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1.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-337444

ABSTRACT

Background SARS-CoV-2 Omicron variant BA.1 first emerged on the Chinese mainland in January 2022 in Tianjin and caused a large wave of infections. During mass PCR testing, a total of 430 cases infected with Omicron were recorded between January 8 and February 7, 2022, with no new infections detected for the following 16 days. Most patients had been vaccinated with SARSCoV-2 inactivated vaccines. The disease profile associated with BA.1 infection, especially after vaccination with inactivated vaccines, is unclear. Whether BA.1 breakthrough infection after receiving inactivated vaccine could create a strong enough humoral immunity barrier against Omicron is not yet investigated. Methods We collected the clinical information and vaccination history of the 430 COVID-19 patients infected with Omicron BA.1. Re-positive cases and inflammation markers were monitored during the patient’s convalescence phase. Ordered multiclass logistic regression model was used to identify risk factors for COVID-19 disease severity. Authentic virus neutralization assays against SARS-CoV-2 wildtype, Beta and Omicron BA.1 were conducted to examine the plasma neutralizing titers induced after post-vaccination Omicron BA.1 infection, and were compared to a group of uninfected healthy individuals who were selected to have a matched vaccination profile. Findings Among the 430 patients, 316 (73.5%) were adults with a median age of 47 years, and 114 (26.5%) were under-age with a median age of 10 years. Female and male patients account for 55.6% and 44.4%, respectively. Most of the patients presented with mild (47.7%) to moderate diseases (50.2%), with only 2 severe cases (0.5%) and 7 (1.6%) asymptomatic infections. No death was recorded. 341 (79.3%) of the 430 patients received inactivated vaccines (54.3% BBIBP-CorV vs. 45.5% CoronaVac), 49 (11.4%) received adenovirus-vectored vaccines (Ad5-nCoV), 2 (0.5%) received recombinant protein subunit vaccines (ZF2001), and 38 (8.8%) received no vaccination. No vaccination is associated with a substantially higher ICU admission rate among Omicron BA.1 infected patients (2.0% for vaccinated patients vs. 23.7% for unvaccinated patients, P<0.001). Compared with adults, child patients presented with less severe illness (82.5% mild cases for children vs. 35.1% for adults, P<0.001), no ICU admission, fewer comorbidities (3.5% vs. 53.2%, P<0.001), and less chance of turning re-positive on nucleic acid tests (12.3% vs. 22.5%, P=0.019). For adult patients, compared with no prior vaccination, receiving 3 doses of inactivated vaccine was associated with significantly lower risk of severe disease (OR 0.227 [0.065-0.787], P=0.020), less ICU admission (OR 0.023 [0.002-0.214], P=0.001), lower re-positive rate on PCR (OR 0.240 [0.098-0.587], P=0.002), and shorter duration of hospitalization and recovery (OR 0.233 [0.091-0.596], P=0.002). At the beginning of the convalescence phase, patients who had received 3 doses of inactivated vaccine had substantially lower systemic immune-inflammation index (SII) and C-reactive protein than unvaccinated patients, while CD4+/CD8+ ratio, activated Treg cells and Th1/Th2 ratio were higher compared to their 2-dose counterparts, suggesting that receipt of 3 doses of inactivated vaccine could step up inflammation resolution after infection. Plasma neutralization titers against Omicron, Beta, and wildtype significantly increased after breakthrough infection with Omicron. Moderate symptoms were associated with higher plasma neutralization titers than mild symptoms. However, vaccination profiles prior to infection, whether 2 doses versus 3 doses or types of vaccines, had no significant effect on post-infection neutralization titer. Among recipients of 3 doses of CoronaVac, infection with Omicron BA.1 largely increased neutralization titers against Omicron BA.1 (8.7x), Beta (4.5x), and wildtype (2.2x), compared with uninfected healthy individuals who have a matched vaccination profile. Interpretation Receipt of 3-dose inactivated vaccines can substantially reduce the disease severity of Omicr n BA.1 infection, with most vaccinated patients presenting with mild to moderate illness. Child patients present with less severe disease than adult patients after infection. Omicron BA.1 convalescents who had received inactivated vaccines showed significantly increased plasma neutralizing antibody titers against Omicron BA.1, Beta, and wildtype SARS-CoV-2 compared with vaccinated healthy individuals.

