scholarly journals Incidence of COVID-19 reinfection among Midwestern healthcare employees

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262164
Author(s):  
Anne Rivelli ◽  
Veronica Fitzpatrick ◽  
Christopher Blair ◽  
Kenneth Copeland ◽  
Jon Richards
Keyword(s):  
Incidence Rate ◽  
Protective Immunity ◽  
Healthcare Workers ◽  
Natural Infection ◽  
Herd Immunity ◽  
Primary Objective ◽  
Observational Cohort ◽  
Frequent Exposure ◽  
Prior Infection ◽  
Healthcare Employees

Given the overwhelming worldwide rate of infection and the disappointing pace of vaccination, addressing reinfection is critical. Understanding reinfection, including longevity after natural infection, will allow us to better know the prospect of herd immunity, which hinges on the assumption that natural infection generates sufficient, protective immunity. The primary objective of this observational cohort study is to establish the incidence of reinfection of COVID-19 among healthcare employees who experienced a prior COVID-19 infection over a 10-month period. Of 2,625 participants who experienced at least one COVID-19 infection during the 10-month study period, 156 (5.94%) experienced reinfection and 540 (20.57%) experienced recurrence after prior infection. Median days were 126.50 (105.50–171.00) to reinfection and 31.50 (10.00–72.00) to recurrence. Incidence rate of COVID-19 reinfection was 0.35 cases per 1,000 person-days, with participants working in COVID-clinical and clinical units experiencing 3.77 and 3.57 times, respectively, greater risk of reinfection relative to those working in non-clinical units. Incidence rate of COVID-19 recurrence was 1.47 cases per 1,000 person-days. This study supports the consensus that COVID-19 reinfection, defined as subsequent infection ≥ 90 days after prior infection, is rare, even among a sample of healthcare workers with frequent exposure.

scholarly journals Incidence of COVID-19 reinfection among Midwestern healthcare employees

2021 ◽  
Author(s):  
Anne Rivelli ◽  
Veronica Fitzpatrick ◽  
Christopher Blair ◽  
Jon Richards ◽  
Kenneth Copeland
Keyword(s):  
Incidence Rate ◽  
Healthcare System ◽  
Natural Infection ◽  
Herd Immunity ◽  
Primary Objective ◽  
Convenience Sample ◽  
Cdc Guidelines ◽  
Prior Infection ◽  
Pcr Test ◽  
Healthcare Employees

Importance: Given the overwhelming worldwide rate of infection and the disappointing pace of vaccination, addressing reinfection is critical. Understanding reinfection, including protection longevity after natural infection, will allow us to better know the prospect of herd immunity, which hinges on the assumption that natural infection generates sufficient, protective immunity. The primary aim of this paper is to provide data on SARS-CoV-2 reinfection over a 10-month period. Objective: The primary objective of this study is to establish the incidence of reinfection of COVID-19 among healthcare employees who experienced a prior COVID-19 infection. Design: This observational cohort study followed a convenience sample of 2,625 participants who experienced a COVID-19 infection for subsequent COVID-19 infection. Setting: Healthcare employees were recruited across a large Midwestern healthcare system. Positive PCR test results were administered and recorded by the system-affiliated lab serving Illinois and Wisconsin. Participants: Adult healthcare system employees who enrolled in a research study focused on SARS-CoV-2 antibodies (N = 16,357) and had at least one positive PCR test result between March 1, 2020 and January 10, 2021 were included (N = 2,625). Exposure: Positive PCR test for SARS-CoV-2 Main Outcome(s) and Measure(s): The primary outcome is incidence of COVID-19 reinfection, defined by current CDC guidelines (i.e. subsequent COVID-19 infection ≥ 90 days from prior infection). COVID-19 recurrence, defined as subsequent COVID-19 infection after prior infection irrespective of time, is also described. Results: Of 2,625 participants who experienced at least one COVID-19 infection during the 10-month study period, 156 (5.94%) experienced reinfection and 540 (20.57%) experienced recurrence after prior infection. Median days were 126.50 (105.50-171.00) to reinfection and 31.50 (10.00-72.00) to recurrence. Incidence rate of COVID-19 reinfection was 0.35 cases per 1,000 person-days, with participants working in COVID-clinical and clinical units experiencing 3.77 and 3.57 times, respectively, greater risk of reinfection relative to those working in non-clinical units. Incidence rate of COVID-19 recurrence was 1.47 cases per 1,000 person-days. Conclusions and Relevance: This study supports the consensus that COVID-19 reinfection, defined as subsequent infection ≥ 90 days after prior infection, is rare, even among a sample of healthcare workers with frequent exposure.

scholarly journals Continued Effectiveness of COVID-19 Vaccination among Urban Healthcare Workers during Delta Variant Predominance

