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Introduction: The protective effect of SARS-CoV-2 vaccines has become a global focus due to Omicron variant pandemic. The effects of various SARS-CoV-2 vaccines are diverse. However, studies on the effect of domestic vaccines on clinical characteristics in convalescent adult patients infected with the Omicron variant are lacking. Methods: In this retrospective, single-center cohort study, the effect of three domestic vaccines on clinical characteristics of convalescent adult patients infected with the Omicron variant was investigated in the initial largest outbreak of the Omicron variant infection between January and February 2022 in Tianjin, China. The primary endpoint was COVID-19 severity and the secondary endpoints were re-positive results on nucleic acid tests, liver and kidney function, and inflammation levels during recovery. Results: A total of 320 adult patients infected with the Omicron variant were enrolled, including 296 post-vaccination and 24 unvaccinated patients. The median age of the unvaccinated patients was higher than that of vaccinated patients, but no significant difference was detected in the sex composition ratio between the different groups. Binary logistic regression results suggested that Sinopharm and Sinovac vaccine was an independent protective factor for relieving the severity of the Omicron variant infection. Regrettably, the vaccines did not showed any protective effect on the liver and kidney function of convalescent adult patients. Three domestic vaccines significantly relieved inflammation and increased the SARS-CoV-2-specific antibody levels. Furthermore, Sinovac and CanSino vaccines had a better immune stimulation effect on increasing T lymphocytes levels in convalescent adult patients. In addition, three domestic vaccines have protective effects on preventing re-detectable positive (RP) result in convalescent adult patients. Conclusion: Although the three domestic vaccines cannot prevent the infection of the Omicron variant, it has a significant protective effect in adult patients. This study supports the policy of accelerating to vaccination worldwide combat the evolving and mutating SARS-CoV-2. Discussion: Omicron spreads faster and might escape antibodies more readily than previous variants, increasing the cases of reinfection and breakthrough infections in vaccinated people. Although vaccinated people are likely to have a much lower risk of severe disease from Omicron infection, many issues still need to be considered. Concerns about lower vaccine efficacy because of new variants might have changed our understanding of the COVID-19 endgame, disabusing the world of the notion that global vaccination is by itself adequate for controlling SARS-CoV-2 infection. The current data showed that vaccination with three domestic SARS-CoV-2 vaccines alleviates the disease severity of adult patients with COVID-19, reduces the inflammation level and the RP rate of convalescent adult patients, and enhances body's defense against the virus in convalescent adult patients. Moreover, our study has highlighted that a combination prevention approach of vaccination and public health measures would be an effective strategy.
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Objective: To compare the clinical manifestations, liver function, and antibody levels between Omicron variant infection patients vaccinated and not vaccinated with COVID-19 vaccine. Methods: Totally 430 convalescent COVID-19 patients infected with Omicron variant in Tianjin were selected, including 150 patients vaccinated with Corona Vaccine(Sinovac group), 185 patients vaccinated with BBIBP-CorV(Beijing biological group), 41 patients vaccinated with Ad5-nCoV vaccine(CanSino group), 16 patients vaccinated with Anhui Zhifei, Changchun Bio, Lanzhou Bio, Shandong Bio, other adenovirus vector vaccines or mixed vaccination(other group), and 38 unvaccinated patients(unvaccinated group). The clinical manifestations, liver function indexes [alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TB), albumin(ALB), total protein(TP), lactate dehydrogenase(LDH)], and antibody levels(IgG, IgM)were compared retrospectively. Results: There was no statistical difference in the sex composition ratio among groups(P > 0.05). The age of the Beijing biological group was significantly lower than that of other groups, and the proportion of time less than 3 months from the last vaccination to admission in the Beijing biological group and CanSino group was significantly higher than that in the Sinovac group and other groups(all P < 0.01). A total of 110 children aged less than 16 years were enrolled, including 7, 88, 0, 1 and 14 cases in the Sinovac group, Beijing biological group, CanSino group, other group, and unvaccinated group, respectively. There were 6 asymptomatic cases, 13 moderate cases, 91 mild cases and 0 severe case. There was no significant difference in the abnormal rate of ALT between Beijing biological group and unvaccinated group(P > 0.05), but the abnormal rates of ALT were higher in the Sinovac group and CanSino group than in the unvaccinated group and Beijing biological group(all P < 0.05). The abnormal rate of AST in the unvaccinated group was higher than that in other groups(P < 0.05). There were no significant differences in AST, TP or TB among the groups(all P > 0.05). The levels of ALT were higher in the Sinovac group and CanSino group than in Beijing biological Group and unvaccinated group, the level of ALB in the unvaccinated group was lower than that in the other groups, and the level of LDH in the Beijing biological group was higher than those in the Sinovac group and CanSino group(both P < 0.05). The IgG and IgM antibody levels of the unvaccinated group were significantly lower than those of the Sinovac group, Beijing biological group and CanSino group(all P < 0.05). Conclusions: Omicron variant infection patients vaccinated with BBIBP-CorV are younger and have a higher proportion of mild conditions, which can protect the liver function of patients to a certain extent. Patients vaccinated with different COVID-19 vaccines can produce higher levels of IgG and IgM antibodies than the unvaccinated patients.
