George Shirreff, Sandra S. Chaves, Laurent Coudeville, Beatriz Mengual-Chuliá, Ainara Mira-Iglesias, Joan Puig-Barberà, Alejandro Orrico-Sanchez, Javier Díez-Domingo, Valencia Hospital Surveillance Network for the Study of Influenza and Other Respiratory Viruses (VAHNSI), Lulla Opatowski, F. Xavier Lopez-Labrador
Background
Respiratory viruses are known to represent a high burden in winter, yet the seasonality of many viruses remains poorly understood. Better knowledge of co-circulation and interaction between viruses is critical to prevention and management. We use > 10-year active surveillance in the Valencia Region to assess seasonality and co-circulation.
Methods
Over 2010–2021, samples from patients hospitalised for acute respiratory illness were analysed using multiplex real-time PCR to test for 9 viruses: influenza, respiratory syncytial virus (RSV), parainfluenza virus (PIV), rhino/enteroviruses (HRV/ENV), metapneumovirus (MPV), bocavirus, adenovirus, SARS-CoV-2 and non-SARS coronaviruses (HCoV). Winter seasonal patterns of incidence were examined. Instances of co-detection of multiple viruses in a sample were analysed and compared with expected values under a crude model of independent circulation.
Results
Most viruses exhibited consistent patterns between years. Specifically, RSV and influenza seasons were clearly defined, peaking in December–February, as did HCoV and SARS-CoV-2. MPV, PIV and HRV/ENV showed less clear seasonality, with circulation outside the observed period. All viruses circulated in January, suggesting any pair had opportunity for co-infection. Multiple viruses were found in 4% of patients, with more common co-detection in children under 5 (9%) than older ages. Influenza co-detection was generally observed infrequently relative to expectation, while RSV co-detections were more common, particularly among young children.
Conclusions
We identify characteristic patterns of viruses associated with acute respiratory hospitalisation during winter. Simultaneous circulation permits extensive co-detection of viruses, particularly in young children. However, virus combinations appear to differ in their rates of co-detection, meriting further study.
{"title":"Seasonality and Co-Detection of Respiratory Viral Infections Among Hospitalised Patients Admitted With Acute Respiratory Illness—Valencia Region, Spain, 2010–2021","authors":"George Shirreff, Sandra S. Chaves, Laurent Coudeville, Beatriz Mengual-Chuliá, Ainara Mira-Iglesias, Joan Puig-Barberà, Alejandro Orrico-Sanchez, Javier Díez-Domingo, Valencia Hospital Surveillance Network for the Study of Influenza and Other Respiratory Viruses (VAHNSI), Lulla Opatowski, F. Xavier Lopez-Labrador","doi":"10.1111/irv.70017","DOIUrl":"10.1111/irv.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory viruses are known to represent a high burden in winter, yet the seasonality of many viruses remains poorly understood. Better knowledge of co-circulation and interaction between viruses is critical to prevention and management. We use > 10-year active surveillance in the Valencia Region to assess seasonality and co-circulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Over 2010–2021, samples from patients hospitalised for acute respiratory illness were analysed using multiplex real-time PCR to test for 9 viruses: influenza, respiratory syncytial virus (RSV), parainfluenza virus (PIV), rhino/enteroviruses (HRV/ENV), metapneumovirus (MPV), bocavirus, adenovirus, SARS-CoV-2 and non-SARS coronaviruses (HCoV). Winter seasonal patterns of incidence were examined. Instances of co-detection of multiple viruses in a sample were analysed and compared with expected values under a crude model of independent circulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most viruses exhibited consistent patterns between years. Specifically, RSV and influenza seasons were clearly defined, peaking in December–February, as did HCoV and SARS-CoV-2. MPV, PIV and HRV/ENV showed less clear seasonality, with circulation outside the observed period. All viruses circulated in January, suggesting any pair had opportunity for co-infection. Multiple viruses were found in 4% of patients, with more common co-detection in children under 5 (9%) than older ages. Influenza co-detection was generally observed infrequently relative to expectation, while RSV co-detections were more common, particularly among young children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We identify characteristic patterns of viruses associated with acute respiratory hospitalisation during winter. Simultaneous circulation permits extensive co-detection of viruses, particularly in young children. However, virus combinations appear to differ in their rates of co-detection, meriting further study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ousseny Zerbo, Julius Timbol, John R. Hansen, Kristin Goddard, Evan Layefsky, Pat Ross, Bruce Fireman, Dao Nguyen, Tara L. Greenhow, Nicola P. Klein
Objectives
The aim of this study is to determine the incidence and risk factors associated with COVID-19 hospitalization among unvaccinated children.
