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Maternal Antibody Response and Transplacental Transfer Following SARS-CoV-2 Infection or Vaccination in Pregnancy 妊娠期SARS-CoV-2感染或疫苗接种后母体抗体反应与胎盘移植
S. Otero, E. Miller, A. Sunderraj, Elisheva D. Shanes, A. Sakowicz, J. Goldstein, L. Mithal
Background: Pregnant persons are at increased risk of severe COVID-19 and adverse obstetric outcomes. Understanding maternal antibody response and transplacental transfer after SARS-CoV-2 infection and COVID-19 vaccination is important to inform public health recommendations. Methods: This prospective observational cohort study included 351 birthing individuals who had SARS-CoV-2 infection or COVID-19 vaccination during pregnancy. IgG and IgM to SARS-CoV-2 S1 receptor binding domain were measured in maternal and cord blood. Antibody levels and transplacental transfer ratios were compared across 1) disease severity for those with SARS-CoV-2 infection and 2) infection versus vaccination. Findings: There were 252 individuals with SARS-CoV-2 infection and 99 who received COVID-19 vaccination during pregnancy. Birthing people with more severe SARS-CoV-2 infection category had higher maternal and cord blood IgG levels (p=0.0001, p=0.0001). Median IgG transfer ratio was 0.87-1.2. Maternal and cord blood IgG were higher after vaccination than infection (p=0.001, p=0.001). Transfer ratio was higher after 90 days in the vaccinated group (p<0.001). Modeling showed higher amplitude and half-life of maternal IgG following vaccination (p<0.0001). There were no significant differences by fetal sex. Interpretation: COVID-19 vaccination in pregnancy leads to higher and longer lasting maternal IgG levels, higher cord blood IgG, and higher transfer ratio after 90 days compared to SARS-CoV-2 infection. Greater infection severity leads to higher maternal and cord blood antibodies. Maternal IgG decreases over time following both vaccination and infection, reinforcing the importance of vaccination, even after infection, and vaccine boosters for pregnant patients.
背景:孕妇患严重COVID-19和不良产科结局的风险增加。了解SARS-CoV-2感染和COVID-19疫苗接种后母体抗体反应和胎盘转移对公共卫生建议具有重要意义。方法:本前瞻性观察队列研究纳入了351例怀孕期间感染SARS-CoV-2或接种COVID-19疫苗的分娩个体。检测母血和脐带血中SARS-CoV-2 S1受体结合域IgG和IgM。比较了抗体水平和胎盘移植比率:1)感染SARS-CoV-2患者的疾病严重程度;2)感染与接种疫苗。结果:有252人感染了SARS-CoV-2, 99人在怀孕期间接种了COVID-19疫苗。SARS-CoV-2感染类型越严重的产妇,其母体和脐带血IgG水平越高(p=0.0001, p=0.0001)。IgG传递比中位数为0.87-1.2。接种疫苗后母体和脐带血IgG高于感染后(p=0.001, p=0.001)。接种组90 d后转移率较高(p<0.001)。模型显示接种疫苗后母体IgG的振幅和半衰期更高(p<0.0001)。胎儿性别差异无统计学意义。解释:与SARS-CoV-2感染相比,妊娠期接种COVID-19疫苗导致母体IgG水平更高且持续时间更长,脐带血IgG水平更高,90天后转运率更高。感染严重程度越高,母体和脐带血抗体越高。在接种疫苗和感染后,母体IgG会随着时间的推移而降低,这就加强了接种疫苗的重要性,即使在感染后也是如此。
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引用次数: 1
Correction to: Dose, Timing, and Spectrum of Prenatal Antibiotic Exposure and Risk of Childhood Asthma. 修正:剂量、时间和产前抗生素暴露与儿童哮喘风险的谱。
K. Turi, T. Gebretsadik, T. Ding, A. Abreo, C. Stone, T. Hartert, Pingsheng Wu
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引用次数: 2
Corrigendum to: Factors Associated With Parental Acceptance of Minimally Invasive Tissue Sampling to Identify the Causes of Stillbirth and Neonatal Death 与父母接受微创组织取样以确定死产和新生儿死亡原因相关的因素的更正
S. S. Tikmani, S. Saleem, Janet L Moore, Sayyeda Reza, Guruprasad Gowder, S. Dhaded, S. Yogeshkumar, S. Goudar, V. Kulkarni, Sunil Kumar, A. Aceituno, Lindsay M. Parlberg, E. Mcclure, Robert L Goldenberg
