Pub Date : 2022-04-17DOI: 10.1101/2022.04.14.22273413
Vesta L Richardson, Martín Alejandro Camacho Franco, Aurora Bautista Márquez, Libny Martínez Valdez, Luis Enrique Castro Ceronio, Vicente Cruz Cruz, R. Gharpure, K. Lafond, Tat S. Yau, E. Azziz‐Baumgartner, M. H. Ávila
Background: Beginning in March 2021, Mexico vaccinated childcare workers with a single-dose CanSino Biologics (Adv5-nCoV) COVID-19 vaccine. Although CanSino is currently approved for use in 10 Latin American, Asian, and European countries, little information is available about its vaccine effectiveness (VE). Methods: We evaluated CanSino VE within a childcare worker cohort that included 1,408 childcare facilities. Participants were followed during March-December 2021 and tested through SARS-CoV-2 RT-PCR or rapid antigen test if they developed any symptom compatible with COVID-19. Vaccination status was obtained through worker registries. VE was calculated as 100% x (1-hazard ratio for SARS-CoV-2 infection in fully vaccinated vs. unvaccinated participants), using an Andersen-Gill model adjusted for age, sex, state, and local viral circulation. Results: The cohort included 43,925 persons who were mostly (96%) female with a median age of 32 years; 37,646 (86%) were vaccinated with CanSino. During March-December 2021, 2,250 (5%) participants had laboratory-confirmed COVID-19, of whom 25 were hospitalized and 6 died. Adjusted VE was 20% (95% CI = 10-29%) against illness, 76% (42-90%) against hospitalization, and 94% (66-99%) against death. VE against illness declined from 48% (95% CI = 33-61) after 14-60 days following full vaccination to 20% (95% CI = 9-31) after 61-120 days. Conclusions: CanSino vaccine was effective at preventing COVID-19 illness and highly effective at preventing hospitalization and death. It will be useful to further evaluate duration of protection and assess the value of booster doses to prevent COVID-19 and severe outcomes.
背景:从2021年3月开始,墨西哥为儿童保育工作者接种了单剂量cansio Biologics (Adv5-nCoV) COVID-19疫苗。尽管CanSino目前已被批准在10个拉丁美洲、亚洲和欧洲国家使用,但关于其疫苗有效性(VE)的信息很少。方法:我们在包括1,408个托儿机构的托儿工作者队列中评估了CanSino VE。在2021年3月至12月期间对参与者进行随访,并通过SARS-CoV-2 RT-PCR或快速抗原检测对他们是否出现任何与COVID-19相容的症状进行检测。通过工人登记获得了疫苗接种状况。VE计算为100% x(完全接种疫苗的受试者与未接种疫苗的受试者感染SARS-CoV-2的1-风险比),使用调整了年龄、性别、州和当地病毒循环的Andersen-Gill模型。结果:该队列包括43,925人,其中大多数(96%)为女性,中位年龄为32岁;37646例(86%)接种了CanSino疫苗。在2021年3月至12月期间,2250名(5%)参与者患有实验室确诊的COVID-19,其中25人住院,6人死亡。对疾病的校正VE为20% (95% CI = 10-29%),对住院的校正VE为76%(42-90%),对死亡的校正VE为94%(66-99%)。在完全接种疫苗后14-60天,疾病预防率从48% (95% CI = 33-61)下降到61-120天后的20% (95% CI = 9-31)。结论:CanSino疫苗预防COVID-19疾病有效,预防住院和死亡效果显著。这将有助于进一步评估保护持续时间和评估加强剂量对预防COVID-19和严重后果的价值。
{"title":"Vaccine effectiveness of CanSino (Adv5-nCoV) COVID-19 vaccine among childcare workers – Mexico, March–December 2021","authors":"Vesta L Richardson, Martín Alejandro Camacho Franco, Aurora Bautista Márquez, Libny Martínez Valdez, Luis Enrique Castro Ceronio, Vicente Cruz Cruz, R. Gharpure, K. Lafond, Tat S. Yau, E. Azziz‐Baumgartner, M. H. Ávila","doi":"10.1101/2022.04.14.22273413","DOIUrl":"https://doi.org/10.1101/2022.04.14.22273413","url":null,"abstract":"Background: Beginning in March 2021, Mexico vaccinated childcare workers with a single-dose CanSino Biologics (Adv5-nCoV) COVID-19 vaccine. Although CanSino is currently approved for use in 10 Latin American, Asian, and European countries, little information is available about its vaccine effectiveness (VE). Methods: We evaluated CanSino VE within a childcare worker cohort that included 1,408 childcare facilities. Participants were followed during March-December 2021 and tested through SARS-CoV-2 RT-PCR or rapid antigen test if they developed any symptom compatible with COVID-19. Vaccination status was obtained through worker registries. VE was calculated as 100% x (1-hazard ratio for SARS-CoV-2 infection in fully vaccinated vs. unvaccinated participants), using an Andersen-Gill model adjusted for age, sex, state, and