Methods
Children aged 0– < 18 years, members of Kaiser Permanente Northern California (KPNC), were followed from March 1, 2020, until the earliest occurrence of: chart-confirmed COVID-19 hospitalization, disenrollment from KPNC, age 18 years, receipt of COVID-19 vaccine, death, or study end (December 31, 2022). We calculated the incidence rate of hospitalization by SARS-CoV-2 variant period and by age group. We determined risk factors for hospitalization using Poisson regression. We also conducted descriptive analyses of hospitalized cases.
Results
Among 1,107,799 children, 423 were hospitalized for COVID-19 during follow-up. The incidence of hospitalization increased with each new SARS-CoV-2 variant and was highest among children aged < 6 months. Among the < 6-month-olds, the incidence rate per 100,000 person-months was 7 during predelta, 13.3 during delta, and 22.4 during omicron. Black (RR = 2.05, 95% CI: 1.33–3.16) and Hispanic children (RR = 1.82, 95% CI: 1.34–2.46) and children with any comorbidities were at high risk of hospitalization (RR = 3.81, 95% CI: 2.94–4.95). Overall, 20.3% of hospitalized children were admitted to an intensive care unit (ICU), but ICU admission was 36.1% among 12– < 18-year-olds. The majority of ICU admits (91.8%) had no comorbidities.
Conclusion
Children too young to be vaccinated had the highest incidence of COVID-19 hospitalization, while adolescents had the highest proportion of ICU admissions. To prevent severe disease in children and adolescents, everyone eligible should be vaccinated.
{"title":"Incidence and Risk of Coronavirus Disease 2019 Hospitalization Among Unvaccinated Children","authors":"Ousseny Zerbo, Julius Timbol, John R. Hansen, Kristin Goddard, Evan Layefsky, Pat Ross, Bruce Fireman, Dao Nguyen, Tara L. Greenhow, Nicola P. Klein","doi":"10.1111/irv.70022","DOIUrl":"10.1111/irv.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study is to determine the incidence and risk factors associated with COVID-19 hospitalization among unvaccinated children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children aged 0– < 18 years, members of Kaiser Permanente Northern California (KPNC), were followed from March 1, 2020, until the earliest occurrence of: chart-confirmed COVID-19 hospitalization, disenrollment from KPNC, age 18 years, receipt of COVID-19 vaccine, death, or study end (December 31, 2022). We calculated the incidence rate of hospitalization by SARS-CoV-2 variant period and by age group. We determined risk factors for hospitalization using Poisson regression. We also conducted descriptive analyses of hospitalized cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,107,799 children, 423 were hospitalized for COVID-19 during follow-up. The incidence of hospitalization increased with each new SARS-CoV-2 variant and was highest among children aged < 6 months. Among the < 6-month-olds, the incidence rate per 100,000 person-months was 7 during predelta, 13.3 during delta, and 22.4 during omicron. Black (RR = 2.05, 95% CI: 1.33–3.16) and Hispanic children (RR = 1.82, 95% CI: 1.34–2.46) and children with any comorbidities were at high risk of hospitalization (RR = 3.81, 95% CI: 2.94–4.95). Overall, 20.3% of hospitalized children were admitted to an intensive care unit (ICU), but ICU admission was 36.1% among 12– < 18-year-olds. The majority of ICU admits (91.8%) had no comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children too young to be vaccinated had the highest incidence of COVID-19 hospitalization, while adolescents had the highest proportion of ICU admissions. To prevent severe disease in children and adolescents, everyone eligible should be vaccinated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simeon Lisovski, Anne Günther, Meagan Dewar, David Ainley, Fabián Aldunate, Rodrigo Arce, Grant Ballard, Silke Bauer, Josabel Belliure, Ashley C. Banyard, Thierry Boulinier, Ashley Bennison, Christina Braun, Craig Cary, Paulo Catry, Augustin Clessin, Maelle Connan, Edna Correia, Aidan Cox, Juan Cristina, Megan Elrod, Julia Emerit, Irene Ferreiro, Zoe Fowler, Amandine Gamble, José P. Granadeiro, Joaquin Hurtado, Dennis Jongsomjit, Célia Lesage, Mathilde Lejeune, Amanda Kuepfer, Amélie Lescroël, Amy Li, Ian R. McDonald, Javier Menéndez-Blázquez, Virginia Morandini, Gonzalo Moratorio, Teresa Militão, Pilar Moreno, Paula Perbolianachis, Jean Pennycook, Maryam Raslan, Scott M. Reid, Roanna Richards-Babbage, Annie E. Schmidt, Martha Maria Sander, Lucy Smyth, Alvaro Soutullo, Andrew Stanworth, Léo Streith, Jérémy Tornos, Arvind Varsani, Ulrike Herzschuh, Martin Beer, Michelle Wille
The current highly pathogenic avian influenza H5N1 panzootic is having substantial impacts on wild birds and marine mammals. Following major and widespread outbreaks in South America, an incursion to Antarctica occurred late in the austral summer of 2023/2024 and was confined to the region of the Antarctic Peninsula. To infer potential underlying processes, we compiled H5N1 surveillance data from Antarctica and sub-Antarctic Islands prior to the first confirmed cases.