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引用次数: 0
Transmission blocking activity of low dose tafenoquine in healthy volunteers experimentally infected with Plasmodium falciparum 低剂量他非诺喹在实验感染恶性疟原虫的健康志愿者中的传播阻断活性
Rebecca Webster, H. Mitchell, J. Peters, J. Heunis, Brighid O'Neill, J. Gower, Sean A Lynch, Helen Jennings, F. Amante, S. Llewellyn, L. Marquart, A. Potter, G. Birrell, M. Edstein, G. Dennis Shanks, J. McCarthy, Bridget E. Barber
Background Blocking the transmission of parasites from humans to mosquitoes is a key component of malaria control. Tafenoquine exhibits activity against all stages of the malaria parasite and may have utility as a transmission blocking agent. We aimed to characterize the transmission blocking activity of low dose tafenoquine. Methods Healthy adults were inoculated with P. falciparum 3D7-infected erythrocytes on day 0. Piperaquine was administered on days 9 and 11 to clear asexual parasitemia while allowing gametocyte development. A single 50 mg oral dose of tafenoquine was administered on day 25. Transmission was determined by enriched membrane feeding assays pre-dose and at 1, 4 and 7 days post-dose. Artemether-lumefantrine was administered following the final assay. Outcomes were the reduction in mosquito infection and gametocytemia post-tafenoquine, and safety parameters. Results Six participants were enrolled, and all were infective to mosquitoes pre-tafenoquine, with a median 86% (range: 22-98) of mosquitoes positive for oocysts and 57% (range: 4-92) positive for sporozoites. By day 4 post-tafenoquine, the oocyst and sporozoite positivity rate had reduced by a median 35% (IQR: 16-46) and 52% (IQR: 40-62), respectively, and by day 7, 81% (IQR 36-92) and 77% (IQR 52-98), respectively. The decline in gametocyte density post-tafenoquine was not significant. No significant participant safety concerns were identified. Conclusion Low dose tafenoquine reduces P. falciparum transmission to mosquitoes, with a delay in effect. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12620000995976). Funding QIMR Berghofer Medical Research Institute.
阻断寄生虫从人向蚊子的传播是疟疾控制的一个关键组成部分。他非诺喹对疟疾寄生虫的所有阶段都有活性,可能有作为传播阻断剂的效用。我们的目的是表征低剂量他非诺喹的传播阻断活性。方法健康成人于第0天接种恶性疟原虫3d7感染红细胞。在第9天和第11天给予哌喹以清除无性寄生虫,同时允许配子细胞发育。第25天给予单次50 mg口服他非诺喹。在给药前和给药后1、4和7天通过富膜饲养试验测定传播率。最终测定后给予蒿甲醚-氨苯曲明。结果是使用他非诺喹后蚊子感染和配子细胞减少,安全性参数提高。结果6例受试者均对他非诺喹使用前感染,卵囊阳性的中位数为86%(范围22 ~ 98),孢子虫阳性的中位数为57%(范围4 ~ 92)。在他非诺喹治疗后第4天,卵囊和孢子子阳性率分别下降了35% (IQR: 16-46)和52% (IQR: 40-62),到第7天,卵囊和孢子子阳性率分别下降了81% (IQR: 36-92)和77% (IQR: 52-98)。他非诺喹后配子细胞密度下降不显著。没有发现明显的参与者安全问题。结论低剂量他非诺喹降低了恶性疟原虫在蚊虫中的传播,且有延迟效应。试验注册澳大利亚新西兰临床试验注册中心(ACTRN12620000995976)。资助QIMR伯格霍夫医学研究所。
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引用次数: 3
Association of frailty, age, and biological sex with SARS-CoV-2 mRNA vaccine-induced immunity in older adults 老年人体弱、年龄和生理性别与SARS-CoV-2 mRNA疫苗诱导免疫的关系
J. Shapiro, I. Sitaras, Han-sol Park, T. Aytenfisu, Christopher A. Caputo, Maggie Li, John Lee, T. Johnston, Huifen Li, C. Wouters, P. Hauk, H. Jacobsen, Yukang Li, Engle Abrams, Steve Yoon, Andrew J. Kocot, Tianrui Yang, Yushu Huang, S. Cramer, M. Betenbaugh, A. Debes, Rosemary Morgan, A. Milstone, A. Karaba, A. Pekosz, S. Leng, S. Klein
