Adiposity and Sex Influence on SARS-CoV-2 Antibody Response in University Students. An ESFUERSO cross-sectional study. (preprint)

Introduction: Prior studies have identified various determinants of differential immune responses to COVID-19. This investigation delves into the Ig-G anti-RBD marker, scrutinizing its potential correlations with sex, vaccine type, body fat percentage, metabolic risk, perceived stress, and previous COVID-19 exposure. Methods. In this study, data were obtained from 116 participants from the ESFUERSO cohort, who completed questionnaires detailing their COVID-19 experiences and stress levels assessed through the SISCO scale. Quantification of Ig-G anti-RBD concentrations was executed using an ELISA assay developed by UNAM. Multiple regression analysis was adeptly employed to control for covariates, including sex, age, body fat percentage, BMI, and perceived stress. Results. This sample comprised young individuals (average age of 21.4 years), primarily consisting of females (70%), with a substantial proportion reporting a family history of diabetes, hypertension, or obesity. Most students had received the Moderna or Pfizer vaccines, and 91% displayed a positive anti-RBD response. A noteworthy finding was the interaction between body fat percentage and sex. In males, increased adiposity was associated with a decrease in Ig-G anti-RBD concentration, while in females, the response increased. Importantly, this trend was consistent regardless of the vaccine received. No significant associations were observed for variables such as dietary habits or perceived stress. Conclusions. In summation, this research reports the impact of both sex and body fat percentage on the immune response through Ig-G anti-RBD levels to COVID-19 vaccines. The implications of these findings offers a foundation for educational initiatives and the formulation of preventive policies aimed at mitigating health disparities.

Detection and genetic characterization of enteric viruses in diarrhoea outbreaks from swine farms in Spain (preprint)

Background: The aim of this work was to study the prevalence and distribution of Porcine astrovirus (PAstV), Porcine kobuvirus (PKoV), Porcine torovirus (PToV), Mammalian orthoreovirus (MRV) and Porcine mastadenovirus (PAdV) as well as their association with widely recognized virus that cause diarrhoea in swine such as coronavirus (CoVs) and rotavirus (RVs) in diarrhoea outbreaks from Spanish swine farms. Furthermore, a selection of the viral strains was genetically characterized. Results: PAstV, PKoV, PToV, MRV and PAdV were frequently detected. Particularly, PAstV and PKoV were detected in almost 50% and 30% of the investigated farms, respectively, with an age-dependent distribution; PAstV was mainly detected in postweaning and fattening pigs, while PKoV was more frequent in sucking piglets. Viral co-infections were detected in almost half of the outbreaks, combining CoVs, RVs and the viruses studied, with a maximum of 5 different viral species reported in three investigated farms. Using a next generation sequencing approach, we obtained a total of 24 ARN viral genomes (>90% genome sequence), characterizing for first time the full genome of circulating strains of PAstV2, PAstV4, PAstV5 and PToV on Spanish farms. Phylogenetic analyses showed that PAstV, PKoV and PToV from Spanish swine farms clustered together with isolates of the same viral species from neighboring pig producing countries. Conclusions: Although further studies to evaluate the role of these enteric viruses in diarrhoea outbreaks are required, their wide distribution and frequent association in co-infections cannot be disregard. Hence, their inclusion into routine diagnostic panels for diarrhoea in swine should be considered.

Perception of health in patients during the COVID-19 pandemic

Objective: To analyze the perception of health in primary care patients of the health department 21 during the COVID-19 epidemic period. Material and Methods: Cross-sectional observational study. Held in the Department of Health 21 (Alicante-Spain) from February 23, 2021, to May 15, 2021. A total of 243 users participated. A semi-structured interview was used, taking as a reference the information from the Valencian Community Health Survey Adapted. The variable result of the perception of health in patients was considered. The inclusion criteria considered 18-year-olds who were served during the COVID-19 pandemic and who wanted to participate in the study. Results: The ages were comprised between 20 and 94, years with an average of 64.55 years (SD 19.97). In the perception of health, we highlight the group of women who reported having a worse health (69%) during the last 12 months and major problems to walk (59.2%). Our results indicate a significant association in the social resources used for the activities of daily life (p<0.001) and teleassistance (p<0.043). Conclusion: On a practical level, if we have an account of life expectancy in the population, associated comorbidities and health care in the pandemic period, we can decide that the perception of health is worse in women. Despite all these factors, satisfaction with health services during the pandemic is satisfactory.Alternate :Objetivo: Analizar la percepción de la salud en los pacientes de atención primaria del departamento de salud 21 durante el período epidémico de la COVID-19. Material y Métodos: Estudio observacional transversal. Realizado en el Departamento de Salud 21 (Alicante-España) en los meses del 23 de febrero de 2021 al 15 de mayo de 2021. Participaron un total de 243 usuarios. Se utilizó una entrevista semiestructurada, tomando como referencia la información del Cuestionario de Salud de la Comunidad Valenciana Adaptado. Se consideró la variable resultado la percepción de la salud en los pacientes. Los criterios de inclusión tomaron en cuenta a personas mayores de 18 años que fueran atendidas durante la pandemia de COVID-19 y que quisieran participar en el estudio. Resultados: Las edades estuvieron comprendidas entre los 20 y 94, años con una media de 64,55 años (DE 19,97). En la percepción de la salud, destacamos el grupo de las mujeres donde refieren tener una peor salud (69%) durante los últimos 12 meses y mayores problemas para caminar (59,2%). Nuestros resultados indican asociación significativa en los recursos sociales utilizados para las actividades de la vida cotidiana (p<0,001) y la teleasistencia (p<0,043). Conclusión: A nivel práctico, si tenemos en cuenta la esperanza de vida en la población, las comorbilidades asociadas y la asistencia sanitaria en el periodo pandémico, podemos decir que la percepción de la salud es peor en las mujeres. A pesar de todos estos factores, la satisfacción con los servicios sanitarios en periodo pandémico es satisfactoria.