{"title":"Unexpected Delayed Incursion of Highly Pathogenic Avian Influenza H5N1 (Clade 2.3.4.4b) Into the Antarctic Region","authors":"Simeon Lisovski, Anne Günther, Meagan Dewar, David Ainley, Fabián Aldunate, Rodrigo Arce, Grant Ballard, Silke Bauer, Josabel Belliure, Ashley C. Banyard, Thierry Boulinier, Ashley Bennison, Christina Braun, Craig Cary, Paulo Catry, Augustin Clessin, Maelle Connan, Edna Correia, Aidan Cox, Juan Cristina, Megan Elrod, Julia Emerit, Irene Ferreiro, Zoe Fowler, Amandine Gamble, José P. Granadeiro, Joaquin Hurtado, Dennis Jongsomjit, Célia Lesage, Mathilde Lejeune, Amanda Kuepfer, Amélie Lescroël, Amy Li, Ian R. McDonald, Javier Menéndez-Blázquez, Virginia Morandini, Gonzalo Moratorio, Teresa Militão, Pilar Moreno, Paula Perbolianachis, Jean Pennycook, Maryam Raslan, Scott M. Reid, Roanna Richards-Babbage, Annie E. Schmidt, Martha Maria Sander, Lucy Smyth, Alvaro Soutullo, Andrew Stanworth, Léo Streith, Jérémy Tornos, Arvind Varsani, Ulrike Herzschuh, Martin Beer, Michelle Wille","doi":"10.1111/irv.70010","DOIUrl":"https://doi.org/10.1111/irv.70010","url":null,"abstract":"<p>The current highly pathogenic avian influenza H5N1 panzootic is having substantial impacts on wild birds and marine mammals. Following major and widespread outbreaks in South America, an incursion to Antarctica occurred late in the austral summer of 2023/2024 and was confined to the region of the Antarctic Peninsula. To infer potential underlying processes, we compiled H5N1 surveillance data from Antarctica and sub-Antarctic Islands prior to the first confirmed cases.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florian Krammer, Jacqueline M. Katz, Othmar G. Engelhardt, Diane J. Post, Paul C. Roberts, Sheena G. Sullivan, S. Mark Tompkins, Christopher Chiu, Stacey Schultz-Cherry, Rebecca Jane Cox
Background
This report summarizes the discussions and conclusions from the “Correlates of Protection for Next Generation Influenza Vaccines: Lessons Learned from the COVID-19 Pandemic” meeting, which took place in Seattle, USA, from March 1, 2023, to March 3, 2023.
Conclusions
Discussions around influenza virus correlates of protection and their use continued from where the discussion had been left off in 2019. While there was not much progress in the influenza field itself, many lessons learned during the coronavirus disease 2019 (COVID-19) pandemic, especially the importance of mucosal immunity, were discussed and can directly be applied to influenza correlates of protection.
{"title":"Meeting Report From “Correlates of Protection for Next Generation Influenza Vaccines: Lessons Learned From the COVID-19 Pandemic”","authors":"Florian Krammer, Jacqueline M. Katz, Othmar G. Engelhardt, Diane J. Post, Paul C. Roberts, Sheena G. Sullivan, S. Mark Tompkins, Christopher Chiu, Stacey Schultz-Cherry, Rebecca Jane Cox","doi":"10.1111/irv.13314","DOIUrl":"10.1111/irv.13314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This report summarizes the discussions and conclusions from the “Correlates of Protection for Next Generation Influenza Vaccines: Lessons Learned from the COVID-19 Pandemic” meeting, which took place in Seattle, USA, from March 1, 2023, to March 3, 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Discussions around influenza virus correlates of protection and their use continued from where the discussion had been left off in 2019. While there was not much progress in the influenza field itself, many lessons learned during the coronavirus disease 2019 (COVID-19) pandemic, especially the importance of mucosal immunity, were discussed and can directly be applied to influenza correlates of protection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hye Won Jeong, Rare Rollon, Se-Mi Kim, Juryeon Gil, Mark Anthony Casel, Hyunwoo Jang, Jeong Ho Choi, Seung-Gyu Jang, Josea Carmel Lazarte, Hee-Sung Kim, Jun Hyoung Kim, Young Ki Choi
Background
Omicron variants have rapidly diversified into sublineages with mutations that enhance immune evasion, posing challenges for vaccination and antibody responses. This study aimed to compare serum cross-neutralizing antibody responses against various SARS-CoV-2 Omicron sublineages (BA.1, BA.5, XBB.1.17.1, FK.1.1, and JN.1) in recipients of monovalent COVID-19 boosters, bivalent booster recipients, and individuals who had recovered from Omicron BA.5 infections.
