Prevalence and characteristics of COVID-19 vaccine breakthrough infection in Upper Egypt

Background Infection breakthrough after COVID-19 vaccination is a point of conflict in current literature not only because of the estimation of the potential hazards and symptoms severity but also due to establishing a vaccination policy and measuring the extent of immunity after vaccination in addition to the waning of the humoral immunity over time. To our knowledge, this is the first study to stratify the risk of post-COVID-19 vaccination breakthroughs in Upper Egypt. Methods In this cross-sectional observational study, we enrolled 369 vaccinated patients registered in our facility either admitted or in out-patient clinic. Patients were interviewed and any proven history of COVID-19 infection after vaccination was recorded. Results In the current study, 18.97% (70 patients) of the 369 subjects enrolled in the study had COVID-19breakthrough infection. Students were the high-risk group representing 18.6% of the study subjects. Hypertension, diabetes, and cardiac disease were the most comorbidities associated with a prevalence of 15.7%, 8.6%, and 4.3% respectively. Prior to COVID-19, confirmed infection was present in 42.9% of the study group. Fever, headache, myalgia, and cough were among the most common symptoms of the post-COVID vaccination breakthrough with a prevalence of 90%, 75.7%, 84.3%, and 74.3% respectively. Conclusion Breakthrough infection after COVID-19 vaccination is not uncommon. Most cases are mild and don't require hospitalization. All types of vaccines tested in the current study offer adequate immunity and guard against severe COVID-19 infection. We encourage the current global policy of full vaccination. Trial registration ClinicalTrials.gov. NCT05033834. Registered September 5, 2021. COVID-19 Infection in After Vaccination-Full Text View-ClinicalTrials.gov.

Comorbidities and outcomes among patients hospitalized with COVID-19 in Upper Egypt.

Background: The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or probable case. Results: Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (LRT) symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 81%, P < 0.001) and death rate was significantly higher in cases with comorbidities (P < 0.001) . The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P < 0.002 and 0.001, respectively). Conclusions: Association of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

The burden of COVID-19 pandemic on tuberculosis detection: a single-center study

Background Since being declared a global pandemic, Coronavirus disease 2019 (COVID-19) took over healthcare providers and researchers’ interest. However, other epidemic diseases, including tuberculosis (TB), are still a health issue that aggravate under the umbrella of health facilities exhaustion. This study aims to evaluate the impact of the COVID-19 pandemic on tuberculosis management. Methods A retrospective analysis of the quarterly reports issued by a tuberculosis management unit from 2017 to June 2021, including data of 12 subunits. The changes in pulmonary and extrapulmonary tuberculosis incidence trends (new + relapsed cases) throughout the 4 years were reported. The quarterly changed percentages in cases numbers along 2020 and first half of 2021 was compared with that of the same periods in 2019. Results Incidence of extrapulmonary tuberculosis was higher than pulmonary tuberculosis throughout the 4 year study periods (7.69 vs. 4.49, 9.44 vs. 4.33, 7.75 vs. 3.58, and 7.82 vs. 2.94/100.000 population, respectively) with a noticeable decline in the incidence of pulmonary TB during 2020. The second quarter of 2020 showed the lowest tuberculosis incidence rate with a 41.6% decline in the total number of diagnosed cases while 2nd quarter of 2021 showed 21.2% decline. During 2020, only 4 cases of multidrug-resistant TB were reported (compared to an average of 8 cases of MDR-TB yearly before the COVID-19 era). Conclusion There was a noticeable drop in tuberculosis case detection during the COVID-19 pandemic. The lockdown, started in Egypt by the end of March 2020, could contribute to the marked drop in the second quarter. However, a steady partial decline was continued during the first half of 2021, which foretells a growing problem.

Determinants of Obtaining COVID-19 Vaccination among Health Care Workers with Access to Free COVID-19 Vaccination: A Cross-Sectional Study.

INTRODUCTION: Despite global efforts to contain the illness, COVID-19 continues to have severe health, life, and economic repercussions; thus, maintaining vaccine development is mandatory. Different directions concerning COVID-19 vaccines have emerged as a result of the vaccine's unpredictability. AIMS: To study the determinants of the attitudes of healthcare workers (HCWs) to receiving or refusing to receive the vaccine. METHODS: The current study adopted an interviewed questionnaire between June and August 2021. A total of 341 HCWs currently working at Assiut University hospitals offered to receive the vaccine were included. RESULTS: Only half of the HCWs (42%) accepted the COVID-19 vaccine. The most common reason that motivated the HCWs was being more susceptible than others to infection (71.8%). On other hand, the common reasons for refusing included: previously contracted the virus (64.8%); did not have time (58.8%); warned by a doctor not to take it (53.8%). Nearly one-third of nonaccepting HCWs depended on television, the Internet, and friends who refused the vaccine for information (p < 0.05). In the final multivariate regression model, there were six significant predictors: sex, job category, chronic disease, being vaccinated for influenza, and using Assiut University hospital staff and the Ministry of Health as sources of information (p < 0.05). CONCLUSION: Misinformation and negative conceptions are still barriers against achieving the desired rate of vaccination, especially for vulnerable groups such as HCWs.