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COVID-19 has spread surprisingly fast worldwide, and new variants continue to emerge. Recently, the World Health Organization acknowledged a new mutant strain "Omicron", with children were accounting for a growing share of COVID-19 cases compared with other mutant strains. However, the clinical and immunological characteristics of convalescent pediatric patients after Omicron infection were lacking. In this study, we comparatively analyzed the clinical data from pediatric patients with adult patients or healthy children and the effects of SARS-CoV-2 vaccine on the clinical and immune characteristics in convalescent pediatric patients. Our results indicated that convalescent pediatric patients had unique clinical and immune characteristics different from those of adult patients or healthy children, and SARS-CoV-2 vaccination significantly affected on the clinical and immune characteristics and the prevention of nucleic acid re-detectable positive (RP) in convalescent patients. Our study further deepens the understanding of the impact of Omicron on the long-term health of pediatric patients and provides a valuable reference for the prevention and treatment of children infected with Omicron.
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BACKGROUND: The outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV-2) Omicron variant occurred in Tianjin, China, at the beginning of 2022. In the present study, we identified risk factors that may affect positive (RP) RNA re-testing in recovered patients infected with Omicron variants during recovery in hospital. METHODS: We retrospectively analyzed the medical records of 425 patients with Omicron variant infection admitted to our medical center from January 21, 2022 to February 24, 2022, based on the recurrence of RT-PCR positive results for SARS-CoV-2 after cure and discharge. Patients were divided into re-tested positive (RP) and non-re-detectable positive patients (NRP) groups, and clinical data from both groups were analyzed to investigate the characteristics and risk factors of RP patients. RESULTS: Univariate analysis showed significant differences in age, vaccination rate and dose, partial signs and symptoms, most co-existing disorders, and levels of CRP and IL-6 between the RP and NRP groups (all P < 0.05), while multifactorial logistic regression analysis showed that vaccination status and levels of IL-6 were independent risk factors for RP patients. CONCLUSION: Our results suggested that clinicians should assess the probability of "re-positive" nucleic acid tests after discharge, taking the following indicators into account: pre-admission underlying diseases, unvaccinated status, and high levels of CRP and IL-6. Post-discharge isolation and follow-up should also be strengthened.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Cross-Sectional Studies , RNA , Aftercare , Interleukin-6 , Retrospective Studies , Patient Discharge , China/epidemiologyABSTRACT
COVID-19 has spread surprisingly fast worldwide, and new variants continue to emerge. Recently, the World Health Organization acknowledged a new mutant strain "Omicron", with children were accounting for a growing share of COVID-19 cases compared with other mutant strains. However, the clinical and immunological characteristics of convalescent pediatric patients after Omicron infection were lacking. In this study, we comparatively analyzed the clinical data from pediatric patients with adult patients or healthy children and the effects of SARS-CoV-2 vaccine on the clinical and immune characteristics in convalescent pediatric patients. Our results indicated that convalescent pediatric patients had unique clinical and immune characteristics different from those of adult patients or healthy children, and SARS-CoV-2 vaccination significantly affected on the clinical and immune characteristics and the prevention of nucleic acid re-detectable positive (RP) in convalescent patients. Our study further deepens the understanding of the impact of Omicron on the long-term health of pediatric patients and provides a valuable reference for the prevention and treatment of children infected with Omicron.