Methods
We conducted a micro-neutralization assay on serum samples from monovalent BNT162b2 booster recipients (N = 54), bivalent BNT162b2 booster recipients (N = 24), and SARS-CoV-2 Omicron BA.5-recovered individuals (N = 13). The history of SARS-CoV-2 Omicron infection was assessed using ELISA against the SARS-CoV-2 NP protein.
Results
Bivalent booster recipients exhibited significantly enhanced neutralization efficacy against Omicron sublineages compared to those who had received monovalent booster vaccinations. Omicron BA.5-recovered individuals displayed similar neutralizing antibodies (NAbs) to the bivalent booster recipients. Despite the improved neutralization in bivalent recipients and BA.5-recovered individuals, there were limitations in neutralization against the recently emerged Omicron subvariants: XBB.1.17.1 FK.1.1, and JN.1. In both monovalent and bivalent booster recipients, a history of Omicron breakthrough infection was associated with relatively higher geometric mean titers of NAbs against Omicron BA.1, BA.5, and XBB.1.17.1 variants.
Conclusion
This study underscores the intricate interplay between vaccination strategies, immune imprinting, and the dynamic landscape of SARS-CoV-2 variants. Although bivalent boosters enhance neutralization, addressing the challenge of emerging sublineages like XBB.1.17.1, FK.1.1, and JN.1 may necessitate the development of tailored vaccines, underscoring the need for ongoing adaptation to effectively combat this highly mutable virus.
{"title":"Enhancing Omicron Sublineage Neutralization: Insights From Bivalent and Monovalent COVID-19 Booster Vaccines and Recent SARS-CoV-2 Omicron Variant Infections","authors":"Hye Won Jeong, Rare Rollon, Se-Mi Kim, Juryeon Gil, Mark Anthony Casel, Hyunwoo Jang, Jeong Ho Choi, Seung-Gyu Jang, Josea Carmel Lazarte, Hee-Sung Kim, Jun Hyoung Kim, Young Ki Choi","doi":"10.1111/irv.70000","DOIUrl":"10.1111/irv.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Omicron variants have rapidly diversified into sublineages with mutations that enhance immune evasion, posing challenges for vaccination and antibody responses. This study aimed to compare serum cross-neutralizing antibody responses against various SARS-CoV-2 Omicron sublineages (BA.1, BA.5, XBB.1.17.1, FK.1.1, and JN.1) in recipients of monovalent COVID-19 boosters, bivalent booster recipients, and individuals who had recovered from Omicron BA.5 infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a micro-neutralization assay on serum samples from monovalent BNT162b2 booster recipients (<i>N</i> = 54), bivalent BNT162b2 booster recipients (<i>N</i> = 24), and SARS-CoV-2 Omicron BA.5-recovered individuals (<i>N</i> = 13). The history of SARS-CoV-2 Omicron infection was assessed using ELISA against the SARS-CoV-2 NP protein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bivalent booster recipients exhibited significantly enhanced neutralization efficacy against Omicron sublineages compared to those who had received monovalent booster vaccinations. Omicron BA.5-recovered individuals displayed similar neutralizing antibodies (NAbs) to the bivalent booster recipients. Despite the improved neutralization in bivalent recipients and BA.5-recovered individuals, there were limitations in neutralization against the recently emerged Omicron subvariants: XBB.1.17.1 FK.1.1, and JN.1. In both monovalent and bivalent booster recipients, a history of Omicron breakthrough infection was associated with relatively higher geometric mean titers of NAbs against Omicron BA.1, BA.5, and XBB.1.17.1 variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the intricate interplay between vaccination strategies, immune imprinting, and the dynamic landscape of SARS-CoV-2 variants. Although bivalent boosters enhance neutralization, addressing the challenge of emerging sublineages like XBB.1.17.1, FK.1.1, and JN.1 may necessitate the development of tailored vaccines, underscoring the need for ongoing adaptation to effectively combat this highly mutable virus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiam Chemaitelly, Houssein H. Ayoub, Peter Coyle, Patrick Tang, Mohammad R. Hasan, Hadi M. Yassine, Asmaa A. Al Thani, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul-Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al-Kuwari, Adeel A. Butt, Hamad Eid Al-Romaihi, Mohamed H. Al-Thani, Abdullatif Al-Khal, Roberto Bertollini, Laith J. Abu-Raddad
Background
This study provides a head-to-head comparison of the protection provided by the BNT162b2 and mRNA-1273 vaccines against SARS-CoV-2 infection and against severe COVID-19, covering primary series and third dose/booster vaccinations over up to 3 years of follow-up, both before and after the emergence of the omicron variant.