Sero-prevalence of anti-SARS-CoV-2 antibodies among healthcare workers: A multicenter study from Egypt.

BACKGROUND: Healthcare workers (HCWs) are at a high risk for disease exposure. Given the limited availability of nucleic acid testing by PCR in low resource settings, serological assays can provide useful data on the proportion of HCWs who have recently or previously been infected. Therefore, in this study, we conducted an immunologic study to determine the seroprevalence of anti-SARS-CoV-2 antibodies in two university hospitals in Egypt. METHODS: in this cross sectional study, HCWs who were working in SARS-CoV-2 Isolation Hospitals were interviewed. Estimating specific antibodies (IgM and IgG) against SARS-CoV-2 was carried out using an enzyme-linked immunosorbent assay targeting the Spike antigen of SARS-CoV-2 virus. RESULTS: Out of 111, 82 (74%) HCWs accepted to participate with a mean age of 31.5 ± 8.5 years. Anti-SARS-COV2 antibodies were detected in 38/82 (46.3%) of cases with a mean age of 31 years and female HCWs constituted 57.6% of cases. The highest rate of seropositivity was from the nurses (60.5%), and physicians (31.6%) with only (7.9%) technicians. Only 28/82 (34.1%) HCWs reported previous history of COVID19. We reported a statistically significant difference in the timing of exposure (p = 0.010) and the frequency of contact with COVID-19 cases (p = 0.040) between previously infected and on-infected HCWs. Longer time of recovery was reported from IgG positive HCWs (p = 0.036). CONCLUSION: The high frequency of seropositive HCWs in investigated hospitals is alarming, especially among asymptomatic personnel. Confirmation of diseased HCWs (among seropositive ones) are warranted.

Predictors of COVID-19 vaccine hesitancy among Egyptian healthcare workers: a cross-sectional study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) vaccination has raised concerns about vaccine hesitancy in general and COVID-19 vaccine hesitancy in particular. Understanding the factors driving the uncertainty regarding vaccination against COVID-19 is crucial. METHODS: This cross-sectional study was designed to identify the perceptions and attitudes of healthcare workers (HCWs) towards COVID-19 vaccines and determine the predictive factors that affect their willingness to receive the COVID-19 vaccine. An online survey was distributed among HCWs to collect data assessing demographic and general characteristics of the participants and vaccine-related characteristics, including source of information about the vaccine. In addition to items assessing the perception of COVID-19, there were items on COVID-19 vaccines and attitude towards vaccination in general and towards COVID-19 vaccines in particular. RESULTS: The participants were classified according to their willingness to take the COVID-19 vaccine as follows: hesitant (41.9%), refusing (32.1%), and willing (26%). Statistically significant differences were observed among the three groups for the perception of COVID-19 vaccines, attitude towards vaccination in general, and COVID-19 vaccines in particular (p < 0.01). CONCLUSIONS: Although the participants adequately perceived COVID-19 severity, prevention, and COVID-19 vaccine safety, they were widely hesitant or refused to be vaccinated. A multidimensional approach is required to increase the vaccine acceptability rate. Higher income and increased years of work experience are positive predictors of willingness to receive a vaccine. Thus, further studies addressing the scope of COVID-19 vaccine hesitancy are warranted as an initial step to build trust in COVID-19 vaccination efforts with continuous monitoring of attitudes and practices of HCWs towards COVID-19 vaccines in the future.

Surveillance Study of Acute Neurological Manifestations among 439 Egyptian Patients with COVID-19 in Assiut and Aswan University Hospitals.

BACKGROUND: COVID-19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study, we estimate the frequency of such complications among hospital inpatients with COVID-19 in Assiut and Aswan university hospitals. MATERIALS AND METHODS: We screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory tests, CT/MRI of the chest and brain, and neurophysiology study were performed for each patient if indicated. RESULTS: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these, 117 had acute neurological disease and the remainder had nonspecific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke and the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of multiple sclerosis (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31) and the others had Guillain-Barré syndrome (4), peripheral neuropathy (3), myasthenia gravis (MG, 2), or myositis (2). Fever, respiratory symptoms, and headache were the most common general symptoms. Hypertension, diabetes mellitus, and ischemic heart disease were the most common comorbidities in patients with CNS affection. CONCLUSION: In COVID-19, both the CNS and PNS are affected. Stroke was the most common complication for CNS, and anosmia and/or ageusia were common for PNS diseases. However, there were 6 cases of encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG, and 2 cases of myositis.