local viral circulation. Results: The cohort included 43,925 persons who were mostly (96%) female with a median age of 32 years; 37,646 (86%) were vaccinated with CanSino. During March-December 2021, 2,250 (5%) participants had laboratory-confirmed COVID-19, of whom 25 were hospitalized and 6 died. Adjusted VE was 20% (95% CI = 10-29%) against illness, 76% (42-90%) against hospitalization, and 94% (66-99%) against death. VE against illness declined from 48% (95% CI = 33-61) after 14-60 days following full vaccination to 20% (95% CI = 9-31) after 61-120 days. Conclusions: CanSino vaccine was effective at preventing COVID-19 illness and highly effective at preventing hospitalization and death. It will be useful to further evaluate duration of protection and assess the value of booster doses to prevent COVID-19 and severe outcomes.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80871336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1101/2022.04.13.22273825
S. Nasreen, Y. Febriani, H. V. Velásquez García, Geng Zhang, M. Tadrous, S. Buchan, C. Righolt, S. Mahmud, N. Janjua, M. Krajden, G. De Serres, J. Kwong
Background: A major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021. Methods: We conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged [≥]18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models. Results: We included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%-94%) [≥]84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%-99%) [≥]112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%-94%) [≥]56 days after a first dose, increasing to 97% (95%CI: 91%-99%) [≥]56 days after a second dose. Lower one-dose effectiveness was observed for adults aged [≥]80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants. Conclusions: Two doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.
{"title":"Effectiveness of COVID-19 vaccines against hospitalization and death in Canada: A multiprovincial test-negative design study","authors":"S. Nasreen, Y. Febriani, H. V. Velásquez García, Geng Zhang, M. Tadrous, S. Buchan, C. Righolt, S. Mahmud, N. Janjua, M. Krajden, G. De Serres, J. Kwong","doi":"10.1101/2022.04.13.22273825","DOIUrl":"https://doi.org/10.1101/2022.04.13.22273825","url":null,"abstract":"Background: A major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021. Methods: We conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged [≥]18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models. Results: We included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%-94%) [≥]84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%-99%) [≥]112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%-94%) [≥]56 days after a first dose, increasing to 97% (95%CI: 91%-99%) [≥]56 days after a second dose. Lower one-dose effectiveness was observed for adults aged [≥]80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants. Conclusions: Two doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"404 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79479120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Paredes, Stephanie M Lunn, M. Famulare, L. Frisbie, I. Painter, R. Burstein, Pavitra Roychoudhury, H. Xie, S. A. Mohamed Bakhash, R. Perez, Maria Lukes, S. Ellis, Saraswathi Sathees, P. Mathias, A. Greninger, L. Starita, C. Frazar, E. Ryke, W. Zhong, L. Gamboa, M. Threlkeld, Jover Lee, E. McDermot, M. Truong, D. Nickerson, Daniel L Bates, M. Hartman, E. Haugen, Truong Nguyen, J. Richards, Jacob L Rodriguez, J. Stamatoyannopoulos, Eric Thorland, G. Melly, P. Dykema, Drew Mackellar, Hannah K. Gray, Avi Singh, J. Peterson, Denny Russell, L. M. Torres, S. Lindquist, T. Bedford, Krisandra J. Allen, H. Oltean
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
