Effectiveness of COVID-19 vaccines against Omicron or Delta infection

Background The incidence of SARS-CoV-2 infection, including among those who have received 2 doses of COVID-19 vaccines, has increased substantially since Omicron was first identified in the province of Ontario, Canada. Methods Applying the test-negative design to linked provincial data, we estimated vaccine effectiveness against infection (irrespective of symptoms or severity) caused by Omicron or Delta between November 22 and December 19, 2021. We included individuals who had received at least 2 COVID-19 vaccine doses (with at least 1 mRNA vaccine dose for the primary series) and used multivariable logistic regression to estimate the effectiveness of two or three doses by time since the latest dose. Results We included 3,442 Omicron-positive cases, 9,201 Delta-positive cases, and 471,545 test-negative controls. After 2 doses of COVID-19 vaccine, vaccine effectiveness against Delta infection declined steadily over time but recovered to 93% (95%CI, 92-94%) ≥7 days after receiving an mRNA vaccine for the third dose. In contrast, receipt of 2 doses of COVID-19 vaccines was not protective against Omicron. Vaccine effectiveness against Omicron was 37% (95%CI, 19-50%) ≥7 days after receiving an mRNA vaccine for the third dose. Conclusions Two doses of COVID-19 vaccines are unlikely to protect against infection by Omicron. A third dose provides some protection in the immediate term, but substantially less than against Delta. Our results may be confounded by behaviours that we were unable to account for in our analyses. Further research is needed to examine protection against severe outcomes.

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Temporal trends and predictors in diagnosing pathologic node-positive prostate cancer in clinically node-negative patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.128 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 128-128

Author(s):

Ryan Hutten ◽

Matthew Parsons ◽

Christopher Weil ◽

Jonathan David Tward ◽

Nataniel Hernan Lester-Coll ◽

...

Keyword(s):

Prostate Cancer ◽

Logistic Regression ◽

Temporal Trends ◽

Demographic Factors ◽

Grade Group ◽

Node Negative ◽

Node Positive ◽

Multivariable Logistic Regression ◽

Treatment Facilities ◽

Over Time

128 Background: The management of men with pathologically node positive (pN+) prostate cancer (PCa) is controversial. Here, we describe the temporal patterns and predictors of incidental pN+ PCa men with clinically node negative (cN0) PCa. Methods: We performed a retrospective analysis of men with nonmetastatic, cN0, PCa from the National Cancer Database from 2010 to 2017. Clinical factors included in analysis were pretreatment PSA, pre-surgical International Society of Urological Pathology (ISUP) grade group (GG), clinical T-stage, margin status, and number of nodes sampled. Patient demographic factors included in analysis were age, comorbidity index, race, insurance status, and treatment facility type. We performed univariable and multivariable logistic regression to evaluate temporal trends in the rates of cN0,pN+ prostate cancer diagnosed over time. Two-level hierarchical logistic regression was used to identify covariates associated with pN+ disease. Patients were clustered within treatment facilities to account for individual facility practice patterns. Results: We identified 304,234 men with cN0 PCa who underwent radical prostatectomy (RP) between 2010 and 2017. Within this group 10,919 (3.59%) were found to have pN+ disease. During this period, the annual rate of pN+ PCa increased from 2.02% (n=822) in 2010 to 5.12% (n=2,072) in 2017 (p<0.001). On multivariable logistic regression, ISUP GG was most strongly associated with detection of pN+ PCa. Compared to ISUP GG1, GG2 (OR 3.5, p <0.001), GG3 (OR 8.8, p <0.001), GG4 (OR 12.6, p <0.001) and GG 5 (OR 26.5, p <0.001 ) were all significantly associated with pN+ PCa. Over the study period, the rates of pN+ identification increased from 5.5% to 9.4% in men with GG4, and from 13.4% to 19.5% in men with GG5 (p <0.001). Between 2010 and 2017, the rates of RP in GG4 and GG5 similarly increased by 12% and 16%, respectively (p <0.001). Other significant covariates are depicted in Table. 22% of the total variance was explained by inter-facility variation. Conclusions: The proportion of men with cN0 found to have pN+ PCa is increasing over time, with pN+ incidentally found in nearly 1 in 10 men with GG4 and 1 in 5 men with GG5 PCa. GG4 and GG5 are the strongest independent predictors of pN+ disease, while controlling for clinical and demographic factors. As incidental pN+ results in upstaging, often requiring adjuvant treatment with radiation and systemic therapies, these data are useful for informing discussions prior to RP. [Table: see text]

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Surge Effects and Survival to Hospital Discharge in Critical Care Patients with COVID-19 During the Early Pandemic: A Cohort Study

10.21203/rs.3.rs-111259/v1 ◽

2020 ◽

Author(s):

Christopher Dale ◽

Rachael Starcher ◽

Shu Ching Chang ◽

Ari Robicsek ◽

Guilford Parsons ◽

...