Methods
Two national, matched, retrospective cohort studies were conducted on Qatar's vaccinated population from December 16, 2020, to February 18, 2024. Subgroup analyses by pre-vaccination SARS-CoV-2 infection history, as well as sensitivity analyses, were also conducted.
Results
The adjusted hazard ratio (AHR) comparing infection incidence in those vaccinated with BNT162b2 versus mRNA-1273 was 1.03 (95% CI: 1.02–1.05) after the primary series and 1.11 (95% CI: 1.09–1.13) after the third (booster) dose. The corresponding AHRs for any severe, critical, or fatal COVID-19 were 1.31 (95% CI: 0.81–2.11) and 1.00 (95% CI: 0.20–4.94), respectively. Subgroup analyses by prior infection status hinted at a dose-dependent immune imprinting effect, where a combination of two types of immunity, pre-omicron and omicron, offered greater protection against infection than one type alone, with this effect being amplified by the higher antigen dose of mRNA-1273 compared to BNT162b2. Sensitivity analyses confirmed the study findings.
Conclusions
BNT162b2 provided slightly less protection against infection than mRNA-1273 following both primary series and booster vaccinations while offering comparable protection against severe COVID-19 outcomes. The findings suggested that the vaccine antigen dose in interaction with infection history may determine the extent of immune protection against infection.
{"title":"BNT162b2 Versus mRNA-1273 Vaccines: Comparative Analysis of Long-Term Protection Against SARS-CoV-2 Infection and Severe COVID-19 in Qatar","authors":"Hiam Chemaitelly, Houssein H. Ayoub, Peter Coyle, Patrick Tang, Mohammad R. Hasan, Hadi M. Yassine, Asmaa A. Al Thani, Zaina Al-Kanaani, Einas Al-Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul-Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al-Kuwari, Adeel A. Butt, Hamad Eid Al-Romaihi, Mohamed H. Al-Thani, Abdullatif Al-Khal, Roberto Bertollini, Laith J. Abu-Raddad","doi":"10.1111/irv.13357","DOIUrl":"10.1111/irv.13357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study provides a head-to-head comparison of the protection provided by the BNT162b2 and mRNA-1273 vaccines against SARS-CoV-2 infection and against severe COVID-19, covering primary series and third dose/booster vaccinations over up to 3 years of follow-up, both before and after the emergence of the omicron variant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two national, matched, retrospective cohort studies were conducted on Qatar's vaccinated population from December 16, 2020, to February 18, 2024. Subgroup analyses by pre-vaccination SARS-CoV-2 infection history, as well as sensitivity analyses, were also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The adjusted hazard ratio (AHR) comparing infection incidence in those vaccinated with BNT162b2 versus mRNA-1273 was 1.03 (95% CI: 1.02–1.05) after the primary series and 1.11 (95% CI: 1.09–1.13) after the third (booster) dose. The corresponding AHRs for any severe, critical, or fatal COVID-19 were 1.31 (95% CI: 0.81–2.11) and 1.00 (95% CI: 0.20–4.94), respectively. Subgroup analyses by prior infection status hinted at a dose-dependent immune imprinting effect, where a combination of two types of immunity, pre-omicron and omicron, offered greater protection against infection than one type alone, with this effect being amplified by the higher antigen dose of mRNA-1273 compared to BNT162b2. Sensitivity analyses confirmed the study findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BNT162b2 provided slightly less protection against infection than mRNA-1273 following both primary series and booster vaccinations while offering comparable protection against severe COVID-19 outcomes. The findings suggested that the vaccine antigen dose in interaction with infection history may determine the extent of immune protection against infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.13357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fariha Binte Hossain, David Muscatello, Sanjay Jayasinghe, Bette Liu
Background
Vaccine-preventable respiratory infections impact on healthcare systems globally. Despite availability of vaccines, fluctuations in vaccination rates, pathogen virulence and community transmission dynamics mean that these respiratory infections continue to pose substantial public health risks. To understand trends in vaccine-preventable respiratory infections, we analysed linked data from emergency department (ED), hospitalisations and deaths in New South Wales, Australia, from 2012 to 2022.