What Do We Know Today about Long COVID? Nursing Care for a New Clinical Syndrome.

Persistent COVID, long COVID, long-effects, long-term effects or chronic COVID are all names of a new syndrome caused by a set of multi-organ symptoms that appear after having been infected with SARS-CoV-2 [...].

Characterization and cross-protection of experimental infections with SeCoV and two PEDV variants. (preprint)

Global emergence and re-emergence of Porcine epidemic diarrhea virus (PEDV), an Alphacoronavirus which causes a highly contagious enteric disease, have led to several studies addressing its variability. The aim of this study was to characterize the infection of weaned pigs with Swine enteric coronavirus (SeCoV) -a chimeric virus most likely originated from a recombination event between PEDV and Transmissible gastroenteritis virus, or its mutant Porcine respiratory coronavirus- , and two PEDV G1b variants, including a recently described recombinant PEDV-SeCoV (rPEDV-SeCoV), as well as to determine the degree of cross-protection achieved against the rPEDV-SeCoV. For this purpose, forty-eight 4-week-old weaned pigs were randomly allocated into four groups of 12 animals; piglets in groups B, C and D were orally inoculated with a PEDV variant (B and D) or SeCoV (C), while piglets in group A were mock inoculated and maintained as controls. At day 20 post-infection all groups were exposed to rPEDV-SeCoV; thus, group D was subjected to a homologous re-challenge, groups B and C to a heterologous re-challenge (PEDV/rPEDV-SeCoV and SeCoV/rPEDV-SeCoV, respectively) and group A was primary challenged (-/rPEDV-SeCoV). Clinical signs, viral shedding, microscopic lesions and specific humoral and cellular immune responses (IgG, IgA, neutralizing antibodies and IgA and IFN-γ-secreting cells) were monitored. After primo-infection all three viral strains induced an undistinguishable mild-to-moderate clinical disease with diarrhea as the main sign and villus shortening lesions in the small intestine. In homologous re-challenged pigs, no clinical signs or lesions were observed, and viral shedding was only detected in a single animal. This fact may be explained by the significant high level of rPEDV-SeCoV-specific neutralizing antibodies found in these pigs before the challenge. In contrast, prior exposition to a different PEDV G1b variant or SeCoV only provided partial cross-protection, allowing rPEDV-SeCoV replication and shedding in feces.

Safety and effectiveness of RBD-specific polyclonal equine F(ab')2 fragments for the treatment of hospitalized patients with severe Covid-19 disease: a retrospective cohort study. (preprint)

Passive immunotherapy has been evaluated as a therapeutic alternative for patients with COVID-19 disease. Equine polyclonal immunotherapy for COVID-19 (EPIC) showed adequate safety and potential efficacy in a clinical trial setting and obtained emergency use authorisation in Argentina. We studied its utility in a real world setting with a larger population. Methods: We conducted a retrospective cohort study at "Hospital de Campana Escuela-Hogar" in Corrientes, Argentina, to assess safety and effectiveness of EPIC in hospitalized adults with severe COVID-19 pneumonia. Primary endpoints were 28-days all cause mortality and safety. Mortality and improvement in modified WHO clinical scale at 14 and 21 days were secondary endpoints. Potential confounder adjustment was made by logistic regression weighted by the inverse of the probability of receiving the treatment (IPTW) and doubly robust approach. Results: Clinical records of 395 exposed (EPIC) and 446 non-exposed (Controls) patients admitted between November 2020 and April 2021 were analyzed. Median age was 58 years, 56.8% males. Mortality at 28 days was 15.7% ( EPIC) vs 21.5% (Control). After IPTW adjustment the OR was 0.66 (95 % CI: 0.46 - 0.96) p= 0.03. The effect was more evident in the subgroup who received two EPIC doses (complete treatment, n=379), OR 0.58 (95% CI 0.39 to 0.85) p=0.005. Overall and serious adverse events were not significantly different between groups.