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BACKGROUND: Large-scale detection has great potential to bring benefits for containing the COVID-19 epidemic and supporting the government in reopening economic activities. Evaluating the true regional mobile severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus nucleic acid testing capacity is essential to improve the overall fighting performance against this epidemic and maintain economic development. However, such a tool is not available in this issue. We aimed to establish an evaluation index system for assessing the regional mobile SARS-CoV-2 virus nucleic acid testing capacity and provide suggestions for improving the capacity level. METHODS: The initial version of the evaluation index system was identified based on massive literature and expert interviews. The Delphi method questionnaire was designed and 30 experts were consulted in two rounds of questionnaire to select and revise indexes at all three levels. The Analytic Hierarchy Process method was used to calculate the weight of indexes at all three levels. RESULTS: The evaluation index system for assessing the regional mobile SARS-CoV-2 virus nucleic acid testing capacity, including 5 first-level indexes, 17 second-level indexes, and 90 third-level indexes. The response rates of questionnaires delivered in the two rounds of consultation were 100 and 96.7%. Furthermore, the authority coefficient of 30 experts was 0.71. Kendall's coordination coefficient differences were statistically significant (P < 0.001). The weighted values of capacity indexes were established at all levels according to the consistency test, demonstrating that 'Personnel team construction' (0.2046) came first amongst the five first-level indexes, followed by 'Laboratory performance building and maintenance' (0.2023), 'Emergency response guarantee' (0.1989), 'Information management system for nucleic acid testing resources' (0.1982) and 'Regional mobile nucleic acid testing emergency response system construction' (0.1959). CONCLUSION: The evaluation system for assessing the regional mobile SARS-CoV-2 virus nucleic acid testing capacity puts forward a specific, objective, and quantifiable evaluation criterion. The evaluation system can act as a tool for diversified subjects to find the weak links and loopholes. It also provides a measurable basis for authorities to improve nucleic acid testing capabilities.
Subject(s)
COVID-19 , Nucleic Acids , COVID-19/diagnosis , COVID-19/epidemiology , China/epidemiology , Delphi Technique , Humans , SARS-CoV-2/geneticsABSTRACT
Major depressive disorder (MDD) is a global healthcare issue and one of the leading causes of disability. Machine learning combined with non-invasive electroencephalography (EEG) has recently been shown to have the potential to diagnose MDD. However, most of these studies analyzed small samples of participants recruited from a single source, raising serious concerns about the generalizability of these results in clinical practice. Thus, it has become critical to re-evaluate the efficacy of various common EEG features for MDD detection across large and diverse datasets. To address this issue, we collected resting-state EEG data from 400 participants across four medical centers and tested classification performance of four common EEG features: band power (BP), coherence, Higuchi's fractal dimension, and Katz's fractal dimension. Then, a sequential backward selection (SBS) method was used to determine the optimal subset. To overcome the large data variability due to an increased data size and multi-site EEG recordings, we introduced the conformal kernel (CK) transformation to further improve the MDD as compared with the healthy control (HC) classification performance of support vector machine (SVM). The results show that (1) coherence features account for 98% of the optimal feature subset; (2) the CK-SVM outperforms other classifiers such as K-nearest neighbors (K-NN), linear discriminant analysis (LDA), and SVM; (3) the combination of the optimal feature subset and CK-SVM achieves a high five-fold cross-validation accuracy of 91.07% on the training set (140 MDD and 140 HC) and 84.16% on the independent test set (60 MDD and 60 HC). The current results suggest that the coherence-based connectivity is a more reliable feature for achieving high and generalizable MDD detection performance in real-life clinical practice.