2.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-334805

ABSTRACT

Omicron sub-lineage BA.2 has rapidly surged globally, accounting for over 60% of recent SARS-CoV-2 infections. Newly acquired RBD mutations and high transmission advantage over BA.1 urge the investigation of BA.2's immune evasion capability. Here, we show that BA.2 causes strong neutralization resistance, comparable to BA.1, in vaccinated individuals' plasma. However, BA.2 displays more severe antibody evasion in BA.1 convalescents, and most prominently, in vaccinated SARS convalescents' plasma, suggesting a substantial antigenicity difference between BA.2 and BA.1. To specify, we determined the escaping mutation profiles1,2 of 714 SARS-CoV-2 RBD neutralizing antibodies, including 241 broad sarbecovirus neutralizing antibodies isolated from SARS convalescents, and measured their neutralization efficacy against BA.1, BA.1.1, BA.2. Importantly, BA.2 specifically induces large-scale escape of BA.1/BA.1.1effective broad sarbecovirus neutralizing antibodies via novel mutations T376A, D405N, and R408S. These sites were highly conserved across sarbecoviruses, suggesting that Omicron BA.2 arose from immune pressure selection instead of zoonotic spillover. Moreover, BA.2 reduces the efficacy of S309 (Sotrovimab)3,4 and broad sarbecovirus neutralizing antibodies targeting the similar epitope region, including BD55-5840. Structural comparisons of BD55-5840 in complexes with BA.1 and BA.2 spike suggest that BA.2 could hinder antibody binding through S371F-induced N343-glycan displacement. Intriguingly, the absence of G446S mutation in BA.2 enabled a proportion of 440-449 linear epitope targeting antibodies to retain neutralizing efficacy, including COV2-2130 (Cilgavimab)5. Together, we showed that BA.2 exhibits distinct antigenicity compared to BA.1 and provided a comprehensive profile of SARS-CoV-2 antibody escaping mutations. Our study offers critical insights into the humoral immune evading mechanism of current and future variants.

3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(12): 2082-2087, 2021 Dec 10.
Article in Chinese | MEDLINE | ID: covidwho-1600042

ABSTRACT

Objective: To understand the epidemiological characteristics of imported COVID-19 cases in Tianjin, and provide references for risk assessment and control of imported COVID-19 cases. Methods: The information of imported COVID-19 cases were obtained from National Notifiable Disease Report System of China CDC. The data of imported COVID-19 cases reported from Tianjin airport and epidemiological surveys by CDCs at all levels from March 15, 2020 to August 31, 2021 were collected and analyzed by using software Excel 2010, SPSS 25.0 and R. Results: From March 15, 2020 to August 31, 2021, a total of 606 imported cases of COVID-19 were reported in Tianjin, in which 552 cases were finally included in the analysis. The male to female ratio of the cases was 1.8∶1, the age of the cases ranged from 3 to 77 years, and the cases were mainly reported in age group 20-39 years (59.8%). The areas where the imported case sojourned within 14 days included Europe (242 cases, 43.8%), Africa (139 cases, 25.2%), Americas (85 cases, 15.4%) and Asia (86 cases, 15.6%). The proportion of confirmed cases in autumn and winter was relatively high. During the study period, the proportion of infected persons found in custom entry quarantine decreased, and the proportion of persons with personal health declaration and under medical isolation observation increased. The interval between entry and diagnosis of infected persons tended to increase. Conclusion: The proportion of imported COVID-19 cases detected on the first day of entry at Tianjin airport decreased, and the interval to detect the infected persons trended to increase, to which close attention must be paid.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , Child , Child, Preschool , China/epidemiology , Female , Humans , Male , Middle Aged , Quarantine , SARS-CoV-2 , Surveys and Questionnaires , United States , Young Adult
4.
European Stroke Journal ; 6(1 SUPPL):17, 2021.
Article in English | EMBASE | ID: covidwho-1468038