2021 ◽  
Author(s):  
Fan-Yun Lan ◽  
Amalia Sidossis ◽  
Eirini Iliaki ◽  
Jane Buley ◽  
Neetha Nathan ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Healthcare Workers ◽  
Secondary Analysis ◽  
Evidence Base ◽  
Vaccination Status ◽  
Acquired Immunity ◽  
Epidemiologic Surveillance ◽  
Information Bias ◽  
Background Data ◽  
Prior Infection

Background: Data on COVID-19 vaccine effectiveness (VE) among healthcare workers (HCWs) during periods of delta variant predominance are limited. Methods: We followed a population of urban Massachusetts HCWs (45% non-White) subject to epidemiologic surveillance. We accounted for covariates such as demographics and community background infection incidence, as well as information bias regarding COVID-19 diagnosis and vaccination status. Results and Discussion: During the study period (December 16, 2020 to September 30, 2021), 4615 HCWs contributed to a total of 1,152,486 person-days at risk (excluding 309 HCWs with prior infection) and had a COVID-19 incidence rate of 5.2/10,000 (114 infections out of 219,842 person-days) for unvaccinated person-days and 0.6/10,000 (49 infections out of 830,084 person-days) for fully vaccinated person-days, resulting in an adjusted VE of 82.3% (95% CI: 75.1-87.4%). For the secondary analysis limited to the period of delta variant predominance in Massachusetts (i.e., July 1 to September 30, 2021), we observed an adjusted VE of 76.5% (95% CI: 40.9-90.6%). Independently, we found no re-infection among those with prior COVID-19, contributing to 74,557 re-infection-free person-days, adding to the evidence base for the robustness of naturally acquired immunity.

scholarly journals Impact of Prior Infection on Protection and Transmission of SARS-CoV-2 in Golden Hamsters

2021 ◽  
Author(s):  
Cheng Zhang ◽  
Zhendong Guo ◽  
Nan Li ◽  
Huan Cui ◽  
Keyin Meng ◽  
...  
Keyword(s):  
Public Health ◽  
Direct Contact ◽  
Protective Immunity ◽  
Herd Immunity ◽  
Transmission Experiment ◽  
Indirect Contact ◽  
Golden Hamsters ◽  
Short Period ◽  
The Impact ◽  
Prior Infection

AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 100 million confirmed human infections, and 2 million more deaths globally since its emergence in the end of 2019. Several studies have shown that prior infection provided protective immunity against SARS-CoV-2 in non-human primate models. However, the effect of prior infection on blocking SARS-CoV-2 transmission is not clear. Here, we evaluated the impact of prior infection on protection and transmission of the SARS-CoV-2 virus in golden hamsters. Our results showed that prior infection provided protective immunity against SARS-CoV-2 re-challenge, but it was not sterizing immunity. The transmission experiment results showed that SARS-CoV-2 was efficiently transmitted from naive hamsters to prior infected hamsters by direct contact and airborne route, but not by indirect contact. Further, the virus was efficiently transmitted from prior infected hamsters to naive hamsters by direct contact, but not by airborne route and indirect contact. Surprisingly, the virus can be transmitted between prior infected hamsters by direct contact during a short period of early infection. Taken together, our study demonstrated that prior infected hamsters with good immunity can still be naturally re-infected, and the virus can be transmitted between prior infected hamsters and the naive through different transmission routes, implying the potential possibility of human re-infection and the risk of virus transmission between prior infected population and the healthy. Our study will help to calculate the herd immunity threshold more accurately, make more reasonable public health decisions, formulate an optimized population vaccination program, as well as aid the implementation of appropriate public health and social measures to control COVID-19.

scholarly journals Serum levels of anti-corona virus specific -IgG and -IgM antibodies in COVID-19 patients at admission and at discharge

2021 ◽  
Vol 19 (1) ◽  
pp. 5-9
Author(s):  
Ganiyu Olatunbosun Arinola ◽  
Keyword(s):  
Protective Immunity ◽  
Natural Infection ◽  
Herd Immunity ◽  
Serum Levels ◽  
Immunoglobulin M ◽  
Clear Understanding ◽  
Igg Antibodies ◽  
Specific Igg ◽  
Prophylactic Vaccines ◽  
Ibadan Nigeria

