Clinical characteristics and immune profile alterations in vaccinated individuals with breakthrough Delta SARS-CoV-2 infections.

Despite timely immunization programs, and efficacious vaccines conveying protection against SARS-CoV-2 infection, breakthrough infections in vaccinated individuals have been reported. The Delta variant of concern (VOC) outbreak in Guangzhou resulted in local transmission in vaccinated and non-vaccinated residents, providing a unique opportunity to study the protective effects of the inactivated vaccines in breakthrough infection. Here, we find that the 2-dose vaccinated group has similar peak viral titers and comparable speeds of viral RNA clearance to the non-vaccinated group but accelerated viral suppression in the middle course of the disease. We quantitatively demonstrate that peak viral pneumonia is significantly mitigated in the 2-dose vaccine group (median 0.298%) compared with the non-vaccinated (5.77%) and 1-dose vaccine (3.34%) groups. Pneumonia absorbance is approximately 6 days ahead in the 2-dose group (median 10 days) than in the non-vaccinated group (16 days) (p = 0.003). We also observe reduced cytokine inflammation and markedly undisturbed gene transcription profiles of peripheral blood mononuclear cells (PBMCs) in the 2-dose group. In short, our study demonstrates that prior vaccination substantially restrains pneumonia development, reduces cytokine storms, and facilitates clinical recovery.

Evaluation and prevention and control measures of urban public transport exposure risk under the influence of COVID-19-Taking Wuhan as an example.

BACKGROUND: Since December 2019, COVID-19 began to spread throughout the world for nearly two years. During the epidemic, the travel intensity of most urban residents has dropped significantly, and they can only complete inflexible travel such as "home to designated hospital" and "home to supermarket" and some special commuting trips. While ensuring basic travel of residents under major public health emergency, there is also a problem of high risk of infection caused by exposure of the population to the public transport network. For the discipline of urban transport, how to use planning methods to promote public health and reduce the potential spread of diseases has become a common problem faced by the government, academia and industry. METHOD: Based on the mobility perspective of travel agents, the spatial analysis methods such as topological model of bus network structure, centrality model of public transport network and nuclear density analysis are used to obtain the exposure risk and spatial distribution characteristics of public transport from two aspects of bus stops and epidemic sites. RESULTS: The overall spatial exposure risk of Wuhan city presents an obvious "multi center circle" structure at the level of bus stops. The high and relatively high risk stops are mainly transport hubs, shopping malls and other sites, accounting for 35.63%. The medium and low-risk stops are mainly the villages and communities outside the core areas of each administrative region, accounting for 64.37%. On the other hand, at the scale of epidemic sites, the coverage covers 4018 bus stops in Wuhan, accounting for 36.5% of all bus stops, and 169 bus lines, accounting for 39.9% of all routes. High risk epidemic sites are mainly concentrated in the core areas within the jurisdiction of Wuhan City, and in the direction of urban outer circle diffusion, they are mainly distributed in the low and medium risk epidemic sites. According to the difference of the risk level of public transport exposure, the hierarchical public transport control measures are formulated. DISCUSSION: This paper proposes differentiated prevention and control countermeasures according to the difference of risk levels, and provides theoretical basis and decision-making reference for urban traffic management departments in emergency management and formulation of prevention and control countermeasures.

How to Formulate Urban Public Transport Management Measures Under the Influence of COVID-19? -- Taking Wuhan as an Example

Ensuring the necessary service functions of public transport under the influence of the epidemic and providing support for blocking the spread of epidemics is an important research issue in urban traffic emergency management. In this paper, based on the public transport network and epidemic information data, considering the two aspects of bus stops and epidemic sites, integrating the spatial analysis methods such as the topological model of public transport network, the centrality model of public transport network and nuclear density analysis, the authors have constructed the risk assessment method of public transport exposure, and done the case study of COVID-19 in Wuhan, China. The results show that the overall exposure risk of bus stops presents a "multi center circle" structure;high-risk and low-risk stops mainly rely on urban trunk roads and branches;high-risk and relatively high-risk stops are mostly traffic hubs and shopping malls, accounting for 35.63%, and medium and low-risk stops account for 64.37%, which are mainly distributed in the peripheral areas of urban core area;high-risk and low-risk sites are mainly distributed in the peripheral areas of urban core areas. Finally, according to the difference of public transport exposure risk level, the study puts forward to formulate classified public transport control measures to achieve differentiated precise prevention and control, so as to provide theoretical basis and decision-making reference for urban traffic management departments to carry out risk management and formulate management and control policy.

Effect of a bundle of intervention strategies for the control of COVID-19 in Henan, a neighboring province of Wuhan, China.

The novel coronavirus disease 2019 (COVID-19) occurred in China (mainly in Wuhan, Hubei Province) at the end of December 2019. Henan province is located in the center of China, borders on Hubei province by land in the south with the nearest distance of 200 kilometers to Wuhan. As the inland provinces in mainland China, frequent communication in transportation and population flow make it difficult to confine the pandemic, which is similar to that in the landlocked countries in Europe. The expected cases in Henan were mainly imported. A bundle of intervention strategies were adopted from 26 January 2020 to cut off the spread between the infected patients and the native residents. The pandemic was controlled 2 month later after the bundle of strategies was adopted although the number of cases continued to increase explosively during the first 10 days. A total of 1273 cases were confirmed, 1251 patients were cured, 22 patients died, and 1 patient was still in hospital until 29 March 2020. The peak of daily increased cases was 109 cases. Our data show that COVID-19 is highly infectious and easy to cause an outbreak, but it can be controlled by early effective interventions. A bundle of strategies according to the specific situation of each country is suggested to be implemented as early as possible.

Clinical risk factors for mortality in patients with cancer and COVID-19: a systematic review and meta-analysis of recent observational studies.

INTRODUCTION: Patients with cancer are more vulnerable to COVID-19 than the general population. Accordingly, it is necessary to identify the risk factors for death in patients with cancer and COVID-19. METHODS: PubMed, Cochrane Library, and Embase Ovid databases were searched for relevant articles published before July 31st, 2020. Studies that explored the risk factors for mortality were included. The effect size was relative risk (RR) and 95% confidence interval (CI). RESULTS: We included 17 observational studies involving 3268 patients. The pooled mortality was 24.8%. Male gender, age above 65 years, and comorbidities (especially hypertension and COPD) were risk factors for death (RR 1.16, 1.27, 1.12; 95% CI 0.7-1.95, 1.08-1.49, 1.04-1.2; P = 0.006, 0.004, and 0.002, respectively). Recent anti-cancer treatments did not increase mortality (P > 0.05). Dyspnea, cough, and sputum canused an elevated risk of death (P < 0.05). Antibiotics, glucocorticoids, interferons, invasive ventilation, and complications were associated with a high probability of death (P < 0.05). CONCLUSIONS: Various demographic and clinical characteristics, such as male gender, advanced age, comorbidities, and symptoms, were risk factors for mortality in patients with cancer and COVID-19. Our findings suggest recent anti-cancer treatments do not increase mortality.