Methods
ED presentations with respiratory infection like illness were linked to hospitalisation and death records. Age-standardised rates of ED presentations, proportions subsequently hospitalised for acute respiratory infection (ARI) and specific vaccine-preventable disease diagnoses and 28-day mortality rates were estimated by year and age.
Results
From 2012 to 2022, there were 3,127,090 ARI-like ED presentations. Age-standardised rates increased until 2020, declined in 2021 and rebounded in 2022. Across all years, of these ARI-like ED presentations, 16.6% were hospitalised for acute respiratory infections, including pneumonia (7.9%), influenza (1.1%), RSV disease (1.3%), COVID-19 (0.8%) and pneumococcal disease (0.3%). Proportions hospitalised were highest in those aged 65+ years, except for RSV, which was highest in children aged 0–4 years. The highest 28-day mortality post-ARI-like ED presentation was observed with COVID-19 in adults aged 65+ years at 13.1%.
Conclusions
This study highlights the continuing burden of vaccine-preventable respiratory infections on an Australian healthcare system. These data can be used to monitor the effectiveness of vaccination programmes and other public health interventions. Future efforts should focus on enhancing surveillance and data linkage to improve precision and guide targeted public health strategies.
{"title":"Trends in Hospitalisations for Vaccine Preventable Respiratory Infections Following Emergency Department Presentations in New South Wales, Australia, 2012–2022","authors":"Fariha Binte Hossain, David Muscatello, Sanjay Jayasinghe, Bette Liu","doi":"10.1111/irv.70015","DOIUrl":"https://doi.org/10.1111/irv.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vaccine-preventable respiratory infections impact on healthcare systems globally. Despite availability of vaccines, fluctuations in vaccination rates, pathogen virulence and community transmission dynamics mean that these respiratory infections continue to pose substantial public health risks. To understand trends in vaccine-preventable respiratory infections, we analysed linked data from emergency department (ED), hospitalisations and deaths in New South Wales, Australia, from 2012 to 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ED presentations with respiratory infection like illness were linked to hospitalisation and death records. Age-standardised rates of ED presentations, proportions subsequently hospitalised for acute respiratory infection (ARI) and specific vaccine-preventable disease diagnoses and 28-day mortality rates were estimated by year and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2012 to 2022, there were 3,127,090 ARI-like ED presentations. Age-standardised rates increased until 2020, declined in 2021 and rebounded in 2022. Across all years, of these ARI-like ED presentations, 16.6% were hospitalised for acute respiratory infections, including pneumonia (7.9%), influenza (1.1%), RSV disease (1.3%), COVID-19 (0.8%) and pneumococcal disease (0.3%). Proportions hospitalised were highest in those aged 65+ years, except for RSV, which was highest in children aged 0–4 years. The highest 28-day mortality post-ARI-like ED presentation was observed with COVID-19 in adults aged 65+ years at 13.1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the continuing burden of vaccine-preventable respiratory infections on an Australian healthcare system. These data can be used to monitor the effectiveness of vaccination programmes and other public health interventions. Future efforts should focus on enhancing surveillance and data linkage to improve precision and guide targeted public health strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 10","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashish C. Shrestha, Emma Field, Dharshi Thangarajah, Ross Andrews, Robert S. Ware, Stephen B. Lambert
Background
In 2022, publicly funded influenza vaccine was made available to all residents of Queensland, Australia. This study compared influenza epidemiology in 2022 with previous years (2017–2021) and estimated influenza vaccine effectiveness (VE) during 2022.
Methods
The study involved a descriptive analysis of influenza notifications and a case–control study to estimate VE. Cases were notifications of laboratory-confirmed influenza, and controls were individuals who were test negative for COVID-19. Cases and controls were matched on age, postcode and specimen collection date. VE against hospitalisation was investigated by matching hospitalised cases to controls. Conditional logistic regression models were adjusted for sex.
Results
In 2022, Queensland experienced an early influenza season onset (April–May) and high case numbers (n = 45,311), compared to the previous 5 years (annual average: 29,364) and 2020–2021 (2020:6047; 2021:301) during the COVID-19 pandemic. Adjusted VE (VEadj) against laboratory-confirmed influenza was 39% (95% confidence interval [CI]: 37–41), highest for children aged 30 months to < 5 years (61%, 95% CI: 49–70) and lowest for adults aged ≥ 65 years (24%, 95% CI: 17–30). VEadj against influenza-associated hospitalisation was 54% (95% CI: 48–59). Among children < 9 years of age, VEadj against laboratory-confirmed influenza (55%, 95% CI: 49–61) and hospitalisation (67%, 95% CI: 39–82) was higher in those who received a complete dose schedule.