Background: Male sex and old age are risk factors for severe COVID-19, but the intersection of sex and aging on antibody responses to SARS-CoV-2 vaccines has not been characterized. Methods: Plasma samples were collected from older adults (75-98 years) before and after three doses of SARS-CoV-2 mRNA vaccination, and from younger adults (18-74 years) post-dose two, for comparison. Antibody binding to SARS-CoV-2 antigens (spike protein [S], S-receptor binding domain [S-RBD], and nucleocapsid [N]) and functional activity against S were measured against the vaccine virus and variants of concern (VOC). Results: Vaccination induced greater antibody titers in older females than males, with both age and frailty associated with reduced antibody responses to vaccine antigens in males, but not females. ACE2 binding inhibition declined more than anti-S or anti-S-RBD IgG in the six months following the second dose (28-fold vs. 12- and 11-fold decreases in titer). The third dose restored functional antibody responses and eliminated disparities caused by sex, age, and frailty in older adults. Responses to the VOC were significantly reduced relative to the vaccine virus, with older males having lower titers to the VOC than females. Older adults had lower responses to the vaccine and VOC viruses than younger adults, with disparities being greater in males than females. Conclusion: Older and frail males may be more vulnerable to breakthrough infections due to low antibody responses before receipt of a third vaccine dose. Promoting third dose coverage in older adults, especially males, is crucial to protecting this vulnerable population.
背景:男性和年龄是重症COVID-19的危险因素,但性别和年龄对SARS-CoV-2疫苗抗体反应的影响尚未明确。方法:收集老年人(75-98岁)在三剂SARS-CoV-2 mRNA疫苗接种前后的血浆样本,以及年轻人(18-74岁)接种两剂后的血浆样本进行比较。测定了SARS-CoV-2抗原(刺突蛋白[S]、S受体结合域[S- rbd]和核衣壳[N])的抗体结合以及对S的功能活性。结果:接种疫苗诱导老年女性的抗体滴度高于男性,年龄和虚弱与男性对疫苗抗原的抗体反应降低有关,但与女性无关。在第二次剂量后的6个月内,ACE2结合抑制比抗s或抗s - rbd IgG下降更多(滴度下降28倍,比12倍和11倍)。第三剂恢复了功能性抗体反应,消除了老年人因性别、年龄和虚弱引起的差异。相对于疫苗病毒,对挥发性有机化合物的反应显著降低,年龄较大的男性对挥发性有机化合物的滴度低于女性。老年人对疫苗和挥发性有机化合物病毒的反应低于年轻人,男性比女性的差异更大。结论:年老体弱的男性在接受第三剂疫苗之前,由于抗体反应较低,可能更容易受到突破性感染。促进老年人,特别是男性老年人的第三剂覆盖对于保护这一脆弱人群至关重要。
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引用次数: 11
Comparison of influenza and COVID-19–associated hospitalizations among children < 18 years old in the United States—FluSurv-NET (October–April 2017–2021) and COVID-NET (October 2020–September 2021) 美国18岁以下儿童流感和covid -19相关住院的比较- flusurv - net(2017-2021年10月- 4月)和COVID-NET(2020年10月- 2021年9月)
M. Delahoy, D. Ujamaa, Christopher Taylor, C. Cummings, O. Anglin, R. Holstein, J. Milucky, A. O’Halloran, Kadam Patel, H. Pham, M. Whitaker, A. Reingold, S. Chai, N. Alden, Breanna Kawasaki, J. Meek, K. Yousey-Hindes, E. Anderson, K. Openo, Andrew Weigel, Kenzie Teno, L. Reeg, Lauren Leegwater, R. Lynfield, M. Mcmahon, S. Ropp, Dominic Rudin, A. Muse, N. Spina, N. Bennett, Kevin Popham, L. Billing, E. Shiltz, M. Sutton, A. Thomas, W. Schaffner, H. Talbot, M. Crossland, Keegan McCaffrey, A. Hall, Erin Burns, M. McMorrow, C. Reed, F. Havers, S. Garg
Background: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. Methods: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. Results: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p<0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p=0.28). Conclusions: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.
