Sero-survey on Long-term Care Facility Residents Reveals Increased Risk of Sub-optimal Antibody Response to BNT162B2: Implications for Breakthrough Prevention (preprint)

Background: The impact of coronavirus disease 2019 caused by Severe Acute Respiratory Syndrome Coronavirus 2 on hosts of Long Term Care Facilities (LTCFs) has been dramatic at global scale as aging and comorbitities pose individuals at increased risk of severe disease and death. Methods: Aim of this study was to evaluate SARS-CoV-2 S-IgG antibodies titers in 478 residents and 649 health care workers of the largest Italian nurse facility two months after the complete vaccination with BNT162B2. Associations among host-related factors and predictors of humoral response were investigated. Results: By stratifying levels of humoral responses, we found that 62.1%, 21.6%, 12.1% and 4.2% of hosts has high (>1,000 BAU/ml), medium (101-1,000), low (1-100) and null (<1 BAU/mL) S-IgG titers, respectively. Hosts with previous COVID-19 and those with SARS-CoV-2 N-IgG positive serology showed higher level of serological response (p<0.001 and p<0.001, respectively), while the administration of corticosteroid or cancer diminished all levels of specific antibodies (p=0.019 and p=0.004). Significant associations were observed for these parameters in those with suboptimal response (p<0.001, p<0.001, p=0.028 and p=0.005) and with a null one (p=0.005, p<0.001 and p=0.039). Predictors of an increased risk of null response were advanced age, corticosteroid therapy and diabetes mellitus (p=0.025, p=0.017 and p=0.037). In contrast, previous diagnosis of COVID-19 resulted strongly associated with a reduced risk of null response to vaccination (p<0.001). Conclusions: SARS-CoV-2 specific antibodies in elderly individuals need to be measured to consider a third dose of vaccine after mass vaccination for prevention of reinfections in LTCFs despite the maintenance of barrier measures.

Is There a Relationship Between Climate, Morphology and Urbanization and COVID19? Preliminary Analysis of Environmental and Pandemic Data in the Lombardy Region (Northern Italy) (preprint)

The coronavirus disease 2019 (COVID-19) pandemic is the defining global health and socioeconomic crisis of our time and represents the greatest challenge faced by the world since the end of the Second World War. The academic literature indicates that climatic features, specifically the temperature and absolute humidity, are very important factors affecting infectious pulmonary disease epidemics (e.g., SARS, MERS); however, the influence of climatic parameters on COVID-19 remains extremely controversial. The goal of this study is to quantify the existing relationship between several daily climate parameters (temperature, relative humidity, accumulated precipitation, solar radiation, wind direction and intensity, and evaporation), local morphological parameters, and new daily positive swabs for COVID-19, which represents the only parameter that can be statistically used to quantify the pandemic. The daily deaths parameter was not considered because it is not reliable due to frequent administrative errors. Daily data on meteorological conditions and new cases of COVID-19 were collected for the Lombardy area from March 1, 2020, to April 20, 2020. This region in Italy exhibited the largest number of official deaths in the world per million inhabitants, with a value of approximately 1700 per million on june 30, 2020. Moreover, the apparent lethality was approximately 17% in this area, mainly due to the considerable housing density and the extensive presence of industrial and craft areas. The Mann-Kendall test and multivariate statistical analysis showed that none of the considered climatic variables exhibited statistically significant relationships with the epidemiological evolution of COVID-19, at least in the spring months in temperate subcontinental climate areas, with the exception of solar radiation, which was directly related and showed an otherwise low explained variability of approximately 20%. Furthermore, the average temperatures of two highly representative meteorological stations of Molise and Lucania, the most weakly affected by the pandemic. The temperatures at these stations were approximately 1.5°C lower than that in the cities in Lombardy of Bergamo and Brescia, again confirming that a significant relationship between the increase in temperature and decrease in virology from COVID-19 was not evident, at least in the Italian peninsula.