Relevance of immune response and vaccination strategies of SARS-CoV-2 in the phase of viral red queen dynamics.

BACKGROUND: Following a relatively mild first wave of coronavirus disease 2019 (COVID-19) in India, a deadly second wave of the pandemic overwhelmed the healthcare system due to the emergence of fast-transmitting SARS-CoV-2 genetic variants. The emergence and spread of the B.1.617.2/Delta variant considered to be driving the devastating second wave of COVID-19 in India. Currently, the Delta variant has rapidly overtaken the previously circulating variants to become the dominant strain. Critical mutations in the spike/RBD region of these variants have raised serious concerns about the virus's increased transmissibility and decreased vaccine effectiveness. As a result, significant scientific and public concern has been expressed about the impact of virus variants on COVID-19 vaccines. OBJECTIVES: The purpose of this article is to provide an additional explanation in the context of the evolutionary trajectory of SARS-CoV-2 variants in India, the vaccine-induced immune response to the variants of concern (VOC), and various vaccine deployment strategies to rapidly increase population immunity. CONTENT: Phylogenetic analysis of SARS-CoV-2 isolates circulating in India suggests the emergence and spread of B.1.617 variant. The immunogenicity of currently approved vaccines indicates that the majority of vaccines elicit an antibody response and some level of protection. According to current data, vaccines in the pre-fusion configuration (2p substitution) have an advantage in terms of nAb titer, but the duration of vaccine-induced immunity, as well as the role of T cells and memory B cells in protection, remain unknown. Since vaccine efficacy on virus variants is one of the major factors to be considered for achieving herd immunity, existing vaccines need to be improved or effective next-generation vaccines should be developed to cover the new variants of the virus.

The impact of the SARS-CoV-2 pandemic on people living with cystic fibrosis in Ireland: real-world data from the Irish cystic fibrosis registry

Objectives: The impact of the SARS-CoV-2 pandemic on people living with cystic fibrosis (PWCF) in Ireland was investigated by comparing the utilisation of regular hospital facilities in 2020, with data collected in 2019. Methods: All data were collated by the Cystic Fibrosis Registry of Ireland (CFRI). Comparisons were made between PWCF's access to regular hospital facilities utilised for the treatment and management of their condition prior to the outbreak of the pandemic in 2019, and preliminary data during the pandemic in 2020. A descriptive analysis of the differences between key outcome measure data was conducted. The outcome measures analysed were (i) the number and type of encounters, (ii) the number of virtual clinics, (iii) the number of pulmonary function tests (PFTs) carried out, (iv) the number of hospital admissions, and (v) the number of individuals receiving home intravenous antibiotic treatment. Results: In 2019, encounter data were recorded for 1,254 individuals, compared to 1,143 in 2020. Overall, fewer encounters took place in 2020 (5,346) than in 2019 (7,947). Decreases were observed across all in-person hospital encounter types in 2020, when compared with 2019 (annual review: 273 vs 747;day-unit review: 1,792 vs 2,864;drop-in: 115 vs 277;OPD appointment: 1,064 vs 3,289). However, since the outbreak of the pandemic, 1,696 virtual encounters occurred. Significantly, the number of PFTs carried out decreased by 58% in 2020 (2,283), when compared with 2019 (5,458). Of the 1,696 virtual encounters, only 183 (10.8%) saw PFTs carried out. Conclusion: Our analysis has shown a clear reduction in the utilisation of usually regular hospital resources by PWCF in 2020 when compared with 2019. In-person hospital encounters have decreased by 55% in total, highlighting the significant impact that the SARS-CoV-2 pandemic has had on PWCF.