scholarly journals High Post-infection Protection after COVID-19 Among Healthcare Workers: A Population-Level Observational Study Regarding SARS-CoV-2 Reinfection, Reactivation, and Re-positivity and its Severity

2021 ◽  
Author(s):  
Golnar Sabetian ◽  
Sepehr Shahriarirad ◽  
Mohsen Moghadami ◽  
Naeimehossadat Asmarian ◽  
Reza Shahriarirad ◽  
...  
Keyword(s):  
Post Infection ◽  
Healthcare Workers ◽  
Population Level ◽  
First Episode ◽  
Fars Province ◽  
Cumulative Number ◽  
Daily Rate ◽  
Previous Infection ◽  
Adjusted Rate ◽  
Repeat Infection

Abstract Introduction: Even though over a year has passed since the coronavirus 2019 (COVID-19) outbreak, our information regarding certain aspects of the disease, such as post-infection immunity is still very limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three subsequent surges.Method: The study population consisted of all HCWs in either public or private hospitals in Fars province, Southern Iran from 20 April 2020 up to 20th February 2021. We calculated the rate of infection as the number of individuals with positive PCR tests divided by the cumulative number of person-days at risk. Poisson regression was utilized to calculate the adjusted rate ratio and estimated protection. Results: During the study period, a total of 30,546 PCR tests were performed among HCWs, of which 13,749 HCWs were positive. Among a total of 141 diagnosed cases who experienced a second episode of COVID-19, 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection was observed. The daily rate of infection was 4.72 for previously infected HCWs, while 2.20 for HCWs without previous infection. The estimated protection against repeat infection after a previous SARS-CoV-2 infection was 94.8% (95% CI: 93.6-95.7).Conclusion: Re-positivity, relapse, and reinfection of SARS-CoV-2 are quite rare in the population of HCWs. Also, after a first episode of infection, estimated protection of 94.8% was achieved against repeat infections.

scholarly journals Direct observation of repeated infections with endemic coronaviruses

2020 ◽  
Author(s):  
Marta Galanti ◽  
Jeffrey Shaman
Keyword(s):  
New York ◽  
Immune Response ◽  
Symptom Severity ◽  
Time Window ◽  
Strong Association ◽  
Immune Memory ◽  
Significant Difference ◽  
Previous Infection ◽  
Repeated Infections ◽  
Repeat Infection

AbstractBackgroundWhile the mechanisms of adaptive immunity to pandemic coronavirus SARS-CoV-2 are still unknown, the immune response to the widespread endemic coronaviruses HKU1, 229E, NL63 and OC43 provide a useful reference for understanding repeat infection risk.MethodsHere we used data from proactive sampling carried out in New York City from fall 2016 to spring 2018. We combined weekly nasal swab collection with self-reports of respiratory symptoms from 191 participants to investigate the profile of recurring infections with endemic coronaviruses.ResultsDuring the study, 12 individuals tested positive multiple times for the same coronavirus. We found no significant difference between the probability of testing positive at least once and the probability of a recurrence for the beta-coronaviruses HKU1 and OC43 at 34 weeks after enrollment/first infection. We also found no significant association between repeat infections and symptom severity but strong association between symptom severity and belonging to the same family.ConclusionThis study provides evidence that re-infections with the same endemic coronavirus are not atypical in a time window shorter than 1 year and that the genetic basis of innate immune response may be a greater determinant of infection severity than immune memory acquired after a previous infection.

scholarly journals Implementation of a Vaccination Program Based on Epidemic Geospatial Attributes: COVID-19 Pandemic in Ohio as a Case Study and Proof of Concept

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1242
Author(s):  
Susanne F. Awad ◽  
Godfrey Musuka ◽  
Zindoga Mukandavire ◽  
Dillon Froass ◽  
Neil J. MacKinnon ◽  
...  
Keyword(s):  
Early Stage ◽  
Infection Intensity ◽  
Population Level ◽  
Vaccine Uptake ◽  
Vaccination Program ◽  
Cumulative Number ◽  
Proof Of Concept ◽  
High Infection ◽  
Epidemiological Characteristics ◽  
The Impact

