ABSTRACT
Background: In the third year of the coronavirus disease 2019 (COVID-19) pandemic, long-term post-COVID syndrome (PCS) following severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infections poses the significant challenge for patients and health systems globally. Whilst COVID-19 vaccinations prior to SARS-CoV-2 infection reduce the risk of PCS, the role of therapeutic vaccination in PCS recovery remains controversial. We present a 15 months longitudinal, prospective observational cohort study to examine long-term clinical courses, PCS recovery with and without vaccination as well as humoral immune responses in initially unvaccinated PCS patients. Method(s): A total of 227 COVID-19 convalescents of our initial mild COVID-19 outpatient cohort (N=958) from which longitudinal data was available were included in this study. PCS was defined according to the WHO definition. 76.7% (174/227) of individuals received at least one vaccination between 10 and 15 months after first SARS-CoV-2 infection. Receptor binding domain (RBD)- specific SARS-CoV-2 immunoglobulin G (IgG) and distinct symptom phenotypes (P) were longitudinally assessed for 15 months. Using binomial regression models, odds ratios (OR) with 95% confidence interval (95%CI) of descriptive, longitudinal variables associated with long-term PCS were calculated. Result(s): 35.8% (82/227) and 31.3% (71/227) of patients had PCS at months 10 and 15 (figure 1A). SARS-CoV-2 IgG titers were equally distributed over time among age groups, sex, and PCS. PCS occurred in 30.5% (53/174) of vaccinated and 34.0% (18/53) of unvaccinated patients. Between 6 and 10 months (DELTAT2/T3: not yet vaccinated) and 10 and 15 months (DELTAT3/T4: vaccinated) after symptom onset (figure 1B), a comparable fraction of PCS patients recovered (DELTAT2/T3: 22.5% and DELTAT3/T4: 20.0%). Fatigue/dyspnea (P2) and not anosmia/ageusia (P1) constituted PCS at month 15 (P2 23.9% versus P1 1.4%). Headache (P4) and diarrhea (P5) at baseline were risk factors for PCS at months 15, respectively (P4: OR 2.01 (95%CI 1.11-3.52), p= .018;P5: OR 3.01(95%CI 1.44-5.94), p= .002). Conclusion(s): Our results indicate, that distinct symptom phenotypes can constitute and predict long-term PCS 15 months after mild COVID. Recovery of PCS was observed similarly in both therapeutically vaccinated and unvaccinated patients. Thus, development of targeted PCS therapeutics is needed to improve patient care and future epidemiological investigations. (Figure Presented).
ABSTRACT
Global strategies to contain a pandemic, such as social distancing and protective measures, are designed to reduce the overall transmission rate between individuals. Despite such measures, essential institutions, including hospitals, schools, and food producing plants, remain focal points of local outbreaks. Here we develop a model for the stochastic infection dynamics that predicts the statistics of local outbreaks from observables of the underlying global epidemics. Specifically, we predict two key outbreak characteristics: the probability of proliferation from a first infection in the local community, and the establishment size, which is the threshold size of local infection clusters where proliferation becomes likely. We derive these results using a contact network model of communities, and we show how the proliferation probability depends on the contact degree of the first infected individual. Based on this model, we suggest surveillance protocols by which individuals are tested proportionally to their degree in the contact network. We characterize the efficacy of contact-based protocols as a function of the epidemiological and the contact network parameters, and we show numerically that such protocols outperform random testing.
ABSTRACT
The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.
ABSTRACT
BACKGROUND: As of 18 June 2020 a total of 187,764 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were reported in Germany and of these 6.9% were under the age of 19 years. There were initial indications that children are often asymptomatic and show a milder clinical course. OBJECTIVE: The aim of this study was to gain information on the prevalence of SARS-CoV2 infections in a pediatric cohort. MATERIAL AND METHODS: Between 13 March and 18 June 2020 all children from whom a smear for SARS-CoV2 was taken either to rule out an infection or as a suspected case were included. Data were collected on standardized patient record sheets. The analysis of data was anonymized and retrospective. RESULTS: During the given period 2192 children were investigated and 37 patients tested positive (1.7%) for SARS-CoV2. Of these 36/37 were suspected cases and 28/37 were symptomatic. The leading symptoms were dry cough, runny nose and fever and three children had to be hospitalized. None showed a difficult course of the disease. Among those tested 505 were patients at risk due to an underlying chronic disease, 3 of whom (0.6%) were tested positive with an asymptomatic or mild course. CONCLUSION: We can confirm the first data showing that children and adolescents often have an asymptomatic or mild clinical course of infection or disease. We found no evidence of a high grey area of SARS-CoV2 infections in this regional pediatric cohort.