XBB.1.5 Spike Protein COVID-19 Vaccine Induces Broadly Neutralizing and Cellular Immune Responses Against EG.5.1 and Emerging XBB Variants (preprint)

Monovalent SARS-CoV-2 Prototype (Wuhan-Hu-1) and bivalent (Prototype + BA.4/5) COVID-19 vaccines have demonstrated a waning of vaccine-mediated immunity highlighted by lower neutralizing antibody responses against SARS-CoV-2 Omicron XBB sub-variants. The reduction of humoral immunity due to the rapid evolution of SARS-CoV-2 has signaled the need for an update to vaccine composition. A strain change for all authorized/approved vaccines to a monovalent composition with Omicron subvariant XBB.1.5 has been supported by the WHO, EMA, and FDA. Here, we demonstrate that immunization with a monovalent recombinant spike protein COVID-19 vaccine (Novavax, Inc.) based on the subvariant XBB.1.5 induces cross-neutralizing antibodies against XBB.1.5, XBB.1.16, XBB.2.3, EG.5.1, and XBB.1.16.6 subvariants, promotes higher pseudovirus neutralizing antibody titers than bivalent (Prototype + XBB.1.5) vaccine, induces SARS-CoV-2 spike-specific Th1-biased CD4+ T-cell responses against XBB subvariants, and robustly boosts antibody responses in mice and nonhuman primates primed with a variety of monovalent and bivalent vaccines. Together, these data support updating the Novavax vaccine to a monovalent XBB.1.5 formulation for the 2023-2024 COVID-19 vaccination campaign.

An increased pretreatment neutrophil-to-lymphocyte ratio predicts severe novel coronavirus-infected pneumonia (preprint)

Objective The aim of this study was to identify early warning signs for severe novel coronavirus-infected pneumonia (COVID-19).Methods We retrospectively analyzed the clinical data of 90 patients with COVID-19 at the Guanggu District of Hubei Women and Children Medical and Healthcare Center comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. Logistic regression analysis was performed to identify the independent risk factors that predicted severe COVID-19. The receiver-operating characteristic (ROC) curve of independent risk factors was calculated, and the area under the curve (AUC) was used to evaluate the efficiency of the prediction of severe COVID-19.Results The patients with mild and severe COVID-19 showed significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and the serum albumin (ALB) level (P<0.05). The severity of COVID-19 was correlated positively with the comorbidity of cancer, age, NLR, and CRP but was negatively correlated with the ALB level (P<0.05). Multivariate logistic regression analysis showed that the NLR and ALB level were independent risk factors for severe COVID-19 (OR=1.319, 95% CI: 1.043-1.669, P=0.021; OR=0.739, 95% CI: 0.616-0.886, P=0.001), with AUCs of 0.851 and 0.128, respectively. An NLR of 4.939 corresponded to the maximum joint sensitivity and specificity according to the ROC curve (0.700 and 0.917, respectively).Conclusion An increased NLR can serve as an early warning sign of severe COVID-19.

Increased pretreatment C-reactive protein-to-albumin ratio predicts severe coronavirus disease 2019 (preprint)

Objective The aim of this study was to identify early warning signs for severe coronavirus disease 2019 (COVID-19). Methods We retrospectively analysed the clinical data of 90 patients with COVID-19 from Guanggu District of Hubei Women and Children Medical and Healthcare Center, comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. The cutoff values were determined by receiver operating characteristic curve analysis. Logistic regression analysis was performed to identify the independent risk factors for severe COVID-19. Results The patients with mild and severe COVID-19 had significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), and pretreatment C-reactive protein-to-albumin ratio (CAR) ( P =0.000; P =0.008; P=0.000; P =0.000). The severity of COVID-19 was positively correlated with comorbid cancer, age, NLR, and CAR ( P <0.005). Multivariate logistic regression analysis showed that age, the NLR and the CAR were independent risk factors for severe COVID-19 (OR=1.086, P =0.008; OR=1.512, P =0.007; OR=17.652, P =0.001). Conclusion An increased CAR can serve as an early warning sign of severe COVID-19 in conjunction with the NLR and age.