Keyword(s):

Logistic Regression ◽

Critical Care ◽

Cohort Study ◽

Intensive Care ◽

Intensive Care Units ◽

Hospital Discharge ◽

Hospital Capacity ◽

Multivariable Logistic Regression ◽

Critical Care Patients ◽

Over Time

Abstract BackgroundThe early months of the COVID-19 pandemic were fraught with much uncertainty and some resource constraint. We assessed the change in survival to hospital discharge over time for intensive care unit patients with COVID-19 during the first three months of the pandemic and the presence of any surge effects on patient outcomes.MethodsRetrospective cohort study with electronic medical record data of all patients with laboratory-confirmed COVID-19 admitted to intensive care units from February 25, 2020 to May 15, 2020 admitted to intensive care units of 26 hospitals of an integrated delivery system in the Western United States. Patient demographic, comorbidity and severity of illness were measured along with exposure to pharmacologic and medical therapies and hospital outcomes over time. Multivariable logistic regression models were constructed to assess the change in survival to hospital discharge over time during the study period.ResultsOf 620 patients with COVID-19 admitted to the study ICUs (mean age 63.5 years (SD 15.7) and 69% male), 403 (65%) survived to hospital discharge and 217 (35%) died in hospital. Survival to hospital discharge increased over the study period from 60.0% in the first two weeks of patient admission to 67.6% in the last two weeks. In a multivariable logistic regression analysis, the risk-adjusted odds of survival to hospital discharge increased over time (bi-weekly change, adjusted odds ratio [aOR] 1.22, 95%CI 1.04-1.40, P = 0.02). Additionally, an a priori-defined explanatory model showed that after adjusting for both hospital occupancy and COVID positive/PUI percent hospital capacity, and the same set of covariates, the temporal trend in risk-adjusted patient survival to hospital discharge remained the same (bi-weekly change, aOR 1.18, 95% CI 1.00 to 1.38, P = 0.04) and a greater COVID positive/PUI percentage of hospital capacity remained significantly and inversely associated with survival to hospital discharge (aOR 0.95, 95% CI 0.92 to 0.98, P < 0.01).ConclusionsDuring the the early COVID-19 pandemic, risk-adjusted survival to hospital discharge increased over time for critical care patients. This may have been partially explained by surge affects, as measured by a greater COVID positive/PUI percentage of hospital capacity.

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Television During Meals in the First 4 Years of Life

Clinical Pediatrics ◽

10.1177/0009922816678585 ◽

2016 ◽

Vol 56 (7) ◽

pp. 659-666 ◽

Cited By ~ 5

Author(s):

Lindsay M. Thimmig ◽

Michael D. Cabana ◽

Michael G. Bentz ◽

Katherine Potocka ◽

Amy Beck ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Early Childhood ◽

Logistic Regression ◽

Controlled Trial ◽

Family Characteristics ◽

Annual Income ◽

Randomized Controlled ◽

Multivariable Logistic Regression ◽

College Educated ◽

Over Time

The development of children’s mealtime television (TV) habits has not been well studied. We assessed whether mealtime TV habits established in infancy will persist into early childhood. We analyzed data collected through parent surveys at birth and at 6-month intervals from a randomized controlled trial. We used t-tests, χ2 tests, and a multivariable logistic regression to determine if family characteristics were associated with mealtime TV. A McNemar test was used to assess whether mealtime TV exposure changed over time. College-educated fathers and families with an annual income >$50 000 were associated with less-frequent TV exposure during children’s mealtimes. It was found that 84% of children retained their level of exposure to TV during mealtimes from the first 24 months through 48 months of life. Clinicians should counsel families about mealtime TV use within the first 2 years of life because these habits seem to develop early and persist into at least early childhood.

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Surge Effects and Survival to Hospital Discharge in Critical Care Patients with COVID-19 During the Early Pandemic: A Cohort Study

10.21203/rs.3.rs-111259/v2 ◽

2021 ◽

Author(s):

Christopher Dale ◽

Rachael Starcher ◽

Shu Ching Chang ◽

Ari Robicsek ◽

Guilford Parsons ◽

...

