circulating worldwide, an increasing number of breakthrough infections have been detected despite the good efficacy of COVID-19 vaccines.MethodsA prospective, comparative cohort study was conducted in Beijing Ditan Hospital to evaluate the clinical, immunological and genomic characteristics of COVID-19 breakthrough infections. Data on 88 COVID-19 breakthrough cases (vaccinated group) and 41 unvaccinated cases (unvaccinated group) from June 1 to August 20, 2021 were extracted from a cloud database. Among these 129 COVID-19 cases, we successfully sequenced 33 whole genomes, including 16 from the vaccinated group and 17 from the unvaccinated group.ResultsAsymptomatic and mild cases predominated in both groups, but 2 patients developed severe disease in the unvaccinated group. Between the two groups, the median time of viral shedding in the vaccinated group were significantly lower than those in the unvaccinated group (p = 0.003). A comparison of dynamic IgG titres of cases in the two groups indicated that IgG titres in the vaccinated group showed a significantly increasing trend (P =0.028). The CD4+T lymphocyte count was lower in the unvaccinated group, and there was a significant difference between the two groups (p=0.018). In the vaccinated group, the number of moderate cases who received Sinopharm BBIBP (42 cases) was significantly higher than those who received Sinovac Coronavac (p=0.020). Whole-genome sequencing revealed 23 cases of delta variants, including 15 patients from the vaccinated group. However, no significant difference was observed in either the RT-qPCR results or viral shedding time.ConclusionsCOVID-19 vaccine breakthrough infections were mainly asymptomatic and mild, the IgG titres were significantly higher and increased rapidly, and the viral shedding was short. Delta variants may be more likely to cause breakthrough infections, and vaccination may not reduce the viral loads and shedding time.

scholarly journals Epidemiological, Virological and Serological Features of Coronavirus Disease 2019 (COVID-19) Cases in People Living With Human Immunodeficiency Virus in Wuhan: A Population-based Cohort Study

2020 ◽  
Author(s):  
Jiao Huang ◽  
Nianhua Xie ◽  
Xuejiao Hu ◽  
Han Yan ◽  
Jie Ding ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Demographic Data ◽  
Case Fatality ◽  
Population Based ◽  
Severe Illness ◽  
Viral Loads ◽  
Viral Shedding ◽  
Signal Value ◽  
Immunodeficiency Virus

Abstract Background We aimed to describe the epidemiological, virological, and serological features of coronavirus disease 2019 (COVID-19) cases in people living with human immunodeficiency virus (HIV; PLWH). Methods This population-based cohort study identified all COVID-19 cases among all PLWH in Wuhan, China, by 16 April 2020. The epidemiological, virological, and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the disease, and SARS-CoV-2–specific immunoglobin (Ig) M and G after recovery. Results From 1 January to 16 April 2020, 35 of 6001 PLWH experienced COVID-19, with a cumulative incidence of COVID-19 of 0.58% (95% confidence interval [CI], .42–.81%). Among the COVID-19 cases, 15 (42.86) had severe illness, with 2 deaths. The incidence, case-severity, and case-fatality rates of COVID-19 in PLWH were comparable to those in the entire population in Wuhan. There were 197 PLWH who had discontinued combination antiretroviral therapy (cART), 4 of whom experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 days (interquartile range, 20–46). Cases with high HIV viral loads (≥20 copies/mL) had lower IgM and IgG levels than those with low HIV viral loads (<20 copies/ml; median signal value divided by the cutoff value [S/CO] for IgM, 0.03 vs 0.11, respectively [P < .001]; median S/CO for IgG, 10.16 vs 17.04, respectively [P = .069]). Conclusions Efforts are needed to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH.

scholarly journals Serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from a prospective community cohort study (Virus Watch).

2021 ◽  
Author(s):  
Cyril Roman Geismar ◽  
Ellen Fragaszy ◽  
Vincent Grigori Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction Increased transmissibility of B.1.17 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.17 variant. Methods The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.17 in national surveillance data for different English regions and study weeks. Results Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely infector infectee pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55;3.81) days. There was no significant difference (p=0.267) between the mean serial interval for Variants of Concern (VOC) hotspots (mean = 3.64 days, (95%CI: 2.55;4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48;3.96)). Conclusions Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals. Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

scholarly journals A 2-month field cohort study of SARS-CoV-2 in saliva of BNT162b2 vaccinated nursing home workers

2022 ◽  
Vol 2 (1) ◽  
Author(s):  
Claude Saegerman ◽  
Anh Nguyet Diep ◽  
Véronique Renault ◽  
Anne-Françoise Donneau ◽  
Lambert Stamatakis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Health Interventions ◽  
Wild Type Virus ◽  
Wild Type ◽  
Public Health Interventions ◽  
Viral Loads ◽  
Viral Shedding ◽  
Home Workers ◽  
Walloon Region

