Pub Date : 2022-03-20DOI: 10.1101/2022.03.17.22272574
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.
{"title":"Maternal Antibody Response and Transplacental Transfer Following SARS-CoV-2 Infection or Vaccination in Pregnancy","authors":"S. Otero, E. Miller, A. Sunderraj, Elisheva D. Shanes, A. Sakowicz, J. Goldstein, L. Mithal","doi":"10.1101/2022.03.17.22272574","DOIUrl":"https://doi.org/10.1101/2022.03.17.22272574","url":null,"abstract":"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.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82198776","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}
K. Turi, T. Gebretsadik, T. Ding, A. Abreo, C. Stone, T. Hartert, Pingsheng Wu
{"title":"Correction to: Dose, Timing, and Spectrum of Prenatal Antibiotic Exposure and Risk of Childhood Asthma.","authors":"K. Turi, T. Gebretsadik, T. Ding, A. Abreo, C. Stone, T. Hartert, Pingsheng Wu","doi":"10.1093/cid/ciac148","DOIUrl":"https://doi.org/10.1093/cid/ciac148","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90231751","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. 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
{"title":"Corrigendum to: Factors Associated With Parental Acceptance of Minimally Invasive Tissue Sampling to Identify the Causes of Stillbirth and Neonatal Death","authors":"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","doi":"10.1093/cid/ciac083","DOIUrl":"https://doi.org/10.1093/cid/ciac083","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72705630","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 : 2022-03-16DOI: 10.1101/2022.03.15.22272229
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.
{"title":"Transmission blocking activity of low dose tafenoquine in healthy volunteers experimentally infected with Plasmodium falciparum","authors":"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","doi":"10.1101/2022.03.15.22272229","DOIUrl":"https://doi.org/10.1101/2022.03.15.22272229","url":null,"abstract":"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.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83360133","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 : 2022-03-13DOI: 10.1101/2022.03.11.22272269
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.
{"title":"Association of frailty, age, and biological sex with SARS-CoV-2 mRNA vaccine-induced immunity in older adults","authors":"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","doi":"10.1101/2022.03.11.22272269","DOIUrl":"https://doi.org/10.1101/2022.03.11.22272269","url":null,"abstract":"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.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77984607","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}
Yaniv Lustig, Ella Mendelson, Michal Mandelboim, Asaf Biber, Einav G Levin, Carmit Cohen, Gili Regev-Yochay, Eli Schwartz
Approximately 1-8% of individuals do not develop antibodies following SARS-CoV-2 infection (sero-negatives). One BNT162b2 dose resulted in potent humoral response in 14 sero-negatives and 15 sero-positives, significantly higher than the response of 15 naïve-individuals, to two doses suggesting that COVID-19 provoked a memory response in individuals without detectable antibodies.
{"title":"Existence of immunological memory response in true sero-negative individuals post COVID-19 molecular diagnosis.","authors":"Yaniv Lustig, Ella Mendelson, Michal Mandelboim, Asaf Biber, Einav G Levin, Carmit Cohen, Gili Regev-Yochay, Eli Schwartz","doi":"10.1093/cid/ciac196","DOIUrl":"10.1093/cid/ciac196","url":null,"abstract":"<p><p>Approximately 1-8% of individuals do not develop antibodies following SARS-CoV-2 infection (sero-negatives). One BNT162b2 dose resulted in potent humoral response in 14 sero-negatives and 15 sero-positives, significantly higher than the response of 15 naïve-individuals, to two doses suggesting that COVID-19 provoked a memory response in individuals without detectable antibodies.</p>","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82315575","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 : 2022-03-10DOI: 10.1101/2022.03.09.22271788
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":null,"pages":null},"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}
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.
{"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":null,"pages":null},"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}
Pub Date : 2022-03-06DOI: 10.1101/2022.03.03.22271803
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).
{"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":null,"pages":null},"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}
{"title":"Examining the robustness of 3ft versus 6ft of physical distancing in schools: a reanalysis of van den Berg et al. (2021).","authors":"Brennan Klein, Daniel A Harris","doi":"10.1093/cid/ciac187","DOIUrl":"https://doi.org/10.1093/cid/ciac187","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73891593","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}
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