Keyword(s):

Logistic Regression ◽

Critical Care ◽

Cohort Study ◽

Intensive Care ◽

Hospital Discharge ◽

Multivariable Logistic Regression Analysis ◽

Hospital Capacity ◽

Multivariable Logistic Regression ◽

Critical Care Patients ◽

Over Time

Abstract BackgroundThe early months of the COVID-19 pandemic were fraught with much uncertainty and some resource constraint. We assessed the change in survival to hospital discharge over time for intensive care unit patients with COVID-19 during the first three months of the pandemic and the presence of any surge effects on patient outcomes.MethodsRetrospective cohort study using electronic medical record data for all patients with laboratory-confirmed COVID-19 admitted to intensive care units from February 25, 2020 to May 15, 2020 at one of 26 hospitals within an integrated delivery system in the Western United States. Patient demographics, comorbidities and severity of illness were measured along with medical therapies and hospital outcomes over time. Multivariable logistic regression models were constructed to assess temporal changes in survival to hospital discharge during the study period.ResultsOf 620 patients with COVID-19 admitted to the ICU (mean age 63.5 years (SD 15.7) and 69% male), 403 (65%) survived to hospital discharge and 217 (35%) died in the hospital. Survival to hospital discharge increased over time, from 60.0% in the first two weeks of the study period to 67.6% in the last two weeks. In a multivariable logistic regression analysis, the risk-adjusted odds of survival to hospital discharge increased over time (bi-weekly change, adjusted odds ratio [aOR] 1.22, 95%CI 1.04-1.40, P = 0.02). Additionally, an a priori-defined explanatory model showed that after adjusting for both hospital occupancy and percent hospital capacity by COVID-19 positive individuals and persons under investigation (PUI), the temporal trend in risk-adjusted patient survival to hospital discharge remained the same (bi-weekly change, aOR 1.18, 95% CI 1.00 to 1.38, P = 0.04). The presence of greater rates of COVID-19 positive/PUI as a percentage of hospital capacity was, however, significantly and inversely associated with survival to hospital discharge (aOR 0.95, 95% CI 0.92 to 0.98, P < 0.01). ConclusionsDuring the early COVID-19 pandemic, risk-adjusted survival to hospital discharge increased over time for critical care patients. An association was also seen between a greater COVID-19 positive/PUI percentage of hospital capacity and a lower survival rate to hospital discharge.

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Humoral Immunogenicity of Three COVID-19 mRNA Vaccine Doses in Patients with Inflammatory Bowel Disease

10.1101/2021.12.22.21268217 ◽

2021 ◽

Author(s):

Trevor L Schell ◽

Keith L Knutson ◽

Sumona Saha ◽

Arnold Wald ◽

Hiep S Phan ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Vaccine Dose ◽

The Third ◽

Primary Series ◽

Inflammatory Bowel

Summary: Herein, we evaluated the humoral immunogenicity of a third COVID-19 mRNA vaccine dose in patients with IBD. All patients were seropositive and had higher antibody concentrations after the third dose than after completion of the two-dose primary series.

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P094 Textbook outcome in Inflammatory Bowel Disease surgery

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.223 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S192-S192

Author(s):

D Burneikis ◽

D Liska ◽

J Lipman ◽

M Valente ◽

E Gorgun ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Logistic Regression ◽

Bowel Disease ◽

Loop Ileostomy ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Improvement Project ◽

