ABSTRACT
Background: Limited data exist regarding the immune benefits of fourth COVID-19 vaccine doses in people with HIV (PWH) receiving antiretroviral therapy (ART), particularly given that most have now experienced SARS-CoV-2 infection. We measured the effect of fourth doses on SARS-CoV-2 neutralization in 63 PWH, including 19 SARS-CoV-2-naive and 44 SARS-CoV-2-experienced participants. Method(s): Wild-type (WT)-, Omicron-BA.5 and Omicron-BQ.1-specific neutralization activities were longitudinally quantified using live virus assays up to one month post-fourth vaccine dose. Multiple linear regression was used to investigate the relationship between sociodemographic, health and vaccinerelated variables and SARS-CoV-2 neutralization. Result(s): Participants (54 male;9 female) received monovalent (44%) or bivalent (56%) mRNA fourth doses. In COVID-19-naive PWH, a fourth dose enhanced WT- and BA.5-specific neutralization modestly above three-dose levels (p=0.1). In COVID-19-experienced PWH, a fourth dose enhanced WT neutralization modestly (p=0.1) and BA.5 neutralization significantly (p=0.002). Consistent with the humoral benefits of 'hybrid' immunity, the highest neutralization was observed in COVID-19-experienced PWH after a fourth dose. Of note, PWH with Omicron-era infections exhibited higher WT-specific (p=0.04), but comparable BA.5- or BQ.1-specific neutralization, compared to PWH with pre-Omicron-era infections. Overall, BA.5 neutralization was significantly lower than WT in all participants regardless of COVID-19 experience, and BQ.1 neutralization was significantly lower than BA.5 (all p< 0.0001). In multivariable analyses, fourth dose valency did not significantly affect neutralization magnitude, nor did sex, age nor CD4+ T-cell count (neither recent nor nadir). Rather, an mRNA-1273 fourth dose (versus a BNT162b2 one) was the strongest correlate of WT-specific neutralization, while prior COVID-19, regardless of infection era, was the strongest correlate of BA.5 and BQ.1-specific neutralization post-fourth dose. Conclusion(s): Fourth COVID-19 vaccine doses, irrespective of valency, benefit PWH regardless of prior SARS-CoV-2 infection, but the highest neutralization of Omicron-BA.5 and BQ.1 variants post-fourth dose occurred in PWH with hybrid immunity. These results support existing recommendations that all adults receive a fourth immunization within 6 months of their third vaccine dose (or their most recent SARS-CoV-2 infection). (Figure Presented).
ABSTRACT
Lung transplant recipients (LTR) are at higher risk of developing allograft dysfunction/serious illness following COVID-19 infection. A national lock-down, plus a multi-pronged prevention strategy started early in the COVID-19 pandemic saw only 12 (2%) LTR in our cohort become COVID-19 positive (COV+) till end of 2021. In 2022, end of compulsory lockdowns and the arrival of the omicron variant resulted in a further 204 (33%) LTR becoming COV+. This paper investigates predictors of COVID-19 severity and outcomes in a large LTR cohort. Demographic, COVID treatment and outcome data on all COV+ LTR between Mar 2020- Sept 2022 were collected prospectively. LTR with higher NIH COVID-19 severity (score ≥ 3) were compared to lower severity using logistic regression. 216 from 650 LTR had 224 COV+ infections. Median age was 60yrs, 55% were male, 98% were bilateral LTR. Median time from LTx to COV+ was 5.2yrs (IQR 2.7-10). 193 (85%) had received ≥ 3 COVID vaccines and 38 (17%) evusheld. COVID treatment was commenced within 48hrs in 151 (70%). 42 (19%) COV+ LTR were hospitalized, 8 (4%) admitted to ICU. Only 13/216 (6%) LTR had a COVID severity score ≥ 3, however 8 /13 (62%) of these died- 5 deaths (at mean 11 days) due to COVID pneumonitis, 3 deaths (at mean 61 days), due to COVID complications. Results from logistic regression analysis to determine risk factors for COVID severity are displayed in Table 1. Predictors of COVID severity were increased BMI, chronic kidney disease stage 4/5, <3 vaccinations, and absence of treatment with remdesivir at time of COV+ diagnosis. Surprisingly, age and CLAD diagnosis did not predict a poor outcome. Vaccination prevention and remdesivir treatment proved potent omicron COVID management strategies. In an evolving COVID environment, rapid patient communication tools were critical to optimizing care. Less morbidity and mortality were seen than previously described. Patients with chronic kidney disease and obesity are a high risk cohort that should be targeted in future COVID-19 waves. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Respiratory viruses contribute to chronic lung allograft dysfunction (CLAD). Limited data is available regarding allograft function following COVID-19. We evaluated the effect of COVID-19 on lung function trajectory in Lung Transplant Recipients (LTR). Data was retrospectively collected at our lung transplant (LTx) center on all LTR with confirmed COVID-19 infection between March 2020-Sept 2022. Spirometry was compared pre and post infection. Risk factors for a decline in FEV1 ≥10% were explored with logistic regression. From a cohort of 650 LTR, there were 224 COVID infections in 216 patients. Median age was 60 years, 118 (54%) were male and the majority were bilateral LTR (122, 88%). Median time from LTx to diagnosis was 5.2 years (IQR 2.8-10). At baseline, 187 patients (85%) received > 3 vaccines and 35 (16%) had tixagevimab/ cilgavimab. Anti-viral therapy was given in 190/216 (88%), most commonly remdesevir 93/216 (43%). 42 patients (19%) were hospitalised, 10 (5%) admitted to ICU and direct COVID related mortality was 8/216 (4%). Pre and post lung function was available on 144 patients. Median time from baseline spirometry to COVID-19 was 2.7 months and 2.2 months post COVID-19. There was a small but statistically significant decline in forced expiratory volume in 1 second (FEV1) post COVID-19, with a median drop of 0.05L (2% decline;IQR -5.6-1.8%, p<0.001);(Figure 1). A ≥10% decline in FEV1 occurred in 24/144 patients (17%) and an increase in FEV1 of >10% occurred in 6/151 (3%) of patients. Baseline demographics, lung function, disease severity, vaccination status and treatment type were not associated with a ≥10% decline in FEV1. In COVID optimized LTR with subsequent infection, the majority had mild disease. Reassuringly, most had stable lung function 2 months post infection. A small proportion had a decline in FEV1 of >10%, but there were no discernible risk factors to predict the decline. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The SARS-CoV-2 pandemic has highlighted the weaknesses of relying on single-use mask and respirator personal protective equipment (PPE) and the global supply chain that supports this market. There have been no major innovations in filter technology for PPE in the past two decades. Non-woven textiles used for filtering PPE are single-use products in the healthcare environment; use and protection is focused on preventing infection from airborne or aerosolized pathogens such as Influenza A virus or SARS-CoV-2. Recently, C-H bond activation under mild and controllable conditions was reported for crosslinking commodity aliphatic polymers such as polyethylene and polypropylene. Significantly, these are the same types of polymers used in PPE filtration systems. In this report, we take advantage of this C-H insertion method to covalently attach a photosensitizing zinc-porphyrin to the surface of a melt-blow non-woven textile filter material. With the photosensitizer covalently attached to the surface of the textile, illumination with visible light was expected to produce oxidizing 1O2/ROS at the surface of the material that would result in pathogen inactivation. The filter was tested for its ability to inactivate Influenza A virus, an enveloped RNA virus similar to SARS-CoV-2, over a period of four hours with illumination of high intensity visible light. The photosensitizer-functionalized polypropylene filter inactivated our model virus by 99.99% in comparison to a control.