背景2019冠状病毒病(COVID-19)大流行以变异病毒为主;由此产生的对疾病严重程度的影响尚不清楚。通过一项回顾性队列研究,我们评估了感染7种严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)变体后的住院风险。方法研究对象为华盛顿疾病报告系统中具有可用病毒基因组数据的SARS-CoV-2逆转录聚合酶链反应(RT-PCR)阳性个体,时间为2020年12月1日至2022年1月14日。分析仅限于通过哨点监测收集标本的病例。使用混合效应的Cox比例风险模型,在调整了年龄、性别、日历周和疫苗接种等因素后,我们估计了感染变异后住院风险的风险比(HR)。结果通过哨点监测共获得58 848例病例,其中1705例(2.9%)因COVID-19住院。与具有祖先血统的感染相比,Gamma (HR 3.20, 95%可信区间[CI] 2.40-4.26)、Beta (HR 2.85, 95% CI 1.56-5.23)、Delta (HR 2.28, 95% CI 1.56-3.34)或Alpha (HR 1.64, 95% CI 1.29-2.07)感染的住院风险更高;Omicron组(HR 0.92, 95% CI 0.56 ~ 1.52)的风险差异无统计学意义。在Alpha、Gamma或Delta感染后,未接种疫苗的患者显示出更高的住院风险,而接种疫苗的患者与未接种疫苗的祖系病例相比,在风险方面没有显着差异。接种疫苗后,感染欧米克隆后住院的风险较低。结论:α、γ或Delta感染可导致较高的住院风险,接种疫苗可降低这种风险。我们的研究结果支持医院准备、疫苗接种和基因组监测。
{"title":"Associations Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants and Risk of Coronavirus Disease 2019 (COVID-19) Hospitalization Among Confirmed Cases in Washington State: A Retrospective Cohort Study","authors":"M. Paredes, Stephanie M Lunn, M. Famulare, L. Frisbie, I. Painter, R. Burstein, Pavitra Roychoudhury, H. Xie, S. A. Mohamed Bakhash, R. Perez, Maria Lukes, S. Ellis, Saraswathi Sathees, P. Mathias, A. Greninger, L. Starita, C. Frazar, E. Ryke, W. Zhong, L. Gamboa, M. Threlkeld, Jover Lee, E. McDermot, M. Truong, D. Nickerson, Daniel L Bates, M. Hartman, E. Haugen, Truong Nguyen, J. Richards, Jacob L Rodriguez, J. Stamatoyannopoulos, Eric Thorland, G. Melly, P. Dykema, Drew Mackellar, Hannah K. Gray, Avi Singh, J. Peterson, Denny Russell, L. M. Torres, S. Lindquist, T. Bedford, Krisandra J. Allen, H. Oltean","doi":"10.1093/cid/ciac279","DOIUrl":"https://doi.org/10.1093/cid/ciac279","url":null,"abstract":"Abstract Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"9 1","pages":"e536 - e544"},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77238867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Cornely, B. Gachot, H. Akan, M. Bassetti, O. Uzun, C. Kibbler, O. Marchetti, Peter de Burghgraeve, Safaa Ramadan, L. Pylkkanen, L. Ameye, M. Paesmans, J. Donnelly
{"title":"Correction to: Epidemiology and Outcome of Fungemia in a Cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).","authors":"O. Cornely, B. Gachot, H. Akan, M. Bassetti, O. Uzun, C. Kibbler, O. Marchetti, Peter de Burghgraeve, Safaa Ramadan, L. Pylkkanen, L. Ameye, M. Paesmans, J. Donnelly","doi":"10.1093/cid/ciac144","DOIUrl":"https://doi.org/10.1093/cid/ciac144","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90381101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-12DOI: 10.1101/2022.04.11.22273721
D. Morgan, M. M. Erik R. Dubberke, BS MT Tiffany Hink, BS Gwen Paszkiewicz, C. D. Burnham, MA Lisa Pineles, PhD Larry Magder, PhD J. Kristie Johnson, Mbbs Mph Surbhi Leekha, A. D. H. M. Mph
Importance: Clostridioides difficile is the most common cause of healthcare-associated infections (HAI) in the US. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile. Objective: To assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of C. difficile compared with usual care. Design, setting, and Participants: Secondary analysis of a cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from January 4, 2012, to October 4, 2012. Interventions: After a baseline period, ICUs were randomized to standard practice for glove and gown use vs. the intervention of all healthcare workers being required to wear gloves and gowns for all patient contact and when entering any patient room (contact precautions). Main outcomes and measures: The primary outcome was acquisition of toxigenic C. difficile determined by surveillance cultures collected on admission and discharge from the ICU. Secondary outcomes included ribotype 027-like C. difficile acquisition and the impact of other factors on acquisition. Results: From the 26,749 patients enrolled in the study, a total of 21,845 patients had both admission and discharge perianal swabs cultured for toxigenic C. difficile. On admission, 9.43% (2,060/21,845) of patients were colonized with toxigenic C. difficile. No significant difference was observed in the rate of toxigenic C. difficile acquisition