Multivariable Logistic Regression ◽

Inflammatory Bowel ◽

Over Time

Abstract Background Textbook outcome (TO) is a composite measure of quality representing the most ideal result that can be expected from a surgical encounter. TOs for hepatobiliary, bariatric and thoracic procedures have been described in the literature. The purpose of this study was to define and to benchmark the rates of TO for common procedures in patients with Inflammatory Bowel Disease (IBD). Methods The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) participant user files (PUF) from 2011 to 2019 were examined. Adults undergoing surgery for Crohn’s disease or ulcerative colitis were included. Four index procedures were selected for the study using Current Procedural Terminology (CPT) codes: ileocolic resection (ICR), diverting loop ileostomy closure (DLIC), total abdominal colectomy (TAC), and ileal pouch construction (IPAA). Four criteria had to be satisfied completely to achieve TO: 1) no 30-day complications, 2) no unplanned return to operating room, 3) no 30-day readmission, and 4) length of hospital stay (LOS) less than or equal to a predetermined threshold for each procedure. The LOS thresholds were derived by surveying 12 colorectal surgeons at our institution about the ideal length of stay for each of index procedure. Relevant preoperative variables collected in the NSQIP PUF were analyzed with multivariable logistic regression to identify potential predictors of TO for each procedure. Results The study included 15,261 distinct surgical encounters containing 6,862 ICR, 1,149 DLIC, 3,835 TAC and 3,415 IPAA. The survey mean ideal LOS for each procedure was 3 days for ICR, 2 days for DLIC, 4 days for TAC, and 4 days for IPAA. Using the above definition, TO was achieved in 29% of ICR, 20% of DLIC, 46% of TAC, and 35% of IPAA. The rate of achieving TO increased over time for all four procedures studied (Figure 1). Multivariable logistic regression identified several unique positive and negative predictors of achieving TO. For ICR, male sex and ASA class 4 were significant negative predictors of TO (OR 0.73 [0.66–0.82] and 0.23 [0.07–0.86] respectively); while for TAC, older age and presence of wound infection [DL3] made TO less likely (OR 0.51 [0.35–0.75] and 0.45 [0.23–0.88] respectively); for IPAA, laparoscopic approach made TO much more likely [DL4] (OR 2.0; [1.62–2.46]). We identified no statistically significant predictors of TO for DLIC. Satisfying the LOS threshold was the greatest determinant of achieving TO for all four procedures studied. Conclusion In this study, we present the rates of TO for the four most common IBD operations as captured in NSQIP. TO has the advantage of being easy to interpret and can be followed over time to benchmark individual and institutional performance.

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Youth Access to School Salad Bars in the United States—2011 to 2014

American Journal of Health Promotion ◽

10.1177/0890117116671645 ◽

2016 ◽

Vol 32 (1) ◽

pp. 84-88 ◽

Cited By ~ 1

Author(s):

Brenna K. VanFrank ◽

Stephen Onufrak ◽

Diane M. Harris

Keyword(s):

United States ◽

Logistic Regression ◽

Regression Models ◽

The United States ◽

Logistic Regression Models ◽

Multivariable Logistic Regression ◽

Let's Move ◽

Race Ethnicity ◽

Nationally Representative ◽

Over Time

Purpose: To examine differences in students’ access to school salad bars across sociodemographic groups and changes in availability over time. Design: Nonexperimental. Setting: Nationally representative 2011 and 2014 YouthStyles surveys. Participants: A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years. Measures: Youth-reported availability of school salad bars. Analysis: Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014. Results: Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01). Conclusion: These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let’s Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.

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Acceptance of a Third Dose of COVID-19 Vaccine and Associated Factors in China Based on Health Belief Model: A National Cross-Sectional Study

Vaccines ◽

10.3390/vaccines10010089 ◽

2022 ◽

Vol 10 (1) ◽

pp. 89

Author(s):

Chenyuan Qin ◽

Ruitong Wang ◽

Liyuan Tao ◽

Min Liu ◽

Jue Liu

Keyword(s):

Logistic Regression ◽

Health Beliefs ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Perceived Susceptibility ◽

The Third ◽

Multivariable Logistic Regression ◽

Cues To Action ◽

High Level

COVID-19 infections are returning to many countries because of the emergence of variants or declining antibody levels provided by vaccines. An additional dose of vaccination is recommended to be a considerable supplementary intervention. We aim to explore public acceptance of the third dose of the COVID-19 vaccine and related influencing factors in China. This nationwide cross-sectional study was conducted in the general population among 31 provinces in November, 2021. We collected information on basic characteristics, vaccination knowledge and attitudes, and vaccine-related health beliefs of the participants. Univariable and multivariable logistic regression models were used to assess factors associated with the acceptance of a third COVID-19 vaccine. A total of 93.7% (95% CI: 92.9–94.6%) of 3119 Chinese residents were willing to receive a third dose of the COVID-19 vaccine. Individuals with low level of perceived susceptibility, perceived benefit, cues to action cues, and high level of perceived barriers, old age, low educational level, low monthly household income, and low knowledge score on COVID-19 were less likely to have the acceptance of a third dose of COVID-19 (all p < 0.05). In the multivariable logistic regression model, acceptance of the third dose of COVID-19 vaccine was mainly related to previous vaccination history [Sinopharm BBIP (aOR = 6.55, 95% CI 3.30–12.98), Sinovac (aOR = 5.22, 95% CI:2.72–10.02), Convidecia (aOR = 5.80, 95% CI: 2.04–16.48)], high level of perceived susceptibility (aOR = 2.48, 95% CI: 1.48–4.31) and high level of action cues (aOR = 23.66, 95% CI: 9.97–56.23). Overall, residents in China showed a high willingness to accept the third dose of COVID-19 vaccines, which can help vaccine manufacturers in China to manage the vaccine production and distribution for the huge domestic and international vaccine demand. Relevant institutions could increase people’s willingness to booster shots by increasing initial COVID-19 vaccination rates, public’s perception of COVID-19 susceptibility and cues to action through various strategies and channels. Meanwhile, it also has certain reference significance for other countries to formulate vaccine promotion strategies.