Abstract Background Nursing home (NH) residents have been severely affected during the COVID-19 pandemic because of their age and underlying comorbidities. Infection and outbreaks in NHs are most likely triggered by infected workers. Screening for asymptomatic NH workers can prevent risky contact and viral transmission to the residents. This study examined the effect of the BNT162b2 mRNA COVID‑19 (Comirnaty®; BioNTech and Pfizer) vaccination on the saliva excretion of SARS-CoV-2 among NH workers, through weekly saliva RT-qPCR testing. Methods A 2-month cohort study was conducted among 99 NHs in the Walloon region (Belgium), at the start of February 2021. Three groups of workers, i.e., non-vaccinated (n = 1618), one-dosed vaccinated (n = 1454), and two-dosed vaccinated (n = 2379) of BNT162b2 mRNA COVID‑19 vaccine, were followed-up weekly. Their saliva samples were used to monitor the shedding of SARS-CoV-2. All positive samples were sequenced and genotyped to identify the circulating wild-type virus or variants of concern. Results The protection fraction against the excretion of the SARS-CoV-2 in the saliva samples of the workers after the second dose is estimated at 0.90 (95% CI: 0.18; 0.99) at 1 week and 0.83 (95% CI: 0.54; 0.95) at 8 weeks. We observe more circulating SARS-CoV-2 and a greater variability of viral loads in the unvaccinated group compared to those of the vaccinated group. Conclusions This field cohort study advances our knowledge of the efficacy of the mRNA BNT162b2 COVID-19 vaccine on the viral shedding in the saliva specimens of vaccinated NH workers, contributing to better decision-making in public health interventions and management.

scholarly journals Increased SAR-CoV-2 shedding associated with reduced disease severity despite continually emerging genetic variants

2021 ◽  
Author(s):  
Cynthia Y. Tang ◽  
Yang Wang ◽  
Cheng Gao ◽  
David R. Smith ◽  
Jane A. McElroy ◽  
...  
Keyword(s):  
Disease Severity ◽  
Genetic Variants ◽  
Severe Disease ◽  
Fold Increase ◽  
Rural Regions ◽  
Multiple Introductions ◽  
Viral Genomes ◽  
Viral Loads ◽  
Viral Shedding ◽  
Hospital Stays

ABSTRACTSince the first report of SARS-CoV-2 in December 2019, genetic variants have continued to emerge, complicating strategies for mitigating the disease burden of COVID-19. Positive SARS-CoV-2 nasopharyngeal swabs (n=8,735) were collected from Missouri, USA, from March-October 2020, and viral genomes (n=178) were sequenced. Hospitalization status and length of stay were extracted from medical charts of 1,335 patients and integrated with emerging genetic variants and viral shedding analyses for assessment of clinical impacts. Multiple introductions of SARS-CoV-2 into Missouri, primarily from Australia, Europe, and domestic states, were observed. Four local lineages rapidly emerged and spread across urban and rural regions in Missouri. While the majority of Missouri viruses harbored Spike-D614G mutations, a large number of unreported mutations were identified among Missouri viruses, including seven in the RNA-dependent RNA polymerase complex and Spike protein that were positively selected. A 15.6-fold increase in viral RNA levels in swab samples occurred from March to May and remained elevated. Accounting for other comorbidities, individuals test-positive for COVID-19 with high viral loads were less likely to be hospitalized (odds ratio=0.39, 95% confidence interval [CI]=0.20, 0.77) and had shorter hospital stays (hazard ratio=0.34, p=0.003) than those with low viral loads. Overall, the first eight months of the pandemic in Missouri saw multiple locally acquired mutants emerge and dominate in urban and rural locations. Although we were unable to find associations between specific variants and greater disease severity, Missouri COVID-positive individuals that presented with increased viral shedding had less severe disease by several measures.

scholarly journals Household serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from prospective community cohort study (Virus Watch)

2021 ◽  
Vol 6 ◽  
pp. 224
Author(s):  
Cyril Geismar ◽  
Ellen Fragaszy ◽  
Vincent Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction: Increased transmissibility of B.1.1.7 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector - infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.1.7 variant. Methods: The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector-infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether or not individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.1.7 in national surveillance data for different English regions and study weeks. Results: Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely ‘infector-infectee’ pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55-3.81, sd=4.36) days. There was no significant difference (p=0.267) between the mean serial interval for VOC hotspots (mean = 3.64 days, (95%CI: 2.55 – 4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48 – 3.96)). Conclusions: Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals.  Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

scholarly journals Burr hole craniostomy versus minicraniotomy in chronic subdural hematoma: a comparative cohort study