背景:流感病毒和SARS-CoV-2是儿童呼吸道疾病的重要病因。方法:通过fluurv - net和COVID-NET这两个集水区和方法相似的人群监测系统,分析18岁以下儿童流感和covid -19相关住院情况。将正在进行的COVID-19大流行期间(2020年10月1日至2021年9月30日)的年度COVID-19相关住院率与2017-18至2019-20流感季节的流感相关住院率进行比较。比较住院结果,包括重症监护病房(ICU)入院和死亡。结果:在<18岁儿童中,新冠肺炎相关住院率(48.2)高于流感相关住院率:2017-18年(33.5)、2018-19年(33.8)和2019-20年(41.7)。12-17岁青少年与COVID-19相关的住院率较高(COVID-19: 59.9;流感范围:12.2-14.1),但5-11岁儿童的范围相似或更低(COVID-19: 25.0;流感范围:24.3-31.7)和0-4 (COVID-19: 66.8;感冒范围:70.9-91.5岁。在<18岁的儿童中,与流感相比,COVID-19需要ICU住院的比例更高(26.4% vs 21.6%;p < 0.01)。在与COVID-19和流感相关的住院期间,儿科死亡都不常见(0.7% vs 0.5%;p = 0.28)。结论:在COVID-19大流行期间采取广泛缓解措施的情况下,与COVID-19大流行前的三个季节相比,2020-2021年期间青少年与COVID-19相关的年度住院率较高,12岁以下儿童的住院率相似或更低。COVID-19大大增加了由流感和其他呼吸道病毒引起的儿科住院和严重后果的现有负担。
{"title":"Comparison of influenza and COVID-19–associated hospitalizations among children < 18 years old in the United States—FluSurv-NET (October–April 2017–2021) and COVID-NET (October 2020–September 2021)","authors":"M. Delahoy, D. Ujamaa, Christopher Taylor, C. Cummings, O. Anglin, R. Holstein, J. Milucky, A. O’Halloran, Kadam Patel, H. Pham, M. Whitaker, A. Reingold, S. Chai, N. Alden, Breanna Kawasaki, J. Meek, K. Yousey-Hindes, E. Anderson, K. Openo, Andrew Weigel, Kenzie Teno, L. Reeg, Lauren Leegwater, R. Lynfield, M. Mcmahon, S. Ropp, Dominic Rudin, A. Muse, N. Spina, N. Bennett, Kevin Popham, L. Billing, E. Shiltz, M. Sutton, A. Thomas, W. Schaffner, H. Talbot, M. Crossland, Keegan McCaffrey, A. Hall, Erin Burns, M. McMorrow, C. Reed, F. Havers, S. Garg","doi":"10.1101/2022.03.09.22271788","DOIUrl":"https://doi.org/10.1101/2022.03.09.22271788","url":null,"abstract":"Background: Influenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. Methods: Influenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. Results: Among children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p<0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p=0.28). Conclusions: In the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses.","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":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77865304","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}
引用次数: 14
Reduced immune response to inactivated SARS-CoV-2 vaccine in a cohort of immunocompromised patients in Chile 智利免疫功能低下患者对灭活SARS-CoV-2疫苗的免疫反应降低
M. Balcells, N. Le Corre, J. Durán, M. Ceballos, C. Vizcaya, S. Mondaca, Martin J. Dib, R. Rabagliati, M. Sarmiento, Paula I. Burgos, M. Espinoza, M. Ferres, C. Martínez-Valdebenito, Cinthya Ruiz-Tagle, Catalina Ortiz, P. Ross, Sigall Budnik, S. Solari, María de Los Ángeles Vizcaya, H. Lembach, R. Berríos-Rojas, Felipe Melo-González, M. Ríos, A. Kalergis, S. Bueno, B. Nervi
Abstract Background Inactivated SARS-CoV-2 vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with five different immunocompromising conditions and 67 controls, receiving two doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Chile. Neutralizing antibodies (NAb) positivity, total anti-SARS-CoV-2 IgG antibodies (TAb) concentration, and T cell response were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% (p<0.0001) and 5.7% (p<0.0001) in the solid organ transplant (SOT) group, 41.5% (p<0.0001) and 19.2% (p<0.0001) in the autoimmune rheumatic diseases group, 43.3% (p=0.0002) and 21.4% (p=0.0013) in the cancer patients with solid tumors group, 45.5% (p<0.0001) and 28.7% (p=0.0006) in the HIV infected group, 64.3% (p=n.s.) and 56.6% (p=n.s.) in the hematopoietic stem cell transplantation (HSCT) group, respectively. TAb seropositivity was also lower for the SOT (20.6%, p<0.0001), rheumatic diseases (61%, p=0.0001) and HIV groups (70.9%, p=0.0032), compared to control group (92.3%). On the other hand, the number of IFN-y Spot Forming T Cells specific for SARS-CoV-2 tended to be lower but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest a boosting vaccination strategy should be considered in these vulnerable patients.