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Impact of the development of an endoscopic eradication program for Barrett’s esophagus with high grade dysplasia or early adenocarcinoma on the frequency of surgery

Endoscopy International Open ◽

10.1055/a-0640-3030 ◽

2018 ◽

Vol 06 (09) ◽

pp. E1085-E1092

Author(s):

Prianka Chilukuri ◽

Mark A. Gromski ◽

Cynthia S. Johnson ◽

Duy Khanh P. Ceppa ◽

Kenneth A. Kesler ◽

...

Keyword(s):

Logistic Regression ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Eradication Therapy ◽

High Grade Dysplasia ◽

High Grade ◽

Multivariable Logistic Regression ◽

Early Adenocarcinoma ◽

The Impact ◽

Over Time

Abstract Background and aims The impact of the advent of an institutional endoscopic eradication therapy (EET) program on surgical practice for Barrett’s esophagus (BE)-associated high grade dysplasia (HGD) or suspected T1a esophageal adenocarcinoma (EAC) is unknown. The aims of this study are to evaluate the different endoscopic modalities used during development of our EET program and factors associated with the use of EET or surgery for these patients after its development. Methods Patients who underwent primary endoscopic or surgical treatment for BE-HGD or early EAC at our hospital between January 1992 and December 2014 were retrospectively identified. They were categorized by their initial modality of treatment during the first year, and the impact over time for choice of therapy was assessed by multivariable logistic regression. Results We identified 386 patients and 80 patients who underwent EET and surgery, respectively. EET included single modality therapy in 254 (66 %) patients and multimodal therapy in 132 (34 %) patients. Multivariable logistic regression showed that, for each subsequent study year, EET was more likely to be performed in patients who were older (P = 0.0009), with shorter BE lengths (P < 0.0001), and with a pretreatment diagnosis of HGD (P = 0.0054) compared to surgical patients. The diagnosis of EAC did not increase the utilization of EET compared to surgery as time progressed (P = 0.8165). Conclusion The introduction of an EET program at our hospital increased the odds of utilizing EET versus surgery over time for initial treatment of patients who were older, had shorter BE lengths or the diagnosis of BE-HGD, but not in patients with EAC.

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Durability of mRNA-1273 vaccine–induced antibodies against SARS-CoV-2 variants

Science ◽

10.1126/science.abj4176 ◽

2021 ◽

pp. eabj4176

Author(s):

Amarendra Pegu ◽

Sarah O’Connell ◽

Stephen D. Schmidt ◽

Sijy O’Dell ◽

Chloe A. Talana ◽

...

Keyword(s):

Single Dose ◽

Immune Responses ◽

Vaccine Dose ◽

Antibody Recognition ◽

Primary Series ◽

Antibody Titers ◽

Low Levels ◽

Functional Antibodies ◽

The Impact ◽

Over Time

SARS-CoV-2 mutations may diminish vaccine-induced protective immune responses, particularly as antibody titers wane over time. Here, we assess the impact of SARS-CoV-2 variants B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), B.1.429 (Epsilon), B.1.526 (Iota), and B.1.617.2 (Delta) on binding, neutralizing, and ACE2-competing antibodies elicited by the vaccine mRNA-1273 over seven months. Cross-reactive neutralizing responses were rare after a single dose. At the peak of response to the second vaccine dose, all individuals had responses to all variants. Binding and functional antibodies against variants persisted in most subjects, albeit at low levels, for 6-months after the primary series of the mRNA-1273 vaccine. Across all assays, B.1.351 had the lowest antibody recognition. These data complement ongoing studies to inform the potential need for additional boost vaccinations.

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