2021 ◽  
Author(s):  
Shaian Zolfaghari ◽  
Jiri Bartek ◽  
Isabelle Strom ◽  
Felix Djärf ◽  
San-San Wong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Recurrence Rate ◽  
Subdural Hematoma ◽  
Surgical Techniques ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Medical Complications ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Comparative Cohort Study

Abstract Background Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases. In surgical management of CSDH, there is a lack of standardized guidelines concerning surgical techniques and a lack of consensus on which technique(s) are optimal. Neurosurgical centers have shown a wide variation in surgical techniques. The purpose of this study was to compare two different surgical techniques, one burr hole craniostomy with an active subgaleal drain (BHC) and minicraniotomy with a passive subdural drain (MC). Methods We conducted a multicenter retrospective cohort study at two neurosurgical centers in Sweden which included patients with unilateral CSDHs that received surgical treatment with either BHC or MC. The primary outcomes in comparison of the techniques were 30-day mortality, recurrence rate, and complications according to the Landriel Ibañez grading system for complications. Results A total of 1003 patients were included in this study. The BHC subgroup included 560 patients, and the MC subgroup included 443 patients. A 30-day mortality when comparing BHC (2.3%) and MC (2.7%) was similar (p = 0.701). Comparing recurrence rate for BHC (8.9%) and MC (10.8%) showed no significant difference (p = 0.336). We found that medical complications were significantly more common in the MC group (p = 0.001). Surgical complications (type IIb) was also associated with the MC group (n = 10, p = 0.003). Out of the 10 patients with type IIb complications in the MC group, 8 had postoperative acute subdural hematomas. Conclusions BHC was comparable to MC concerning 30-day mortality rate and recurrence rates. We did, however, find that MC was significantly associated with medical complications and serious surgical postoperative complications.

scholarly journals Serial interval of COVID-19 and the effect of Variant B.1.1.7: analyses from prospective community cohort study (Virus Watch)

2021 ◽  
Vol 6 ◽  
pp. 224
Author(s):  
Cyril Geismar ◽  
Ellen Fragaszy ◽  
Vincent Nguyen ◽  
Wing Lam Erica Fong ◽  
Madhumita Shrotri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Illness Episode ◽  
Viral Shedding ◽  
Serial Interval ◽  
Significant Difference ◽  
Rapid Spread ◽  
Global Spread ◽  
The Mean ◽  
The Uk ◽  
Rapid Emergence

Introduction: Increased transmissibility of B.1.1.7 variant of concern (VOC) in the UK may explain its rapid emergence and global spread. We analysed data from putative household infector - infectee pairs in the Virus Watch Community cohort study to assess the serial interval of COVID-19 and whether this was affected by emergence of the B.1.1.7 variant. Methods: The Virus Watch study is an online, prospective, community cohort study following up entire households in England and Wales during the COVID-19 pandemic. Putative household infector-infectee pairs were identified where more than one person in the household had a positive swab matched to an illness episode. Data on whether or not individual infections were caused by the B.1.1.7 variant were not available. We therefore developed a classification system based on the percentage of cases estimated to be due to B.1.1.7 in national surveillance data for different English regions and study weeks. Results: Out of 24,887 illnesses reported, 915 tested positive for SARS-CoV-2 and 186 likely ‘infector-infectee’ pairs in 186 households amongst 372 individuals were identified. The mean COVID-19 serial interval was 3.18 (95%CI: 2.55 - 3.81) days. There was no significant difference (p=0.267) between the mean serial interval for VOC hotspots (mean = 3.64 days, (95%CI: 2.55 – 4.73)) days and non-VOC hotspots, (mean = 2.72 days, (95%CI: 1.48 – 3.96)). Conclusions: Our estimates of the average serial interval of COVID-19 are broadly similar to estimates from previous studies and we find no evidence that B.1.1.7 is associated with a change in serial intervals.  Alternative explanations such as increased viral load, longer period of viral shedding or improved receptor binding may instead explain the increased transmissibility and rapid spread and should undergo further investigation.