Conclusion
In Queensland, the 2022 influenza season started earlier than the previous 5 years. VE against influenza notifications varied across age groups. VE estimates against influenza-associated hospitalisation were higher than those against laboratory-confirmed influenza.
{"title":"Influenza Epidemiology and Vaccine Effectiveness Following Funded Influenza Vaccine in Queensland, Australia, 2022","authors":"Ashish C. Shrestha, Emma Field, Dharshi Thangarajah, Ross Andrews, Robert S. Ware, Stephen B. Lambert","doi":"10.1111/irv.70007","DOIUrl":"https://doi.org/10.1111/irv.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In 2022, publicly funded influenza vaccine was made available to all residents of Queensland, Australia. This study compared influenza epidemiology in 2022 with previous years (2017–2021) and estimated influenza vaccine effectiveness (VE) during 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study involved a descriptive analysis of influenza notifications and a case–control study to estimate VE. Cases were notifications of laboratory-confirmed influenza, and controls were individuals who were test negative for COVID-19. Cases and controls were matched on age, postcode and specimen collection date. VE against hospitalisation was investigated by matching hospitalised cases to controls. Conditional logistic regression models were adjusted for sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2022, Queensland experienced an early influenza season onset (April–May) and high case numbers (<i>n</i> = 45,311), compared to the previous 5 years (annual average: 29,364) and 2020–2021 (2020:6047; 2021:301) during the COVID-19 pandemic. Adjusted VE (VE<sub>ad</sub>j) against laboratory-confirmed influenza was 39% (95% confidence interval [CI]: 37–41), highest for children aged 30 months to < 5 years (61%, 95% CI: 49–70) and lowest for adults aged ≥ 65 years (24%, 95% CI: 17–30). VE<sub>adj</sub> against influenza-associated hospitalisation was 54% (95% CI: 48–59). Among children < 9 years of age, VE<sub>adj</sub> against laboratory-confirmed influenza (55%, 95% CI: 49–61) and hospitalisation (67%, 95% CI: 39–82) was higher in those who received a complete dose schedule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In Queensland, the 2022 influenza season started earlier than the previous 5 years. VE against influenza notifications varied across age groups. VE estimates against influenza-associated hospitalisation were higher than those against laboratory-confirmed influenza.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 9","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Osei-Yeboah, Stephen Amankwah, Elizabeth Begier, Miranda Adedze, Franklin Nyanzu, Pious Appiah, Jochebed Ode Boakye Ansah, Harry Campbell, Reiko Sato, Luis Jodar, Bradford D. Gessner, Harish Nair
Background
Older adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalization, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalization and case fatality.
Methods
The study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE, and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted.
Results
Of 18,690 studies screened, 32 were selected for full-text review, and 20 were included. Overall, the number of NCH residents ranged from 42 to 1459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7% to 47.6% and annual incidence ranged from 0.5% to 14%. Case fatality rates ranged from 7.7% to 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4582 (95% CI: 3259–6264) and 4785 (95% CI: 2258–10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3040 (95% CI: 1986–4454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190–10,000) and 1104 (95% CI: 350–1930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5.
Conclusion
Data on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalization, and high mortality. Preventive interventions, such as vaccination, should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents.
{"title":"Burden of Respiratory Syncytial Virus (RSV) Infection Among Adults in Nursing and Care Homes: A Systematic Review","authors":"Richard Osei-Yeboah, Stephen Amankwah, Elizabeth Begier, Miranda Adedze, Franklin Nyanzu, Pious Appiah, Jochebed Ode Boakye Ansah, Harry Campbell, Reiko Sato, Luis Jodar, Bradford D. Gessner, Harish Nair","doi":"10.1111/irv.70008","DOIUrl":"https://doi.org/10.1111/irv.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalization, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalization and case fatality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE, and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 18,690 studies screened, 32 were selected for full-text review, and 20 were included. Overall, the number of NCH residents ranged from 42 to 1459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7% to 47.6% and annual incidence ranged from 0.5% to 14%. Case fatality rates ranged from 7.7% to 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4582 (95% CI: 3259–6264) and 4785 (95% CI: 2258–10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3040 (95% CI: 1986–4454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190–10,000) and 1104 (95% CI: 350–1930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Data on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalization, and high mortality. Preventive interventions, such as vaccination, should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 9","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is still a lack of clinical evidence comprehensively evaluating the effectiveness of antiviral treatments for COVID-19 hospitalized patients.
Methods
A retrospective cohort study was conducted at Beijing You'An Hospital, focusing on patients treated with nirmatrelvir/ritonavir or azvudine. The study employed a tripartite analysis—viral dynamics, survival curve analysis, and AI-based radiological analysis of pulmonary CT images—aiming to assess the severity of pneumonia.