Introduction. Clear understanding of duration of antibody based protective immunity following natural infection with SARSCoV- 2 will give idea about the efficacy of proposed prophylactic vaccines against SARS-CoV-2, establishment of herd immunity and use of convalescent plasma. Aim. This study clarified the kinetics and magnitude of the initial antibody response against SARS-CoV-2 in a cohort of symptomatic COVID-19 patients from Ibadan, Nigeria. Material and methods. This study quantified immunoglobulin M (IgM) and G (IgG) antibodies recognizing the SARS-CoV-2 Spike (S) protein in 35 symptomatic COVID-19 patients at admission and at discharge using ELISA. Results. CovIgG was positive in none (0)% and 20% of COVID-19 patients at admission and at discharge respectively while CovIgM was positive in 54% and 69% of COVID-19 patients at admission and at discharged respectively. The level of CovIgG was significantly higher in COVID-19 patients at discharge compared with the level at admission while the level of CovIgM was insignificantly reduced in COVID-19 patients at discharge compared with the level at admission. Conclusion. The data indicates increased anti-SARS-COV-2 IgG Spike antibody in symptomatic COVID-19 at discharge, thus providing basis for antibody-based therapies to treat COVID-19 patients.

scholarly journals Comparative Immunogenicity of BNT162b2 mRNA Vaccine with Natural SARS-CoV-2 Infection

Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1017
Author(s):  
Mina Psichogiou ◽  
Andreas Karabinis ◽  
Garyphallia Poulakou ◽  
Anastasia Antoniadou ◽  
Anastasia Kotanidou ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Healthcare Workers ◽  
Natural Infection ◽  
Comparative Data ◽  
Spike Protein ◽  
Clinical Heterogeneity ◽  
Prior Infection ◽  
High Immunogenicity ◽  
Post Onset

BNT162b2 has proven to be highly effective, but there is a paucity of data regarding immunogenicity factors and comparison between response to vaccination and natural infection. This study included 871 vaccinated healthcare workers (HCW) and 181 patients with natural infection. Immunogenicity was assessed by measuring anti-SARS-CoV-2 against the RBD domain of the spike protein (anti-RBD). Samples were collected 1–2 weeks after vaccination or 15–59 days post-onset of symptoms. Post-vaccine anti-RBD concentrations were associated with age, gender, vaccination side-effects (VSE) and prior infection (Pr-CoV). Anti-RBD median levels (95%CI) were lower by 2466 (651–5583), 6228 (3254–9203) and 7651 (4479–10,823) AU/mL in 35–44, 45–54, 55–70 yrs, respectively, compared with the 18–34 yrs group. In females, the median levels were higher by 2823 (859–4787), 5024 (3122–6926) in individuals with VSE, and 9971 (5158–14,783) AU/mL in HCWs with Pr-CoV. The ratio of anti-RBD in vaccinated individuals versus those with natural infection varied from 1.0 to 19.4. The high immunogenicity of BNT162b2 is verified, although its sustainability has yet to be elucidated. The use of comparative data from natural infection serological panels, expressing the clinical heterogeneity of natural infection, may facilitate early decisions for candidate vaccines to be evaluated in clinical trials.

scholarly journals COVID-19 Vaccine Intention among Healthcare Workers in Saudi Arabia: A Cross-Sectional Survey

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 835
Author(s):  
Mohammed Noushad ◽  
Mohammad Zakaria Nassani ◽  
Anas B. Alsalhani ◽  
Pradeep Koppolu ◽  
Fayez Hussain Niazi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Vaccine Coverage ◽  
Vaccination Campaign ◽  
Herd Immunity ◽  
Positive Sign ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Strategies

The COVID-19 pandemic has caused largescale morbidity and mortality and a tremendous burden on the healthcare system. Healthcare workers (HCWs) require adequate protection to avoid onward transmission and minimize burden on the healthcare system. Moreover, HCWs can also influence the general public into accepting the COVID-19 vaccine. Therefore, determining COVID-19 vaccine intention among HCWs is of paramount importance to plan tailor-made public health strategies to maximize vaccine coverage. A structured questionnaire was administered in February and March 2021 among HCWs in Saudi Arabia using convenience sampling, proceeding the launch of the vaccination campaign. HCWs from all administrative regions of Saudi Arabia were included in the study. In total, 674 out of 1124 HCWs responded and completed the survey (response rate 59.9%). About 65 percent of the HCWs intended to get vaccinated. The intention to vaccinate was significantly higher among HCWs 50 years of age or older, Saudi nationals and those who followed the updates about COVID-19 vaccines (p < 0.05). The high percentage (26 percent) of those who were undecided in getting vaccinated is a positive sign. As the vaccination campaign gathers pace, the attitude is expected to change over time. Emphasis should be on planning healthcare strategies to convince the undecided HCWs into accepting the vaccine in order to achieve the coverage required to achieve herd immunity.

scholarly journals 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 ◽  
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.