Geospatial vaccine uptake is a critical factor in designing strategies that maximize the population-level impact of a vaccination program. This study uses an innovative spatiotemporal model to assess the impact of vaccination distribution strategies based on disease geospatial attributes and population-level risk assessment. For proof of concept, we adapted a spatially explicit COVID-19 model to investigate a hypothetical geospatial targeting of COVID-19 vaccine rollout in Ohio, United States, at the early phase of COVID-19 pandemic. The population-level deterministic compartmental model, incorporating spatial-geographic components at the county level, was formulated using a set of differential equations stratifying the population according to vaccination status and disease epidemiological characteristics. Three different hypothetical scenarios focusing on geographical subpopulation targeting (areas with high versus low infection intensity) were investigated. Our results suggest that a vaccine program that distributes vaccines equally across the entire state effectively averts infections and hospitalizations (2954 and 165 cases, respectively). However, in a context with equitable vaccine allocation, the number of COVID-19 cases in high infection intensity areas will remain high; the cumulative number of cases remained >30,000 cases. A vaccine program that initially targets high infection intensity areas has the most significant impact in reducing new COVID-19 cases and infection-related hospitalizations (3756 and 213 infections, respectively). Our approach demonstrates the importance of factoring geospatial attributes to the design and implementation of vaccination programs in a context with limited resources during the early stage of the vaccine rollout.

scholarly journals The Effectiveness of Post-Vaccination and Post-Infection Protection in the Hospital Staff of Three Prague Hospitals: A Cohort Study of 8-Month Follow-Up from the Start of the COVID-19 Vaccination Campaign (COVANESS)

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 9
Author(s):  
Marek Petráš ◽  
Ivana Králová Lesná ◽  
Livia Večeřová ◽  
Elka Nyčová ◽  
Jana Malinová ◽  
...  
Keyword(s):  
Cohort Study ◽  
Post Infection ◽  
Vaccination Campaign ◽  
Hospital Staff ◽  
Public Confidence ◽  
Continuous Assessment ◽  
Hospital Workers ◽  
Post Vaccination ◽  
Previous Infection

Continuous assessment of the effectiveness of approved COVID-19 vaccines is crucial to gain an insight into the longer-term impact on health outcomes, and eventually boosting public confidence. For this reason, we conducted a multicenter, retrospective cohort study using data on infection and vaccination rates among employees of three Prague hospitals in the period between 27 December 2020 and 31 August 2021. The post-vaccination and post-infection protectiveness were assessed in a total of 11,443 hospital workers who were followed up for more than 14 days either after their Comirnaty vaccination or study enrolment, depending on their previous SARS-CoV-2 infection. The effectiveness of full vaccination against any SARS-CoV-2 infection achieved 88.3% (83.2–91.8%) over the eight months of follow-up, a figure not much different from the 92.5% (76.5–97.6%) level of protection built by a previous infection. Despite this, the post-vaccination level of protection declined to about 65% between June and August. No case of breakthrough infection was registered among hospital workers having received one or two vaccine doses more than three months after previous infection. The eight-month effectiveness of the Comirnaty vaccine exhibited a declining trend requiring a new booster dose. The need for vaccination in the previously infected employees was not demonstrated conclusively in this study.

scholarly journals SARS-CoV-2 induces a durable and antigen specific humoral immunity after asymptomatic to mild COVID-19 infection

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262169
Author(s):  
Sebastian Havervall ◽  
August Jernbom Falk ◽  
Jonas Klingström ◽  
Henry Ng ◽  
Nina Greilert-Norin ◽  
...  
Keyword(s):  
Post Infection ◽  
Nucleocapsid Protein ◽  
Healthcare Workers ◽  
Humoral Response ◽  
Population Based ◽  
Target Antigen ◽  
Neutralization Capacity ◽  
Study Participants ◽  
Antibody Kinetics ◽  
Study Inclusion