Results
Of 370 patients treated with either nirmatrelvir/ritonavir or azvudine as monotherapy, those in the nirmatrelvir/ritonavir group experienced faster viral clearance than those treated with azvudine (5.4 days vs. 8.4 days, p < 0.001). No significant differences were observed in the survival curves between the two drug groups. AI-based radiological analysis revealed that patients in the nirmatrelvir group had more severe pneumonia conditions (infection ratio is 11.1 vs. 5.35, p = 0.007). Patients with an infection ratio higher than 9.2 had nearly three times the mortality rate compared to those with an infection ratio lower than 9.2.
Conclusions
Our study suggests that in real-world studies regarding hospitalized patients with COVID-19 pneumonia, the antiviral effect of nirmatrelvir/ritonavir is significantly superior to azvudine, but the choice of antiviral agents is not necessarily linked to clinical outcomes; the severity of pneumonia at admission is the most important factor to determine prognosis. Additionally, our findings indicate that pulmonary AI imaging analysis can be a powerful tool for predicting patient prognosis and guiding clinical decision-making.
引言 目前仍缺乏全面评估 COVID-19 住院患者抗病毒治疗效果的临床证据。 方法 北京佑安医院开展了一项回顾性队列研究，主要针对接受尼马瑞韦/利托那韦或阿兹夫定治疗的患者。研究采用了三方面的分析方法--病毒动态分析、生存曲线分析和基于人工智能的肺部 CT 图像放射学分析，旨在评估肺炎的严重程度。 结果 在接受奈瑞韦酯/利托那韦或阿兹夫定单药治疗的 370 名患者中，奈瑞韦酯/利托那韦组患者的病毒清除速度快于阿兹夫定组患者（5.4 天 vs. 8.4 天，p < 0.001）。两组患者的生存曲线没有明显差异。基于 AI 的放射学分析显示，尼马瑞韦组患者的肺炎病情更为严重（感染比为 11.1 vs. 5.35，p = 0.007）。感染比高于 9.2 的患者死亡率是感染比低于 9.2 的患者死亡率的近三倍。 结论 我们的研究表明，在有关 COVID-19 肺炎住院患者的真实世界研究中，奈瑞韦/利托那韦的抗病毒效果明显优于阿兹夫定，但抗病毒药物的选择与临床预后没有必然联系；入院时肺炎的严重程度是决定预后的最重要因素。此外，我们的研究结果表明，肺部 AI 成像分析可以成为预测患者预后和指导临床决策的有力工具。
{"title":"Antiviral Effectiveness, Clinical Outcomes, and Artificial Intelligence Imaging Analysis for Hospitalized COVID-19 Patients Receiving Antivirals","authors":"Yuan Gao, Yixi Dong, Qiushi Bu, Zhijie Gong, Wei Wang, Zhongkai Zhou, Yunyi Gao, Liwei Liu, Menghua Wu, Jiaying Zhang, Lianchun Liang, Hongjun Li, Mengxi Jiang, Zujin Luo, Yingmin Ma, Xinyu Zhang, Zhongjie Hu","doi":"10.1111/irv.70006","DOIUrl":"https://doi.org/10.1111/irv.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is still a lack of clinical evidence comprehensively evaluating the effectiveness of antiviral treatments for COVID-19 hospitalized patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted at Beijing You'An Hospital, focusing on patients treated with nirmatrelvir/ritonavir or azvudine. The study employed a tripartite analysis—viral dynamics, survival curve analysis, and AI-based radiological analysis of pulmonary CT images—aiming to assess the severity of pneumonia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 370 patients treated with either nirmatrelvir/ritonavir or azvudine as monotherapy, those in the nirmatrelvir/ritonavir group experienced faster viral clearance than those treated with azvudine (5.4 days vs. 8.4 days, <i>p</i> < 0.001). No significant differences were observed in the survival curves between the two drug groups. AI-based radiological analysis revealed that patients in the nirmatrelvir group had more severe pneumonia conditions (infection ratio is 11.1 vs. 5.35, <i>p</i> = 0.007). Patients with an infection ratio higher than 9.2 had nearly three times the mortality rate compared to those with an infection ratio lower than 9.2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study suggests that in real-world studies regarding hospitalized patients with COVID-19 pneumonia, the antiviral effect of nirmatrelvir/ritonavir is significantly superior to azvudine, but the choice of antiviral agents is not necessarily linked to clinical outcomes; the severity of pneumonia at admission is the most important factor to determine prognosis. Additionally, our findings indicate that pulmonary AI imaging analysis can be a powerful tool for predicting patient prognosis and guiding clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 9","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142234701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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