Seguridad de medicamentos durante la pandemia Covid-19 en las enfermeras de atención primaria Medication safety during the Covid-19 pandemic in primary care nurses

Objetivo: Conocer la percepción de las enfermeras sobre los factores que influyen en la administración segura de medicamentos durante el periodo Covid-19, en el contexto laboral en un departamento de salud de atención primaria del sistema nacional de salud de España. Diseño: Se trata de un estudio cualitativo fenomenológico. Sitio: Realizado en el Departamento de salud 21 (Alicante-España) entre los meses de septiembre 2021 a noviembre del 2021. Participantes: 15 enfermeras elegidas por muestreo intencionado. Métodos: Se utilizó una entrevista semiestructurada con una duración entre 30 y 60 minutos, grabadas y transcritas de manera textual por el equipo investigador. Se estableció una categoría principal denominada “conocer” que engloba todas las reflexiones acerca de la actuación de la enfermera durante el proceso administración de medicamentos. Resultados: Las participantes manifestaron preocupación ante la realización de los procedimientos de administración de medicamentos, lo que permitió percibir la seguridad como la mayor preocupación en la unidad de estudio. A partir de esta categoría principal se desarrollan las siguientes subcategorías: sobrecarga de trabajo, formación insuficiente, distracciones y fallos de comunicación e información. Conclusión: Conocer la percepción de las enfermeras sobre los factores que influyen en la administración segura de medicamentos nos podría facilitar el uso de instrumentos para estandarizar y disminuir la variabilidad en la administración segura de medicamentos. Así como mejorar las condiciones en los entornos laborales a nivel comunitario, y no favorecer la estigmatización social, personal y profesional por el error asistencial.

Safety and immunogenicity of a high-dose quadrivalent influenza vaccine administered concomitantly with a third dose of the mRNA-1273 SARS-CoV-2 vaccine in adults >= 65 years of age: a Phase II, open-label study (preprint)

Background Concomitant seasonal influenza vaccination with a COVID-19 vaccine booster could help to minimise potential disruption to the seasonal influenza vaccination campaign and maximise protection against both diseases among individuals at risk of severe disease and hospitalisation. This study assesses the safety and immunogenicity of concomitant administration of high-dose quadrivalent influenza vaccine (QIV-HD) and a mRNA-1273 vaccine booster dose in older adults. Methods This is an ongoing Phase II, multi-centre, open-label study (NCT04969276). We describe interim results up to 21 days after vaccination (July 2021-August 2021). Adults aged [≥] 65 years living in the community, who were to have received a second mRNA-1273 dose at least five months previously, were randomised (1:1:1) to concomitant QIV-HD and mRNA-1273 vaccination (Coad), QIV-HD alone, or mRNA-1273 vaccine alone. Unsolicited adverse events (AEs) occurring immediately, solicited local and systemic reactions up to day (D)8, and unsolicited AEs, serious AEs (SAEs), AEs of special interest (AESIs) and medically attended AEs (MAAEs) up to D22 were reported. Haemagglutination inhibition (HAI) antibody responses to influenza A/H1N1, A/H3N2, B/Yamagata and B/Victoria strains and SARS CoV-2 binding antibody responses (SARS-CoV-2 Pre-Spike IgG ELISA) were assessed at D1 and D22. Findings Of 306 participants randomised, 296 were included for analysis (Coad, n=100; QIV-HD, n=92; mRNA-1273, n=104). Reactogenicity profiles were similar between the Coad and mRNA-1273 groups, with lower reactogenicity rates in the QIV-HD group (frequency [95% CIs] of solicited injection site reactions: 86{middle dot}0% [77{middle dot}6-92{middle dot}1], 91{middle dot}3% [84{middle dot}2-96{middle dot}0] and 61{middle dot}8% [50{middle dot}9-71{middle dot}9] ; solicited systemic reactions: 80{middle dot}0% [70{middle dot}8-87{middle dot}3], 83{middle dot}7% [75{middle dot}1-90{middle dot}2] and 49{middle dot}4% [38{middle dot}7-60{middle dot}2], respectively). Up to D22, unsolicited AEs were reported for 17{middle dot}0% and 14{middle dot}4% participants in the Coad and mRNA-1273 groups, respectively, with a lower rate (10{middle dot}9%) in the QIV-HD group. Seven MAAEs were reported (Coad, n=3; QIV-HD, n=1; mRNA-1273, n=3). There were no SAEs, AESIs or deaths. HAI antibody geometric mean titres (GMTs) increased from D1 to D22 to similar levels for each influenza strain in the Coad and QIV-HD groups (GMTs [95% confidence interval], range across strains: Coad, 286 [233-352] to 429 [350-525] ; QIV-HD, 315 [257-386] to 471 [378-588]). SARS-CoV-2 binding antibody geometric mean concentrations (GMCs) also increased to similar levels in the Coad and mRNA-1273 groups (D22 GMCs [95% confidence interval]: 7634 [6445-9042] and 7904 [6883-9077], respectively). Interpretation No safety concerns or immune interference were observed for concomitant administration of QIV-HD with mRNA-1273 booster in adults aged [≥] 65 years, supporting co-administration recommendations.