Current SARS-CoV-2 serological assays generate discrepant results, and the longitudinal characteristics of antibodies targeting various antigens after asymptomatic to mild COVID-19 are yet to be established. This longitudinal cohort study including 1965 healthcare workers, of which 381 participants exhibited antibodies against the SARS-CoV-2 spike antigen at study inclusion, reveal that these antibodies remain detectable in most participants, 96%, at least four months post infection, despite having had no or mild symptoms. Virus neutralization capacity was confirmed by microneutralization assay in 91% of study participants at least four months post infection. Contrary to antibodies targeting the spike protein, antibodies against the nucleocapsid protein were only detected in 80% of previously anti-nucleocapsid IgG positive healthcare workers. Both anti-spike and anti-nucleocapsid IgG levels were significantly higher in previously hospitalized COVID-19 patients four months post infection than in healthcare workers four months post infection (p = 2*10−23 and 2*10−13 respectively). Although the magnitude of humoral response was associated with disease severity, our findings support a durable and functional humoral response after SARS-CoV-2 infection even after no or mild symptoms. We further demonstrate differences in antibody kinetics depending on the antigen, arguing against the use of the nucleocapsid protein as target antigen in population-based SARS-CoV-2 serological surveys.

scholarly journals Antibody Response after BNT162b2 Vaccination in Healthcare Workers Previously Exposed and Not Exposed to SARS-CoV-2

2021 ◽  
Vol 10 (18) ◽  
pp. 4204
Author(s):  
Marcello Salvaggio ◽  
Federica Fusina ◽  
Filippo Albani ◽  
Maurizio Salvaggio ◽  
Rasula Beschi ◽  
...  
Keyword(s):  
Antibody Response ◽  
Healthcare Workers ◽  
Antibody Concentration ◽  
Clinical Documentation ◽  
Receptor Binding Domain ◽  
Effective Number ◽  
Significant Difference ◽  
Before And After ◽  
Previous Infection ◽  
Antibody Levels

The Pfizer/BioNtech Comirnaty vaccine (BNT162b2 mRNA COVID-19) against SARS-CoV-2 is currently in use in Italy. Antibodies to evaluate SARS-CoV-2 infection prior to administration are not routinely tested; therefore, two doses may be administered to asymptomatic previously exposed subjects. The aim of this study is to assess if any difference in antibody concentration between subjects exposed and not exposed to SARS-CoV-2 prior to BNT162b2 was present after the first dose and after the second dose of vaccine. Data were retrospectively collected from the clinical documentation of 337 healthcare workers who underwent SARS-CoV-2 testing before and after BNT162b2. Total anti RBD (receptor-binding domain) antibodies against SARS-CoV-2′s spike protein were measured before and 21 days after the first dose, and 12 days after the second dose of BNT162b2. Twenty-one days after the first dose, there was a statistically significant difference in antibody concentration between the two groups, which was also maintained twelve days after the second dose. In conclusion, antibody response after receiving BNT162b2 is greater in subjects who have been previously exposed to SARS-CoV-2 than in subjects who have not been previously exposed to the virus, both after 21 days after the first dose and after 12 days from the second dose. Antibody levels, 21 days after the first dose, reached a titer considered positive by the test manufacturer in the majority of subjects who have been previously infected with SARS-CoV-2. Evaluating previous infection prior to vaccination in order to give the least effective number of doses should be considered.

scholarly journals A Retrospective Survey among SARS-CoV-1 Infected Healthcare Workers after Three Years Post-Infection

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1078
Author(s):  
Szu-Wei Huang ◽  
Aspiro Nayim Urbina ◽  
Yi-Ming Arthur Chen ◽  
Sheng-Fan Wang
Keyword(s):  
Statistical Analysis ◽  
Post Infection ◽  
Neutralizing Antibodies ◽  
Healthcare Workers ◽  
Blood Samples ◽  
Retrospective Survey ◽  
Factors Affecting ◽  
Factors Associated ◽  
Neutralization Ability