Abstract 205: New Onset Heart Failure and Adverse Ischemic Events Associated with Amiodarone and Dronedarone Use among Atrial Fibrillation Patients

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Gosia Sylwestrzak ◽  
Jinan Liu ◽  
Alan Rosenberg ◽  
Jeffrey White ◽  
John Barron ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Incidence Rate ◽  
Statistical Significance ◽  
Administrative Claims ◽  
Risk Of Death ◽  
Observational Cohort ◽  
New Onset

Background: Dronedarone is a non-iodinated form of amiodarone that may not cause some of serious adverse effects associated with amiodarone. However, it is less effective than amiodarone in maintaining normal sinus rhythm, and it does not improve success of electrical cardioversion. Additionally, dronedarone use has been associated with new onset or worsening of heart failure (HF), including a doubling of the risk of death in patients with symptomatic heart failure. We aimed to compare the incidence of newly diagnosed HF and HF hospitalizations among dronedarone and amiodarone users. Secondary outcomes of interest included rates of acute ischemic stroke (IS) and transient ischemic attack (TIA). Methods: This retrospective study utilized administrative claims data between 1/1/2007-9/30/2011 from the HealthCore Integrated Research Environment (HIRE ® ). Patients were required to have at least one claim for atrial fibrillation. Propensity score matching was employed to adjust for differences between the cohorts. Incidence rate of HF, HF hospitalizations, IS and TIA events were compared between matched cohorts using Poisson time-to-event model. Results: The cohort consisted of 6,013 amiodarone and 1,534 dronedarone patients. Dronedarone patients were younger, healthier per Deyo-Charlson Index (DCI) and CHADS2 score, and less likely to have underlying heart disease (all p-values<0.05). In the propensity score matching process 838 patients with comparable baseline characteristics were selected in each group. Median follow up was 552 days in the amiodarone cohort and 412 days in the dronedarone cohort. Among patients without HF history, new onset HF incidence rate was 34.6 per 100 person-year in amiodarone cohort and 19.1 per 100 person-year in dronedarone cohort (IRR=1.61, 95% CI: 1.30-2.01, p<0.01). The incidence rate for HF hospitalization was also higher in amiodarone patients-- 10.7 per 100 person-year against 7.8 per 100 person-year for dronedarone (IRR=1.39, 95% CI: 1.02-1.85, p=0.03). For IS, the incidence rate was 1.68 per 100 person-year in amiodarone vs. 0.84 in dronedarone but results did not reach statistical significance (IRR=1.91, 95% CI: 0.84-4.30, p=0.12); for TIA, it was 3.67 vs. 2.35 for amiodarone and dronedarone respectively (IRR=2.01, 95% CI: 1.14-3.57, p=0.02). Conclusions: In a propensity score matched observational cohort study, amiodarone use was associated with higher incidence rate of new onset HF, HF hospitalizations, and TIA as identified from claims. This finding differs from other clinical studies. Future observational cohort studies should incorporate medical record review for validation since information from claims might be insufficient to fully account for underlying patient risk status, or accurately determine if HF was new onset. Key words: amiodarone; dronedarone; atrial fibrillation; heart failure.

scholarly journals Effect of Delta variant on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK

2021 ◽  
Author(s):  
Koen B. Pouwels ◽  
Emma Pritchard ◽  
Philippa C. Matthews ◽  
Nicole Stoesser ◽  
David W. Eyre ◽  
...  
Keyword(s):  
Natural Infection ◽  
Absolute Difference ◽  
Community Based ◽  
Symptomatic Infection ◽  
The United Kingdom ◽  
Viral Burden ◽  
Alpha Variant ◽  
The Uk ◽  
Prior Infection ◽  
Similar Peak

AbstractThe effectiveness of the BNT162b2 and ChAdOx1 vaccines against new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections requires continuous re-evaluation, given the increasingly dominant B.1.617.2 (Delta) variant. In this study, we investigated the effectiveness of these vaccines in a large, community-based survey of randomly selected households across the United Kingdom. We found that the effectiveness of BNT162b2 and ChAdOx1 against infections (new polymerase chain reaction (PCR)-positive cases) with symptoms or high viral burden is reduced with the B.1.617.2 variant (absolute difference of 10–13% for BNT162b2 and 16% for ChAdOx1) compared to the B.1.1.7 (Alpha) variant. The effectiveness of two doses remains at least as great as protection afforded by prior natural infection. The dynamics of immunity after second doses differed significantly between BNT162b2 and ChAdOx1, with greater initial effectiveness against new PCR-positive cases but faster declines in protection against high viral burden and symptomatic infection with BNT162b2. There was no evidence that effectiveness varied by dosing interval, but protection was higher in vaccinated individuals after a prior infection and in younger adults. With B.1.617.2, infections occurring after two vaccinations had similar peak viral burden as those in unvaccinated individuals. SARS-CoV-2 vaccination still reduces new infections, but effectiveness and attenuation of peak viral burden are reduced with B.1.617.2.

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