with universal gown and glove use. Differences in acquisition rates in the study period compared to baseline period in control ICUs were 1.49 per 100 patient days vs 1.68 per 100 patient days in universal gown and glove ICUs, (rate difference -0.28, generalized linear mixed model, p=0.091). Similarly, there was no difference in rates of ribotype 027-like C. difficile acquisition: control ICUs 0.13 per 100 patient days vs. 0.16 per 100 patient days in universal gown and glove ICUs during the study period, (rate difference -0.03, generalized linear mixed model, p=0.35). Secondary analyses identified C. difficile colonization was associated with acquisition, p=0.014). Conclusions and relevance: Glove and gown use for all patient contact in medical and surgical ICUs did not result in a reduction in the acquisition of C. difficile compared with usual care.
{"title":"The impact of universal glove and gown use on Clostridioides difficile acquisition, a cluster randomized trial","authors":"D. Morgan, M. M. Erik R. Dubberke, BS MT Tiffany Hink, BS Gwen Paszkiewicz, C. D. Burnham, MA Lisa Pineles, PhD Larry Magder, PhD J. Kristie Johnson, Mbbs Mph Surbhi Leekha, A. D. H. M. Mph","doi":"10.1101/2022.04.11.22273721","DOIUrl":"https://doi.org/10.1101/2022.04.11.22273721","url":null,"abstract":"Importance: Clostridioides difficile is the most common cause of healthcare-associated infections (HAI) in the US. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile. Objective: To assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of C. difficile compared with usual care. Design, setting, and Participants: Secondary analysis of a cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from January 4, 2012, to October 4, 2012. Interventions: After a baseline period, ICUs were randomized to standard practice for glove and gown use vs. the intervention of all healthcare workers being required to wear gloves and gowns for all patient contact and when entering any patient room (contact precautions). Main outcomes and measures: The primary outcome was acquisition of toxigenic C. difficile determined by surveillance cultures collected on admission and discharge from the ICU. Secondary outcomes included ribotype 027-like C. difficile acquisition and the impact of other factors on acquisition. Results: From the 26,749 patients enrolled in the study, a total of 21,845 patients had both admission and discharge perianal swabs cultured for toxigenic C. difficile. On admission, 9.43% (2,060/21,845) of patients were colonized with toxigenic C. difficile. No significant difference was observed in the rate of toxigenic C. difficile acquisition with universal gown and glove use. Differences in acquisition rates in the study period compared to baseline period in control ICUs were 1.49 per 100 patient days vs 1.68 per 100 patient days in universal gown and glove ICUs, (rate difference -0.28, generalized linear mixed model, p=0.091). Similarly, there was no difference in rates of ribotype 027-like C. difficile acquisition: control ICUs 0.13 per 100 patient days vs. 0.16 per 100 patient days in universal gown and glove ICUs during the study period, (rate difference -0.03, generalized linear mixed model, p=0.35). Secondary analyses identified C. difficile colonization was associated with acquisition, p=0.014). Conclusions and relevance: Glove and gown use for all patient contact in medical and surgical ICUs did not result in a reduction in the acquisition of C. difficile compared with usual care.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83343612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Butt, S. Dargham, Srusvin Loka, R. Shaik, H. Chemaitelly, P. Tang, M Zahid Hasan, P. Coyle, H. Yassine, H. Al-Khatib, M. Smatti, A. Kaleeckal, A. Latif, Ahmed Zaqout, M. Almaslamani, A. Al Khal, R. Bertollini, A. Abou-Samra, L. Abu-Raddad
Abstract Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.
