ABSTRACT
Background Current data suggest that SARS-CoV-2 reinfections are rare. Uncertainties remain, however, on the duration of the natural immunity, its protection against Omicron variant, and on the impact of vaccination to reduce reinfection rates. Methods In this retrospective cohort analysis of the entire population of an Italian Region, we followed 1,293,941 subjects from the beginning of the pandemic to the current scenario of Omicron predominance (up to mid-February 2022). We assessed the proportion of reinfections overall, and by demographic and clinical characteristics, time after primary infection, and predominant circulating variant. Cox proportional hazard analysis was used to compute the relative hazards of reinfection. Results After an average of 277 days, we recorded 729 reinfections among 119,266 previously infected subjects (overall rate: 6.1‰), eight COVID-19-related hospitalizations (7/100,000), and two deaths. Importantly, the incidence of reinfection did not vary substantially over time: after 18-22 months from the primary infection, the reinfection rate was still 6.7‰, suggesting that protection conferred by natural immunity may last beyond 12 months. The risk of reinfection was significantly higher among females, unvaccinated subjects, and during the Omicron wave. Conclusions This study confirms and expands previous findings reporting a low risk of SARS-CoV-2 reinfection, and a very low risk of severe or lethal COVID-19 for those who recovered from primary infection, suggesting that the protection conferred by the natural immunity lasts beyond 12 months. Although the marked increase of the reinfection rates during the Omicron wave is concerning, the risk of a secondary severe disease or death remained close to zero. Vaccines were able to significantly reduce the likelihood of reinfection in both pre-Omicron and Omicron waves, although the risk-benefit profile of multiple vaccine doses for this population should be carefully evaluated. Key messages • After primary infection, the risk of SARS-CoV-2 reinfection and of severe/lethal COVID-19 was low, suggesting that natural immunity lasts beyond 12 months. • Despite increasing reinfection rates with Omicron, the risk of a secondary severe/lethal disease was close to zero, and vaccines reduced the likelihood of reinfection before and during Omicron waves.
ABSTRACT
Aim: Delays in the screening programs for colorectal cancer and the reluctance of patients to seek medical attention due to the outbreak of SARS-CoV- 2 could have resulted in more advanced cancers at diagnosis. The aim of this study was to compare the oncologic outcomes of patients with colorectal cancer in Italy between the pandemic and pre-pandemic periods. Method(s): A retrospective multicentre cohort study of 17,938 patients who underwent surgery for colorectal cancer from March 2020 to December 2021 (pandemic period: 7796 patients, 43.5%) and from January 2018 to February 2020 (pre-pandemic period: 10,142 patients, 56.5%) in 81 centres. The primary outcome was advanced stage at diagnosis. Secondary outcomes were T4 stage, M stage, aggressive biology, stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. Result(s): At the logistic regression, the SARS-CoV- 2 pandemic period was significantly associated with an increased rate of advanced stage (OR 1.07, 95% CI 1.00-1.13, p = 0.034), distant metastases (OR 1.10, 95% CI 1.00-1.21, p = 0.050), aggressive biology (OR 1.32, 95% CI 1.15-1.53, p < 0.001), and stenotic lesions (OR 1.16, 95% CI 1.02-1.31, p = 0.028). Conclusion(s): The present study reports a significant correlation between the SARSR-CoV- 2 pandemic and the worsening of the oncologic outcomes in patients undergoing surgery for colorectal cancer, and might predict a potential reduction of survival of these patients. An adequate large-scale response is necessary to reduce the impact of the pandemic on colorectal cancer patients' survival.
ABSTRACT
Background The spread of SARS-CoV-2 required virtually all governments to employ non-pharmaceutical infection containment measures such as quarantine and generalised lockdowns. Several authors raised warnings about potential negative changes in alcohol-related behaviours due to the lockdowns. The objective of the present systematic review was to summarise available evidence on trends of alcohol consumption temporally associated with COVID-19 lockdowns. Methods We performed a systematic review in PubMed, Scopus, Web of Science and EMBASE, using the search terms ‘coronavirus', with either ‘alcohol drinking', ‘alcoholism', ‘alcoholic beverages', and ‘alcohol intoxication'. Studies were included if they evaluated the change in alcohol consumption prevalence or frequency both before and during the lockdowns, or if they assessed changes in alcohol use retrospectively. The outcomes were changes in prevalence of alcohol consumption, or in its frequency. Results A total of 128 records were retrieved, and 24 studies met eligibility criteria. Most samples were drawn from either the general population (e.g. social media users), university students, or regular drinkers. The outcomes measurements varied widely, and multiple scales were also used for the assessment of harmful alcohol use. The majority of the studies found that alcohol consumption prevalence increased during lockdowns (e.g. +25.7% in UK). Also, increased frequencies were reported by 14.0% in Poland and 32.1% in China. Finally, one study from Australia observed no overall changes, while one from Cyprus reported decreased alcohol consumption frequency. Conclusions Understanding the impact of lockdowns on alcohol consumption is essential for countering possible increases in harmful use, and a consensus should be reached for performing standardised and comparable assessments. Key messages Alcohol consumption increased in many countries during the COVID-19 lockdowns, with local variations. Assessments used a great variety of outcomes, hindering a comprehensive assessment of this phenomena.
ABSTRACT
BACKGROUND: Current data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections are rare, but no information are available on minors and after 12 months of follow-up. METHODS: This retrospective cohort study included all the population of an Italian Province, diagnosed with a SARS-CoV-2 infection from March 2020 to May 2021. The primary outcome was the incidence of a reinfection, defined as a new positive polymerase chain reaction (PCR) test occurring ≥90 days after complete resolution of the first infection, and data were retrieved from the official datasets (coronavirus disease 2019 [COVID-19], demographic, hospital and co-pay exemption) of the Local Health Unit (LHU) of Pescara. RESULTS: After an average of 201 days of follow-up (max. 414), we recorded 24 reinfections ≥90 days after the resolution of the first 7173 infections (0.33%). Four reinfections required hospitalization, one was lethal. Most of the reinfections (n = 13) occurred 6-9 months after the resolution of the first infection; no new infection was detected 12 or more months later and among the 832 minors. CONCLUSIONS: This study confirms previous findings on a low risk of SARS-CoV-2 reinfection. If confirmed, these findings suggest that more targeted restriction policies can be applied to the subjects that recovered after a first infection.