Standard and adjusted criteria for the use of the misoprostol vaginal insert for labor induction: a comparative cohort study

2019 ◽  
Vol 47 (7) ◽  
pp. 750-756 ◽  
Author(s):  
Aleke Brandstetter ◽  
Moritz Döbert ◽  
Peter Schwaerzler ◽  
Timm Fabian Döbert ◽  
Hendrik Hasselbeck ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Delivery ◽  
Statistical Significance ◽  
Labor Induction ◽  
Delivery Rate ◽  
Consecutive Series ◽  
Academic Center ◽  
Significant Difference ◽  
Comparative Cohort Study ◽  
Cesarean Delivery Rate

Abstract Objective To compare the efficacy of misoprostol vaginal insert (MVI) for labor induction using standard and adjusted criteria. Methods A single-center, comparative cohort study using a consecutive series of pregnant women ≥37/0 weeks undergoing labor induction with either standard criteria for MVI (administration for up to 24 h; MVI-24) or with adjusted criteria (MVI administration for a maximum of 10 h; MVI-10) conducted at a tertiary academic center in Germany. The primary outcomes were the time from start of induction to any delivery and cesarean delivery rate. Results A total of 138 women were included in the study, 69 in each group. The mean time from MVI administration to any delivery showed no significant difference between the MVI-24 and MVI-10 groups (954 vs. 969 min, respectively; P = 0.679). The cesarean delivery rate was proportionally lower for the MVI-10 group [39.1% (27/69) vs. 24.6% (17/69); P = 0.10]. Conclusion The time from induction to delivery with MVI was similar when using standard criteria of up to 24 h of exposure vs. adjusted criteria of up to 10 h of exposure. Although the threshold for statistical significance for cesarean section was not attained, there is nonetheless a considerable difference between the MVI-24 and MVI-10 groups.

scholarly journals Conjunctival colonisation and antibiotic resistance of coagulase-negativeStaphylococcusafter cataract surgery: a 6-month longitudinal study at a medical centre in Taiwan

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027036
Author(s):  
Eugene Yu-Chuan Kang ◽  
Chiun-Ho Hou ◽  
Yhu-Chering Huang ◽  
Ching-Hsi Hsiao
Keyword(s):  
Antibiotic Resistance ◽  
Cohort Study ◽  
Cataract Surgery ◽  
Outcome Measure ◽  
Medical Centre ◽  
Main Outcome Measure ◽  
Colonisation Rate ◽  
Significant Difference ◽  
Increasing Trend

ObjectiveTo explored 6-month longitudinal changes in conjunctival colonisation and antibiotic resistance profiles of coagulase-negativeStaphylococcus(CNS) after cataract surgery with 1 month tobramycin treatment.DesignProspective cohort study between 1 August 2012, and 31 July 2013.SettingA single medical centre in Taiwan.ParticipantsA total of 128 Taiwanese patients with 46.9% of male participants.InterventionsSamples from the conjunctival sacs of both operation (OP) and non-OP eyes were obtained separately before cataract surgery and at 1, 3 and 6 months after surgery. Tobramycin (0.3%) treatment was applied four times daily for 1 month postoperatively.Main outcome measureIdentification of CNS isolates and their antibiotic susceptibility by using disk diffusion or E-test.ResultsCNS was detected in 24.2% of patients at baseline. During postoperative follow-up, the CNS colonisation rate did not decrease in either eye but showed an increasing trend in the OP eyes at 1 month (p=0.06). The colonisation rate showed no significant difference between the OP and non-OP eyes from baseline to a specific follow-up. We observed a significant increase (p<0.05) in resistance to tobramycin at 1 month and to ciprofloxacin at 3 months in the OP eyes and to trimethoprim/sulfamethoxazole at 1 month and 3 months and to oxacillin at 6 months in the non-OP eyes.ConclusionsDuring the 6-month postoperative follow-up, 0.3% tobramycin administration failed to reduce CNS colonisation but increased resistance to several antibiotics. Postoperative antibiotic treatment may be replaced by other evidence-endorsed prophylactic routines.

scholarly journals Use and influence of Delivery and Birth Plans in the humanizing delivery process

2015 ◽  
Vol 23 (3) ◽  
pp. 520-526 ◽  
Author(s):  
María Suárez-Cortés ◽  
David Armero-Barranco ◽  
Manuel Canteras-Jordana ◽  
María Emilia Martínez-Roche
Keyword(s):  
Cohort Study ◽  
Health Policies ◽  
First Year ◽  
Birth Process ◽  
Cross Sectional ◽  
Birth Plan ◽  
Skin Contact ◽  
Significant Difference ◽  
Comparative Cohort Study ◽  
Skin To Skin

OBJECTIVES: get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not.METHOD: quantitative and cross-sectional, observational, descriptive and comparative cohort study, carried out over two years. All women who gave birth during the study period were selected, including 9303 women in the study.RESULTS: 132 Delivery and Birth Plans were presented during the first year of study and 108 during the second. Among the variables analyzed, a significant difference was found in "skin to skin contact", "choice of dilation and delivery posture", "use of enema", "intake of foods or fluids", "eutocic deliveries", "late clamping of the umbilical cord" and "perineal shaving".CONCLUSIONS: the Delivery and Birth Plans positively influence the delivery process and its outcome. Health policies are needed to increase the number of Delivery and Birth Plans in our hospitals.

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