背景评估感染Omicron变异的儿童/青少年COVID-19疾病严重程度的数据有限。方法:我们从卡塔尔国家COVID-19数据库中筛选了δ型SARS-CoV-2感染的儿童和<18岁的青少年,并将倾向评分匹配的对照组与Omicron变体感染进行比对。主要结局是疾病严重程度,由入院、入住ICU或诊断14天内的机械通气或28天内的死亡决定。结果在2021年6月1日至11月6日期间的1735例德尔塔变异感染病例和2022年1月1日至1月15日期间的32635例无既往感染且未接种疫苗的欧米克隆变异感染病例中,我们确定了985对倾向评分匹配。在三角洲感染人群中,84.2%为轻度,15.7%为中度,0.1%为重度/危重型。感染Omicron的患者中,97.8%为轻度,2.2%为中度,无重症/危重症(P < 0.001)。组粒变异感染(相对于δ)与中度或重度/危重性疾病的几率显著降低相关(调整后的优势比,0.12;95% ci 0.07-0.18)。6-11岁和12-<18岁的患者与6岁以下的患者相比,发生中度或重度/危重性疾病的几率较低(aOR, 95% CI 0.47;6-11岁0.33-0.66;12-<18岁的aOR 0.45, 95% CI 0.21-0.94)。结论从住院率和ICU护理或机械通气的需求来衡量,儿童/青少年Omicron变异感染与Delta变异感染的严重程度较低。6岁至18岁以下儿童的疾病严重程度也低于6岁以下儿童。
{"title":"COVID-19 Disease Severity in Children Infected with the Omicron Variant","authors":"A. Butt, S. Dargham, Srusvin Loka, R. Shaik, H. Chemaitelly, P. Tang, M Zahid Hasan, P. Coyle, H. Yassine, H. Al-Khatib, M. Smatti, A. Kaleeckal, A. Latif, Ahmed Zaqout, M. Almaslamani, A. Al Khal, R. Bertollini, A. Abou-Samra, L. Abu-Raddad","doi":"10.1093/cid/ciac275","DOIUrl":"https://doi.org/10.1093/cid/ciac275","url":null,"abstract":"Abstract Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78460418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina R Paganelli, N. Kassebaum, Kathleen L Strong, P. Suchdev, W. Voskuijl, Q. Bassat, D. Blau, D. Denno
{"title":"Corrigendum to: Guidance for Systematic Integration of Undernutrition in Attributing Cause of Death in Children","authors":"Christina R Paganelli, N. Kassebaum, Kathleen L Strong, P. Suchdev, W. Voskuijl, Q. Bassat, D. Blau, D. Denno","doi":"10.1093/cid/ciac084","DOIUrl":"https://doi.org/10.1093/cid/ciac084","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"35 1","pages":"1891 - 1891"},"PeriodicalIF":0.0,"publicationDate":"2022-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81711203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Gómez-Moyano, S. M. García, M. Ayala-Blanca, F. Oñate, L. Pilar
{"title":"Midline Destructive Lesions in Previously Healthy Adult.","authors":"E. Gómez-Moyano, S. M. García, M. Ayala-Blanca, F. Oñate, L. Pilar","doi":"10.1093/cid/ciz559","DOIUrl":"https://doi.org/10.1093/cid/ciz559","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"23 1","pages":"1257-1259"},"PeriodicalIF":0.0,"publicationDate":"2022-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83945125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Kolodziej, S. V. van Lelyveld, Mildred E Haverkort, R. Mariman, Judith G. C. Sluiter-Post, P. Badoux, E. M. de Koff, Jeffrey C D Koole, W. Miellet, Adriaan N Swart, E. Coipan, A. Meijer, E. Sanders, K. Trzciński, S. Euser, D. Eggink, M. V. van Houten
Abstract Background Understanding the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission is important for adequate infection control measures in this ongoing pandemic. Methods Households were enrolled upon a polymerase chain reaction–confirmed index case between October and December 2020, prior to the coronavirus disease 2019 vaccination program. Saliva samples were obtained by self-sampling at days 1, 3, 5, 7, 10, 14, 21, 28, 35, and 42 from study inclusion. Nasopharyngeal swabs (NPS) and oropharyngeal swabs (OPS) were collected by the research team at day 7 and capillary blood samples at day 42. Household secondary attack rate (SAR) and per-person SAR were calculated based on at least 1 positive saliva, NPS, OPS, or serum sample. Whole genome sequencing was performed to investigate the possibility of multiple independent SARS-CoV-2 introductions within a household. Results Eighty-five households were included consisting of 326 (unvaccinated) individuals. Comparable