背景灭活SARS-CoV-2疫苗已在中低收入国家广泛实施。然而,免疫功能低下患者的免疫原性尚未确定。在此,我们旨在评估这些患者对CoronaVac疫苗的免疫反应。该前瞻性队列研究包括193名患有5种不同免疫功能低下疾病的参与者和67名对照组,在入组前8-12周接受两剂CoronaVac治疗。该研究于2021年5月至8月在智利的Red de Salud UC-CHRISTUS进行。检测中和抗体(NAb)阳性、抗sars - cov -2 IgG抗体(TAb)总浓度及T细胞应答。结果NAb阳性和中位中和活性在对照组分别为83.1%和51.2%,而实体器官移植(SOT)组分别为20.6% (p<0.0001)和5.7% (p<0.0001),自身免疫性风湿病组分别为41.5% (p<0.0001)和19.2% (p<0.0001),癌症合并实体瘤组分别为43.3% (p=0.0002)和21.4% (p=0.0013), HIV感染组分别为45.5% (p<0.0001)和28.7% (p=0.0006)。造血干细胞移植(HSCT)组分别为64.3% (p= 0.05)和56.6% (p= 0.05)。SOT组(20.6%,p<0.0001)、风湿病组(61%,p=0.0001)和HIV组(70.9%,p=0.0032) TAb血清阳性也低于对照组(92.3%)。另一方面,SARS-CoV-2特异性IFN-y斑点形成T细胞的数量趋于减少,但组间差异不显著。结论不同的免疫损害条件显著降低了冠状病毒疫苗的体液应答。这些发现表明,在这些易感患者中应考虑加强疫苗接种策略。
{"title":"Reduced immune response to inactivated SARS-CoV-2 vaccine in a cohort of immunocompromised patients in Chile","authors":"M. Balcells, N. Le Corre, J. Durán, M. Ceballos, C. Vizcaya, S. Mondaca, Martin J. Dib, R. Rabagliati, M. Sarmiento, Paula I. Burgos, M. Espinoza, M. Ferres, C. Martínez-Valdebenito, Cinthya Ruiz-Tagle, Catalina Ortiz, P. Ross, Sigall Budnik, S. Solari, María de Los Ángeles Vizcaya, H. Lembach, R. Berríos-Rojas, Felipe Melo-González, M. Ríos, A. Kalergis, S. Bueno, B. Nervi","doi":"10.1093/cid/ciac167","DOIUrl":"https://doi.org/10.1093/cid/ciac167","url":null,"abstract":"Abstract Background Inactivated SARS-CoV-2 vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with five different immunocompromising conditions and 67 controls, receiving two doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Chile. Neutralizing antibodies (NAb) positivity, total anti-SARS-CoV-2 IgG antibodies (TAb) concentration, and T cell response were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% (p<0.0001) and 5.7% (p<0.0001) in the solid organ transplant (SOT) group, 41.5% (p<0.0001) and 19.2% (p<0.0001) in the autoimmune rheumatic diseases group, 43.3% (p=0.0002) and 21.4% (p=0.0013) in the cancer patients with solid tumors group, 45.5% (p<0.0001) and 28.7% (p=0.0006) in the HIV infected group, 64.3% (p=n.s.) and 56.6% (p=n.s.) in the hematopoietic stem cell transplantation (HSCT) group, respectively. TAb seropositivity was also lower for the SOT (20.6%, p<0.0001), rheumatic diseases (61%, p=0.0001) and HIV groups (70.9%, p=0.0032), compared to control group (92.3%). On the other hand, the number of IFN-y Spot Forming T Cells specific for SARS-CoV-2 tended to be lower but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest a boosting vaccination strategy should be considered in these vulnerable patients.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85673873","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}
引用次数: 23
Testing Frequency Matters | An Evaluation of the Diagnostic Performance of a SARS-CoV-2 Rapid Antigen Test in United States Correctional Facilities 检测频率至关重要美国教养所SARS-CoV-2快速抗原检测诊断效果评价
M. Lind, Olivia Schultes, Alexander J Robertson, A. Houde, D. Cummings, A. Ko, B. Kennedy, R. P. Richeson
