scholarly journals Increased risk of infection with SARS-CoV-2 Beta, Gamma, and Delta variant compared to Alpha variant in vaccinated individuals

2021 ◽  
Author(s):  
Stijn P. Andeweg ◽  
Harry Vennema ◽  
Irene Veldhuijzen ◽  
Naomi Smorenburg ◽  
Dennis Schmitz ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
The Netherlands ◽  
Immune Status ◽  
Risk Of Infection ◽  
National Community ◽  
Increased Risk ◽  
Alpha Variant ◽  
Induced Immunity

The extent to which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) break through infection- or vaccine-induced immunity is not well understood. Here, we analyze 28,578 sequenced SARS-CoV-2 samples from individuals with known immune status obtained through national community testing in the Netherlands from March to August 2021. We find evidence for an increased risk of infection by the Beta (B.1.351), Gamma (P.1), or Delta (B.1.617.2) variants compared to the Alpha (B.1.1.7) variant after vaccination. No clear differences were found between vaccines. However, the effect was larger in the first 14-59 days after complete vaccination compared to 60 days and longer. In contrast to vaccine-induced immunity, no increased risk for reinfection with Beta, Gamma or Delta variants relative to Alpha variant was found in individuals with infection-induced immunity.

scholarly journals Increased risk of infection with SARS-CoV-2 Omicron compared to Delta in vaccinated and previously infected individuals, the Netherlands, 22 November to 19 December 2021

2021 ◽  
Author(s):  
Dirk Eggink ◽  
Stijn P. Andeweg ◽  
Harry Vennema ◽  
Noortje van Maarseveen ◽  
Klaas Vermaas ◽  
...  
Keyword(s):  
The Netherlands ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Substantial Decrease ◽  
Risk Of Infection ◽  
Gene Target ◽  
S Gene ◽  
Increased Risk ◽  
Induced Immunity

Infections by the Omicron SARS-CoV-2 variant are rapidly increasing worldwide. Among 70,983 infected individuals (age ≥ 12 years), we observed an increased risk of S-gene target failure, predictive of the Omicron variant, in fully vaccinated (odds ratio: 5.0; 95% confidence interval: 4.0-6.1) and previously infected individuals (OR: 4.9: 95% CI: 3.1-7.7) compared with infected naive individuals. This suggests a substantial decrease in protection from vaccine- or infection-induced immunity against SARS-CoV-2 infections caused by the Omicron variant compared with the Delta variant.

scholarly journals High SARS-CoV-2 attack rates following exposure during singing events in the Netherlands, September-October 2020

2021 ◽  
Author(s):  
Anita A. Shah ◽  
Florien Dusseldorp ◽  
Irene K. Veldhuijzen ◽  
Margreet J.M. te Wierik ◽  
Alvin Bartels ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
The Netherlands ◽  
Index Case ◽  
Sequencing Data ◽  
Airborne Transmission ◽  
Indirect Contact ◽  
Increased Risk ◽  
Respiratory Droplets ◽  
Droplet Transmission ◽  
Interpretation Of Results

AbstractPrevious reports indicate that there may be an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during singing events. We describe SARS-CoV-2 transmission in six singing events from September–October 2020, across the Netherlands, with attack rates from 25–74%. We investigated potential routes of SARS-CoV-2 transmission for each event. Events included 9–21 persons, aged 20–79 years. SARS-CoV-2 transmission likely took place during five out of six events; a possible index case could be identified in four out of five clusters. Limited sequencing data was available, hampering interpretation of results. Indirect contact and droplet transmission (<1.5m) may have caused some cases, but are unlikely to explain the high attack rates. The previously published AirCoV2 model indicated that airborne transmission (via infectious droplets/ aerosols over longer distances (>1.5m)) due to singing is possible in case of supershedder presence (≥1010 RNA copies/mL). Also, airflow expelling respiratory droplets over longer distances (>1.5m) may have influenced transmission. In conclusion, a combination of transmission routes probably caused these five clusters. Proportions attributable to each route cannot be deduced. It is possible that airborne transmission of SARS-CoV-2 due to singing (partly) led to the high attack rates observed in these clusters.

scholarly journals Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020

2020 ◽  
Vol 25 (14) ◽  
Author(s):  
Alexander J Keeley ◽  
Cariad Evans ◽  
Hayley Colton ◽  
Michael Ankcorn ◽  
Alison Cope ◽  
...  
Keyword(s):  
United Kingdom ◽  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Teaching Hospitals ◽  
Risk Of Infection ◽  
Staffing Levels ◽  
The United Kingdom ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
Roll Out

Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak.

scholarly journals COVID-19: Considerations for Children and Adolescents with Diabetes

2020 ◽  
Author(s):  
Devi Dayal
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Children And Adolescents ◽  
Poor Prognosis ◽  
Clinical Course ◽  
Morbidity And Mortality ◽  
Metabolic Decompensation ◽  
Healthy Children ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Morbid Conditions

Recent reports suggest that the clinical course of coronavirus disease 2019 (COVID-19) in previously healthy children is usually milder as compared to adults. However, children with co-morbid conditions such as diabetes are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as morbidity and mortality due to COVID-19. Experience in adults with diabetes shows that they are prone to faster metabolic decompensation, develop diabetes-related complications and have a poor prognosis when hospitalised with COVID-19. The data in children is limited. The aim of this mini-review is to discuss the possible risks to children and adolescents with diabetes during the current pandemic and the special considerations in management in those affected with COVID-19.

Immune status is associated with the mode of delivery in infants at increased risk for Type 1 Diabetes

2014 ◽  
Vol 9 (S 01) ◽  
Author(s):  
O D'Orlando ◽  
R Puff ◽  
A Henniger ◽  
S Krause ◽  
F Haupt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Immune Status ◽  
Mode Of Delivery ◽  
Increased Risk

scholarly journals 1095. Investigation of Risk Factors Associated with Serious Bacterial, Viral and Invasive Fungal Infections in Hematologic Patients on Ibrutinib

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S576-S577
Author(s):  
Thomas Holowka ◽  
Harry Cheung ◽  
Maricar F Malinis ◽  
Sarah Perreault ◽  
Iris Isufi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infections ◽  
Antimicrobial Prophylaxis ◽  
Hematologic Malignancy ◽  
Invasive Fungal Infections ◽  
Risk Of Infection ◽  
Factors Associated ◽  
Serious Infection ◽  
Increased Risk ◽  
Serious Infections

Abstract Background Ibrutinib is a tyrosine kinase inhibitor used to treat hematologic malignancies that may increase the risk of serious infection including invasive fungal infections (IFI). In a study of 378 patients with hematologic malignancy on ibrutinib, serious infection and IFI occurred in 11% and 4% respectively (Varughese et al. Clin Infect Dis). The primary aims of our study were to determine the incidence of serious infection and associated risk factors in patients on ibrutinib. Methods We performed a retrospective analysis of patients with hematologic malignancy prescribed ibrutinib for ≥ 1 week at Yale New Haven Hospital from 2014 to 2019 to identify serious infections defined as those requiring inpatient management. We collected demographic, clinical and oncologic data. Chi-squared tests were used to determine factors associated with an increased risk of infection. Results A total of 254 patients received ibrutinib including 156 with CLL, 89 with NHL and 9 with other leukemias. Among these, 21 underwent HSCT, 9 complicated by GVHD. There were 51 (20%) patients with serious infections including 45 (17.7%) bacterial, 9 (3.5%) viral and 5 (2%) IFI (1 pulmonary cryptococcosis, 4 pulmonary aspergillosis). Anti-mold prophylaxis was prescribed to 7 (2.8%) patients, none of whom developed IFI. Risk factors associated with serious infection included ECOG score ≥ 2 (OR 4.6, p &lt; 0.001), concurrent steroid use (≥ 10 mg prednisone daily for ≥ 2 weeks; OR 3.0, p &lt; 0.001), neutropenia (OR 3.6, p &lt; 0.01), lymphopenia (OR 2.4, p &lt; 0.05) and maximum ibrutinib dose of 560 mg (OR 2, p &lt; 0.05). There was a dose dependent increase in infections based on number of chemotherapy regimens prior to ibrutinib initiation: 14.3% with 0, 19.7% with 1-2 and 28.7% with ≥ 3 prior treatments. Conclusion The incidence of serious infection in hematologic patients on ibrutinib was higher than previously reported (20% versus 11%) but the rate of IFI was lower (2% versus 4%). High ECOG score, leukopenia, steroids, and higher ibrutinib doses were associated with an increased risk for serious infection. Targeted antimicrobial prophylaxis should be considered for patients on ibrutinib with these risk factors. Improving functional status may also reduce the risk of infection in patients on ibrutinib. Disclosures All Authors: No reported disclosures

scholarly journals A novel box for aerosol and droplet guarding and evacuation in respiratory infection (BADGER) for COVID-19 and future outbreaks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hau D. Le ◽  
Gordon A. Novak ◽  
Kevin C. Janek ◽  
Jesse Wang ◽  
Khang N. Huynh ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Healthcare Providers ◽  
Airborne Particles ◽  
Risk Of Infection ◽  
Indirect Contact ◽  
Vacuum Suction ◽  
Qualitative And Quantitative ◽  
Additional Layer ◽  
Increased Risk ◽  
Design Construction