numbers of secondary cases were identified by saliva (133/241 [55.2%]) and serum (127/213 [59.6%]). The household SAR was 88.2%. The per-person SAR was 64.3%. The majority of the secondary cases tested positive in saliva at day 1 (103/150 [68.7%]). Transmission from index case to household member was not affected by age or the nature of their relationship. Phylogenetic analyses suggested a single introduction for the investigated households. Conclusions Households have a pivotal role in SARS-CoV-2 transmission. By repeated saliva self-sampling combined with NPS, OPS, and serology, we found the highest SARS-CoV-2 household transmission rates reported to date. Salivary (self-) sampling of adults and children is suitable and attractive for near real-time monitoring of SARS-CoV-2 transmission in this setting.
{"title":"High Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Household Transmission Rates Detected by Dense Saliva Sampling","authors":"L. Kolodziej, S. V. van Lelyveld, Mildred E Haverkort, R. Mariman, Judith G. C. Sluiter-Post, P. Badoux, E. M. de Koff, Jeffrey C D Koole, W. Miellet, Adriaan N Swart, E. Coipan, A. Meijer, E. Sanders, K. Trzciński, S. Euser, D. Eggink, M. V. van Houten","doi":"10.1093/cid/ciac261","DOIUrl":"https://doi.org/10.1093/cid/ciac261","url":null,"abstract":"Abstract Background Understanding the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission is important for adequate infection control measures in this ongoing pandemic. Methods Households were enrolled upon a polymerase chain reaction–confirmed index case between October and December 2020, prior to the coronavirus disease 2019 vaccination program. Saliva samples were obtained by self-sampling at days 1, 3, 5, 7, 10, 14, 21, 28, 35, and 42 from study inclusion. Nasopharyngeal swabs (NPS) and oropharyngeal swabs (OPS) were collected by the research team at day 7 and capillary blood samples at day 42. Household secondary attack rate (SAR) and per-person SAR were calculated based on at least 1 positive saliva, NPS, OPS, or serum sample. Whole genome sequencing was performed to investigate the possibility of multiple independent SARS-CoV-2 introductions within a household. Results Eighty-five households were included consisting of 326 (unvaccinated) individuals. Comparable numbers of secondary cases were identified by saliva (133/241 [55.2%]) and serum (127/213 [59.6%]). The household SAR was 88.2%. The per-person SAR was 64.3%. The majority of the secondary cases tested positive in saliva at day 1 (103/150 [68.7%]). Transmission from index case to household member was not affected by age or the nature of their relationship. Phylogenetic analyses suggested a single introduction for the investigated households. Conclusions Households have a pivotal role in SARS-CoV-2 transmission. By repeated saliva self-sampling combined with NPS, OPS, and serology, we found the highest SARS-CoV-2 household transmission rates reported to date. Salivary (self-) sampling of adults and children is suitable and attractive for near real-time monitoring of SARS-CoV-2 transmission in this setting.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"33 1","pages":"e10 - e19"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84621010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Gazit, R. Shlezinger, G. Perez, Roni Lotan, A. Peretz, A. Ben-Tov, E. Herzel, H. Alapi, D. Cohen, K. Muhsen, G. Chodick, T. Patalon