Healthcare workers (HCWs) are on the frontline fighting several infectious diseases including SARS-CoV-1 and COVID-19. Coronavirus neutralizing antibodies (nAbs) were recently reported to last for a certain period. The factors affecting nAbs’ existence remain unclear. Here, we retrospectively analyzed the factors correlating with nAbs’ from SARS-CoV-1 long-term convalescence HCWs in Taiwan. One hundred and thirty SARS-CoV-1 convalescent patients were recruited between August 2006 and March 2007. Blood samples were collected to determine the anti-nucleocapsid (N) and anti-spike (S) antibodies’ existence status and neutralization ability. Neutralization ability was measured using SARS-CoV-1 pseudotyped viruses. Statistical analysis of factors associated with anti-SARS-CoV-1 antibodies’ existence status was determined using SAS software. 46.2% SARS-CoV-1 convalescent patients presented anti-N antibody after three years post-infection. Among sixty participants, ten participants co-presented anti-S antibodies. Eight participants with anti-S antibody displayed neutralization ability to SARS-CoV-1. The gender, age, and disease severity of participants did not affect the anti-N antibody existence status, whereas the anti-S antibody is significantly reduced in participants with old age (>50 years, p = 0.0434) after three years post SARS-CoV-1 infection. This study suggests that age is an important factor correlated with the duration of SARS-CoV-1 protective antibody existence status.

scholarly journals The 2015 National Canadian Homeless Youth Survey: Mental Health and Addiction Findings

2017 ◽  
Vol 62 (7) ◽  
pp. 493-500 ◽  
Author(s):  
Sean A. Kidd ◽  
Stephen Gaetz ◽  
Bill O’Grady
Keyword(s):  
Mental Health ◽  
Prince Edward Island ◽  
Homeless Youth ◽  
Suicide Attempts ◽  
Health Indicators ◽  
Population Level ◽  
Female Gender ◽  
First Episode ◽  
Related Data ◽  
Youth Survey

Objective: This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population. Methods: This study reports mental health–related data from the 2015 “Leaving Home” national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators. Results: Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]). Conclusions: This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.

scholarly journals High Rates of Recurrent Tuberculosis Disease: A Population-level Cohort Study

2020 ◽  
Author(s):  
Sabine M Hermans ◽  
Nesbert Zinyakatira ◽  
Judy Caldwell ◽  
Frank G J Cobelens ◽  
Andrew Boulle ◽  
...  
Keyword(s):  
Cape Town ◽  
Population Level ◽  
Fold Increase ◽  
First Episode ◽  
Individual Treatment ◽  
Risk Of Infection ◽  
Hiv Status ◽  
Recurrence Rates ◽  
Increased Risk ◽  
Subsequent Episode

Abstract Background Retreatment tuberculosis (TB) disease is common in high-prevalence settings. The risk of repeated episodes of recurrent TB is unknown. We calculated the rate of recurrent TB per subsequent episode by matching individual treatment episodes over a period of 13 years. Methods All recorded TB episodes in Cape Town between 2003 and 2016 were matched by probabilistic linkage of personal identifiers. Among individuals with a first episode notified in Cape Town and who completed their prior treatment successfully we estimated the recurrence rate stratified by subsequent episode and HIV status. We adjusted person-time to background mortality by age, sex, and HIV status. Results A total of 292 915 TB episodes among 263 848 individuals were included. The rate of recurrent TB was 16.4 per 1000 person-years (95% CI, 16.2–16.6), and increased per subsequent episode (8.4-fold increase, from 14.6 to 122.7 per 1000 from episode 2 to 6, respectively). These increases were similar stratified by HIV status. Rates among HIV positives were higher than among HIV negatives for episodes 2 and 3 (2- and 1.5-fold higher, respectively), and the same thereafter. Conclusions TB recurrence rates were high and increased per subsequent episode, independent of HIV status. This suggests that HIV infection is insufficient to explain the high burden of recurrence; it is more likely due to a high annual risk of infection combined with an increased risk of infection or progression to disease associated with a previous TB episode. The very high recurrence rates would justify increased TB surveillance of patients with >1 episode.