AbstractThe coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions and killed more than 1.7 million people worldwide as of December 2020. Healthcare providers are at increased risk of infection when caring for patients with COVID-19. The mechanism of transmission of SARS-CoV-2 is beginning to emerge as airborne spread in addition to direct droplet and indirect contact as main routes of transmission. Here, we report on the design, construction, and testing of the BADGER (Box for Aerosol and Droplet Guarding and Evacuation in Respiratory Infection), an affordable, scalable device that contains droplets and aerosol particles, thus minimizing the risk of infection to healthcare providers. A semi-sealed environment is created inside the BADGER, which is placed over the head of the patient and maintains at least 12-air changes per hour using in-wall vacuum suction. Multiple hand-ports enable healthcare providers to perform essential tasks on a patient’s airway and head. Overall, the BADGER has the potential to contain large droplets and small airborne particles as demonstrated by simulated qualitative and quantitative assessments to provide an additional layer of protection for healthcare providers treating COVID-19 and future respiratory contagions.

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman

2020 ◽  
Author(s):  
Sam Schoenmakers ◽  
Pauline Snijder ◽  
Robert M Verdijk ◽  
Thijs Kuiken ◽  
Sylvia S M Kamphuis ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Vertical Transmission ◽  
Neonatal Intensive Care ◽  
Quantitative Polymerase Chain Reaction ◽  
Antigen Expression ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Placental Infection ◽  
Emergency Cesarean ◽  
Increased Risk

Abstract Background In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood. Methods Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy. Results RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts. Conclusions Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic.

scholarly journals Risk of infection associated with targeted therapies for solid organ and hematological malignancies

2021 ◽  
Vol 8 ◽  
pp. 204993612198954
Author(s):  
Isabel Ruiz-Camps ◽  
Juan Aguilar-Company
Keyword(s):  
Hematological Malignancies ◽  
Opportunistic Infections ◽  
Respiratory Infections ◽  
Fungal Infections ◽  
Checkpoint Inhibitors ◽  
Janus Kinase ◽  
Prolonged Treatment ◽  
Solid Organ ◽  
Risk Of Infection ◽  
Increased Risk

Higher risks of infection are associated with some targeted drugs used to treat solid organ and hematological malignancies, and an individual patient’s risk of infection is strongly influenced by underlying diseases and concomitant or prior treatments. This review focuses on risk levels and specific suggestions for management, analyzing groups of agents associated with a significant effect on the risk of infection. Due to limited clinical experience and ongoing advances in these therapies, recommendations may be revised in the near future. Bruton tyrosine kinase (BTK) inhibitors are associated with a higher rate of infections, including invasive fungal infection, especially in the first months of treatment and in patients with advanced, pretreated disease. Phosphatidylinositol 3-kinase (PI3K) inhibitors are associated with an increased risk of Pneumocystis pneumonia and cytomegalovirus (CMV) reactivation. Venetoclax is associated with cytopenias, respiratory infections, and fever and neutropenia. Janus kinase (JAK) inhibitors may predispose patients to opportunistic and fungal infections; need for prophylaxis should be assessed on an individual basis. Mammalian target of rapamycin (mTOR) inhibitors have been linked to a higher risk of general and opportunistic infections. Breakpoint cluster region-Abelson (BCR-ABL) inhibitors are associated with neutropenia, especially over the first months of treatment. Anti-CD20 agents may cause defects in the adaptative immune response, hypogammaglobulinemia, neutropenia, and hepatitis B reactivation. Alemtuzumab is associated with profound and long-lasting immunosuppression; screening is recommended for latent infections and prevention strategies against CMV, herpesvirus, and Pneumocystis infections. Checkpoint inhibitors (CIs) may cause immune-related adverse events for which prolonged treatment with corticosteroids is needed: prophylaxis against Pneumocystis is recommended.

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