BACKGROUND Waning of protection against infection with SARS-CoV-2 conferred by 2 doses of the BNT162b2 vaccine begins shortly after inoculation and becomes substantial within four months. With that, the impact of prior infection on incident SARS-CoV-2 reinfection is unclear. Therefore, we examined the long-term protection of naturally acquired immunity (protection conferred by previous infection) compared to vaccine-induced immunity. METHODS A retrospective observational study of 124,500 persons, compared two groups: (1) SARS-CoV-2-naïve individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, and (2) previously infected individuals who have not been vaccinated. Two multivariate logistic regression models were applied, evaluating four SARS-CoV-2-related outcomes - infection, symptomatic disease (COVID-19), hospitalization and death - between June 1 to August 14, 2021, when the Delta variant was dominant in Israel. RESULTS SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08-21.11) increased risk for breakthrough infection with the Delta variant compared to unvaccinated-previously-infected individuals, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant for symptomatic disease as well. When allowing the infection to occur at any time between March 2020 to February 2021, evidence of waning naturally acquired immunity was demonstrated, though SARS-CoV-2 naïve vaccinees still had a 5.96-fold (95% CI, 4.85-7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51-9.21) increased risk for symptomatic disease. CONCLUSIONS Naturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity.
{"title":"SARS-CoV-2 Naturally Acquired Immunity vs. Vaccine-induced Immunity, Reinfections versus Breakthrough Infections: a Retrospective Cohort Study.","authors":"S. Gazit, R. Shlezinger, G. Perez, Roni Lotan, A. Peretz, A. Ben-Tov, E. Herzel, H. Alapi, D. Cohen, K. Muhsen, G. Chodick, T. Patalon","doi":"10.1093/cid/ciac262","DOIUrl":"https://doi.org/10.1093/cid/ciac262","url":null,"abstract":"BACKGROUND\u0000Waning of protection against infection with SARS-CoV-2 conferred by 2 doses of the BNT162b2 vaccine begins shortly after inoculation and becomes substantial within four months. With that, the impact of prior infection on incident SARS-CoV-2 reinfection is unclear. Therefore, we examined the long-term protection of naturally acquired immunity (protection conferred by previous infection) compared to vaccine-induced immunity.\u0000\u0000\u0000METHODS\u0000A retrospective observational study of 124,500 persons, compared two groups: (1) SARS-CoV-2-naïve individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, and (2) previously infected individuals who have not been vaccinated. Two multivariate logistic regression models were applied, evaluating four SARS-CoV-2-related outcomes - infection, symptomatic disease (COVID-19), hospitalization and death - between June 1 to August 14, 2021, when the Delta variant was dominant in Israel.\u0000\u0000\u0000RESULTS\u0000SARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08-21.11) increased risk for breakthrough infection with the Delta variant compared to unvaccinated-previously-infected individuals, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant for symptomatic disease as well. When allowing the infection to occur at any time between March 2020 to February 2021, evidence of waning naturally acquired immunity was demonstrated, though SARS-CoV-2 naïve vaccinees still had a 5.96-fold (95% CI, 4.85-7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51-9.21) increased risk for symptomatic disease.\u0000\u0000\u0000CONCLUSIONS\u0000Naturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84929509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}