scholarly journals Neutralising reactivity against SARS-CoV-2 B.1.617.2 (Delta) variant by vaccination status and pre-exposure

2021 ◽  
Author(s):  
Enrico Lavezzo ◽  
Monia Pacenti ◽  
Laura Manuto ◽  
Caterina Boldrin ◽  
Margherita Cattai ◽  
...  
Keyword(s):  
Antibody Response ◽  
Post Infection ◽  
Healthcare Workers ◽  
Natural Infection ◽  
Vaccination Status ◽  
Control Groups ◽  
Post Exposure ◽  
The Third ◽  
Antibody Levels

Abstract In February and March 2020, one of the first Italian clusters of SARS-CoV-2 infection was detected in the municipality of Vo’. Positive subjects were followed up at 2 and 9 months post-infection with different immuno-assays and a micro-neutralisation test. Here we report on the results of the third serosurvey conducted in the same population in June 2021, 15 months post-infection, when we tested 61% of the infected individuals (n=76). Antibodies against the spike (S) antigen significantly decreased (P<0.006, Kruskal-Wallis test) among unvaccinated subjects (n=35) and increased (P<0.0001) in vaccinated individuals (n=41), whereas those against the nucleocapsid (N) decreased in the whole cohort. From the comparison with two control groups (naïve Vo’ inhabitants (n=20) and healthcare workers (HCW, n=61)), subjects vaccinated post exposure (hybrid immunity) had higher antibody levels (P<0.0001) than subjects vaccinated when naïve. Two doses of vaccine elicited stronger anti-S antibody response than natural infection (P<0.0001). Finally, the neutralising reactivity of sera against the B.1.617.2 (Delta) was lower than compared to the B.1 strain (median 1:320 versus 1:1280 1/dil, P<0.0001, and 1:640 versus 1:2560 1/dil, P=0.0014, after one or two vaccine doses, respectively), although subjects with hybrid immunity maintained neutralising titres above 1:40 1/dil.

scholarly journals Previous Influenza Infection Exacerbates Allergen Specific Response and Impairs Airway Barrier Integrity in Pre-Sensitized Mice

2021 ◽  
Vol 22 (16) ◽  
pp. 8790
Author(s):  
Kevin Looi ◽  
Alexander N. Larcombe ◽  
Kara L. Perks ◽  
Luke J. Berry ◽  
Graeme R. Zosky ◽  
...  
Keyword(s):  
Lung Function ◽  
Post Infection ◽  
Influenza A ◽  
Influenza Infection ◽  
Specific Ige ◽  
Specific Response ◽  
Barrier Integrity ◽  
Cellular Inflammation ◽  
Downstream Effects ◽  
Previous Infection

In this study we assessed the effects of antigen exposure in mice pre-sensitized with allergen following viral infection on changes in lung function, cellular responses and tight junction expression. Female BALB/c mice were sensitized to ovalbumin and infected with influenza A before receiving a second ovalbumin sensitization and challenge with saline, ovalbumin (OVA) or house dust mite (HDM). Fifteen days post-infection, bronchoalveolar inflammation, serum antibodies, responsiveness to methacholine and barrier integrity were assessed. There was no effect of infection alone on bronchoalveolar lavage cellular inflammation 15 days post-infection; however, OVA or HDM challenge resulted in increased bronchoalveolar inflammation dominated by eosinophils/neutrophils or neutrophils, respectively. Previously infected mice had higher serum OVA-specific IgE compared with uninfected mice. Mice previously infected, sensitized and challenged with OVA were most responsive to methacholine with respect to airway resistance, while HDM challenge caused significant increases in both tissue damping and tissue elastance regardless of previous infection status. Previous influenza infection was associated with decreased claudin-1 expression in all groups and decreased occludin expression in OVA or HDM-challenged mice. This study demonstrates the importance of the respiratory epithelium in pre-sensitized individuals, where influenza-infection-induced barrier disruption resulted in increased systemic OVA sensitization and downstream effects on lung function.

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