Abstract Background: The CDC recommends serial rapid antigen assay collection within congregate facilities for screening and outbreak testing. Though modeling and observational studies from community and long-term care facilities have shown serial collection provides adequate sensitivity and specificity, the diagnostic accuracy of this testing strategy within correctional facilities remains unknown. Methods: Using Connecticut Department of Corrections (DOC) data from November 21st 2020 to June 15th 2021, we estimated the accuracy of a rapid assay, BinaxNOW, under three collection strategies, a single test in isolation and two and three serial tests separated by 1-4 day intervals. Diagnostic accuracy metrics were estimated in relation to RT-PCRs collected within one day before the first or after the last included rapid antigen tests in a series. Results: Of the 17,669 residents who contributed at least one RT-PCR or rapid antigen during the study period, 3,979 contributed [≥]1 paired rapid antigen test series. In relation to RT-PCR, the three-rapid antigen test strategy had a sensitivity of 89.6% (95% confidence intervals: 86.1-92.6%) and specificity of 97.2% (CI: 95.1-98.3%). The sensitivities for two and one-rapid antigen test strategy were 75.2% and 52.8%, respectively, and the specificities were 98.5% and 99.4%, respectively. The sensitivity was higher among symptomatic residents and when the RT-PCR was collected before the rapid antigen tests. Conclusions: We found the serial collection of an antigen test resulted in high diagnostic accuracy. These findings support serial testing within correctional facilities for outbreak investigation, screening, and when rapid detection is required (such as intakes or transfers).
背景:美国疾病控制与预防中心建议在聚集设施内进行连续快速抗原检测,以进行筛查和疫情检测。虽然来自社区和长期护理机构的建模和观察研究表明,连续收集提供了足够的敏感性和特异性,但这种测试策略在惩教机构中的诊断准确性仍然未知。方法:利用2020年11月21日至2021年6月15日康涅狄格州惩正局(DOC)的数据,我们评估了快速检测方法BinaxNOW在三种收集策略下的准确性,即单次分离检测和两次和三次间隔1-4天的连续检测。在第一次或最后一次快速抗原检测后一天内收集的rt - pcr诊断准确性指标进行了估计。结果:在研究期间,17669名至少提供了一种RT-PCR或快速抗原的居民中,3979名提供了[≥]1对快速抗原检测系列。与RT-PCR相比,三速抗原检测策略的敏感性为89.6%(95%置信区间:86.1-92.6%),特异性为97.2% (CI: 95.1-98.3%)。两种快速抗原检测策略的敏感性分别为75.2%和52.8%,特异性分别为98.5%和99.4%。有症状的居民和在快速抗原检测前收集RT-PCR时敏感性较高。结论:我们发现连续收集抗原检测结果可提高诊断准确性。这些发现支持在惩教设施内进行系列检测,以进行疫情调查、筛查,并在需要快速检测时(如收容或转移)。
{"title":"Testing Frequency Matters | An Evaluation of the Diagnostic Performance of a SARS-CoV-2 Rapid Antigen Test in United States Correctional Facilities","authors":"M. Lind, Olivia Schultes, Alexander J Robertson, A. Houde, D. Cummings, A. Ko, B. Kennedy, R. P. Richeson","doi":"10.1101/2022.03.03.22271803","DOIUrl":"https://doi.org/10.1101/2022.03.03.22271803","url":null,"abstract":"Abstract Background: The CDC recommends serial rapid antigen assay collection within congregate facilities for screening and outbreak testing. Though modeling and observational studies from community and long-term care facilities have shown serial collection provides adequate sensitivity and specificity, the diagnostic accuracy of this testing strategy within correctional facilities remains unknown. Methods: Using Connecticut Department of Corrections (DOC) data from November 21st 2020 to June 15th 2021, we estimated the accuracy of a rapid assay, BinaxNOW, under three collection strategies, a single test in isolation and two and three serial tests separated by 1-4 day intervals. Diagnostic accuracy metrics were estimated in relation to RT-PCRs collected within one day before the first or after the last included rapid antigen tests in a series. Results: Of the 17,669 residents who contributed at least one RT-PCR or rapid antigen during the study period, 3,979 contributed [≥]1 paired rapid antigen test series. In relation to RT-PCR, the three-rapid antigen test strategy had a sensitivity of 89.6% (95% confidence intervals: 86.1-92.6%) and specificity of 97.2% (CI: 95.1-98.3%). The sensitivities for two and one-rapid antigen test strategy were 75.2% and 