ABSTRACT

Background and Aims: Rapid intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) is crucial for improving outcomes. However, randomized trials to reduce in-hospital delay are clearly limited in China. We aimed to evaluate the effect of a multi-component intervention on thrombolytic door-to needle time (DNT) of AIS patients via video teleconference based on the Behavior Change Wheel method. Methods: This trial randomly allocated 22 hospitals equally to PEITEM (Persuasion Environment reconstruction Incentivisation Training Education Modeling) intervention or routine care plus stroke registry and subsequently enrolled 1634 AIS patients who receiving IVT within 4.5 hours upon stroke onset from participant hospitals. The PEITEM group received a one-year PEITEM intervention based on the behavioral theory monthly via video teleconference. Results: A total of 1, 634 patients from the 22 hospitals were enrolled. The proportion of DNT ≤ 60 minutes was 82.0% in the PEITEM group and 73.7% in the control group (adjusted odds ratio, 1.85;95% confidence interval [CI], 1.42 to 2.42, P<0.001). The average DNT was 43 minutes in the PEITEM group and 50 minutes in the control group (β: -9.00;95% CI, -11.37 to ≤6.63, P<0.001). Favorable neurological outcomes were achieved in 55.6% patients in the PEITEM group and 50.4% patients in the control group (adjusted odds ratio, 1.34;95% CI, 1.02 to 1.75;P=0.04). Conclusions: The teleconference-delivered PEITEM intervention resulted in a moderately but clinically relevant shorter DNT and better neurological outcomes in the AIS treated with the IVT. Video teleconference may be more appropriate and easier for quality improvement in the current global COVID-19 public health crisis disrupting healthcare services.

5.
Nat Commun ; 12(1): 5173, 2021 08 27.
Article in English | MEDLINE | ID: covidwho-1376196

ABSTRACT

Disease modelling has had considerable policy impact during the ongoing COVID-19 pandemic, and it is increasingly acknowledged that combining multiple models can improve the reliability of outputs. Here we report insights from ten weeks of collaborative short-term forecasting of COVID-19 in Germany and Poland (12 October-19 December 2020). The study period covers the onset of the second wave in both countries, with tightening non-pharmaceutical interventions (NPIs) and subsequently a decay (Poland) or plateau and renewed increase (Germany) in reported cases. Thirteen independent teams provided probabilistic real-time forecasts of COVID-19 cases and deaths. These were reported for lead times of one to four weeks, with evaluation focused on one- and two-week horizons, which are less affected by changing NPIs. Heterogeneity between forecasts was considerable both in terms of point predictions and forecast spread. Ensemble forecasts showed good relative performance, in particular in terms of coverage, but did not clearly dominate single-model predictions. The study was preregistered and will be followed up in future phases of the pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Forecasting , Germany/epidemiology , Humans , Models, Statistical , Pandemics/statistics & numerical data , Poland/epidemiology , SARS-CoV-2/physiology , Seasons
6.
National Health Statistics Reports ; 2021, 2021.
Article in English | Scopus | ID: covidwho-1296259

ABSTRACT

Background and objectives-In March 2020, the coronavirus disease 2019 (COVID-19) pandemic halted National Health and Nutrition Examination Survey (NHANES) field operations. As data collected in the partial 2019–2020 cycle (herein referred to as 2019–March 2020) are not nationally representative, they were combined with previously released 2017–2018 data to produce nationally representative estimates. This report explains the creation of the 2017–March 2020 prepandemic data files, provides recommendations for and limitations of the files’ use, and presents prevalence estimates for selected health outcomes based on the files. Methods-The 2019–2020 primary sampling units (PSUs) were reassigned to the 2015–2018 sample design strata and combined with the 2017–2018 data to create a data set that could be used to calculate nationally representative estimates. A PSUlevel adjustment factor was created to equalize the contribution of each stratum to the total survey sample and applied to participant base weights. Interview and examination weights were calculated from the adjusted base weights. The performance of final interview weights was assessed by comparing the demographic characteristics of the weighted NHANES 2017–March 2020 prepandemic sample with nationally representative estimates from the 2018 5-year American Community Survey. Prevalence estimates and 95% confidence intervals were calculated for selected health outcomes. Results-Among children and adolescents aged 2–19 years, the prevalence of obesity was 19.7% and the prevalence of untreated or restored dental caries in one or more primary or permanent teeth was 46.0%. Among adults aged 20 and over, the age-adjusted prevalence of obesity was 41.9%, severe obesity was 9.2%, and diabetes was 14.8%. Among adults aged 18 and over, the age-adjusted prevalence of hypertension was 45.1%. Among adults aged 65 and over, the age-adjusted prevalence of complete tooth loss was 13.8%. Conclusion-A PSU-level adjustment factor and additional weighting adjustments made nationally representative estimates from the 2017–March 2020 prepandemic data files possible;this was the last NHANES data collected before widespread transmission of COVID-19. © 2021, National Center for Health Statistics. All rights reserved.

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