52.8%, respectively, and the specificities were 98.5% and 99.4%, respectively. The sensitivity was higher among symptomatic residents and when the RT-PCR was collected before the rapid antigen tests. Conclusions: We found the serial collection of an antigen test resulted in high diagnostic accuracy. These findings support serial testing within correctional facilities for outbreak investigation, screening, and when rapid detection is required (such as intakes or transfers).","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78970712","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}
引用次数: 1
Examining the robustness of 3ft versus 6ft of physical distancing in schools: a reanalysis of van den Berg et al. (2021). 检查学校3英尺与6英尺物理距离的稳健性:van den Berg等人(2021)的再分析。
Brennan Klein, Daniel A Harris
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引用次数: 0
The Nicaraguan Pediatric Influenza Cohort Study, 2011-2019: influenza incidence, seasonality, and transmission 尼加拉瓜儿童流感队列研究,2011-2019:流感发病率、季节性和传播
Hannah E Maier, G. Kuan, L. Gresh, G. Chowell, K. Bakker, R. López, N. Sanchez, Brenda López, Amy J Schiller, S. Ojeda, E. Harris, A. Balmaseda, A. Gordon
Background. Children account for a large portion of global influenza burden and transmission, and a better understanding of influenza in children is needed to improve prevention and control strategies. Methods. To examine the incidence and transmission of influenza we conducted a prospective community-based study of children aged 0-14 years in Managua, Nicaragua between 2011 and 2019. Participants were provided with medical care through study physicians and symptomatic influenza was confirmed by RT-PCR. Wavelet analyses were used to examine seasonality. Generalized growth models (GGMs) were used to estimate effective reproduction numbers. Results. From 2011-2019, 3,016 children participated, with an average of ~1,800 participants per year and median follow-up time of 5 years per child, and 48.3% of the cohort in 2019 had been enrolled their entire lives. The overall incidence rates per 100 person-years were 14.5 symptomatic influenza cases (95%CI: 13.9-15.1) and 1.0 influenza-associated ALRI case (95%CI: 0.8-1.1). Symptomatic influenza incidence peaked at age 9-11 months. Infants born during peak influenza circulation had lower incidence in the first year of their lives. The mean effective reproduction number was 1.2 (range 1.02-1.49), and we observed significant annual patterns for influenza and influenza A, and a 2.5-year period for influenza B. Conclusions. This study provides important information for understanding influenza epidemiology and informing influenza vaccine policy. These results will aid in informing strategies to reduce the burden of influenza.
背景。儿童占全球流感负担和传播的很大一部分,需要更好地了解儿童流感,以改进预防和控制战略。方法。为了检查流感的发病率和传播,我们在2011年至2019年期间对尼加拉瓜马那瓜0-14岁儿童进行了一项前瞻性社区研究。研究医生为参与者提供医疗护理,并通过RT-PCR证实有症状的流感。小波分析用于检验季节性。使用广义生长模型(GGMs)估计有效繁殖数。结果。从2011年到2019年,共有3016名儿童参与,平均每年约1800名参与者,每个儿童的中位随访时间为5年,2019年队列中48.3%的儿童终身参与。每100人年的总发病率为14.5例有症状的流感病例(95%CI: 13.9-15.1)和1.0例流感相关的ALRI病例(95%CI: 0.8-1.1)。有症状的流感发病率在9-11个月大时达到高峰。在流感流行高峰期出生的婴儿在其生命的第一年发病率较低。平均有效繁殖数为1.2(范围1.02-1.49),我们观察到流感和甲型流感的年周期显著,乙型流感的周期为2.5年。本研究为了解流感流行病学和制定流感疫苗政策提供了重要信息。这些结果将有助于为减轻流感负担的战略提供信息。
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引用次数: 6
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Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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