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1.
Pediatr Infect Dis J ; 41(12): e513-e516, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2051630

ABSTRACT

Although post-acute sequelae of COVID-19 among adult survivors has gained significant attention, data in children hospitalized for severe acute respiratory syndrome coronavirus 2 is limited. This study of commercially insured US children shows that those hospitalized with COVID-19 or multisystem inflammatory syndrome in children have a substantial burden of severe acute respiratory syndrome coronavirus 2 sequelae and associated health care visits postdischarge.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Adult , Humans , Aftercare , Follow-Up Studies , Patient Discharge , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/therapy , Disease Progression , Delivery of Health Care
2.
Nat Commun ; 13(1): 2377, 2022 05 02.
Article in English | MEDLINE | ID: covidwho-1890173

ABSTRACT

Real-world analysis of the incidence of SARS-CoV-2 infection post vaccination is important in determining the comparative effectiveness of the available vaccines. In this retrospective cohort study using deidentified administrative claims for Medicare Advantage and commercially insured individuals in a research database we examine over 3.5 million fully vaccinated individuals, including 8,848 individuals with SARS-CoV-2 infection, with a follow-up period between 14 and 151 days after their second dose. Our primary outcome was the rate of Covid-19 infection occurring at 30, 60, and 90 days at least 14 days after the second dose of either the mRNA-1273 vaccine or the BNT162b2 vaccine. Sub-analyses included the incidence of hospitalization, ICU admission, and death/hospice transfer. Separate analysis was conducted for individuals above and below age 65 and those without a prior diagnosis of Covid-19. We show that immunization with mRNA-1273, compared to BNT162b2, provides slightly more protection against SARS-CoV-2 infection that reaches statistical significance at 90 days with a number needed to vaccinate of >290. There are no differences in vaccine effectiveness for protection against hospitalization, ICU admission, or death/hospice transfer (aOR 1.23, 95% CI (0.67, 2.25)).


Subject(s)
COVID-19 , Viral Vaccines , 2019-nCoV Vaccine mRNA-1273 , Aged , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Medicare , Retrospective Studies , SARS-CoV-2/genetics , United States/epidemiology
3.
Hum Vaccin Immunother ; 18(1): 2020573, 2022 12 31.
Article in English | MEDLINE | ID: covidwho-1799504

ABSTRACT

Limited information is available about post-marketing safety of Japanese encephalitis (JE) vaccines. Using data from SmartVax, an active surveillance system for monitoring vaccine safety, adverse events following immunizations (AEFIs) were compared between the two JE vaccines available in Australia (a chimeric live attenuated vaccine [Imojev] and a Vero cell-derived inactivated vaccine [JEspect]). Data from 2756 patients (1855 Imojev and 901 JEspect) were included. Overall (7.0%), systemic (2.8%), and local (1.9%) AEFIs were uncommon. There were no significant differences in the odds of overall (OR = 1.27; 95%CI: 0.91-1.77), systemic (OR = 1.23; 95%CI: 0.74-2.06), or local (OR = 1.20; 95%CI: 0.65-2.22) AEFIs with Imojev compared to JEspect. There was an increase in odds of overall AEFI in patients aged <5 years (OR = 2.39; 95%CI: 1.10-5.19) compared to those aged >50 years. Both JE vaccines available in Australia are safe and well tolerated. Odds of AEFIs were age-dependent, young children should be carefully observed for AEFIs after vaccination.


Subject(s)
Encephalitis, Japanese , Japanese Encephalitis Vaccines , Animals , Australia , Child , Child, Preschool , Chlorocebus aethiops , Encephalitis, Japanese/prevention & control , Humans , Middle Aged , Vaccines, Attenuated/adverse effects , Vaccines, Inactivated/adverse effects , Vero Cells , Watchful Waiting
4.
Pathog Glob Health ; 116(5): 269-281, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1662085

ABSTRACT

This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies and T and B memory cells after recovery. In addition, the prevalence of COVID-19 reinfection and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. A synthesis of existing research was conducted. The Cochrane Library, the China Academic Journals Full Text Database, PubMed, and Scopus, and preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. Included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity was assessed using the I2 and Cochran's Q statistics and publication bias was assessed using Doi plots. Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG - 90.4% (95%CI 72.2-99.9, I2 = 89.0%), CD4+ - 91.7% (95%CI 78.2-97.1y), and memory B cells 80.6% (95%CI 65.0-90.2) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0-0.7, I2 = 98.8). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1-0.3, I2 = 90.5%). Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection.RegistrationPROSPERO: CRD42020201234.


Subject(s)
COVID-19 , Adaptive Immunity , COVID-19/epidemiology , Humans , Prevalence , Reinfection/epidemiology , SARS-CoV-2
5.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294470

ABSTRACT

Objectives This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 specific antibodies as well as memory T and B cells after recovery. In addition, the prevalence of COVID-19 reinfection, and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. Methods and analyses A synthesis of existing research was conducted. The Cochrane Library for COVID-19 resources, the China Academic Journals Full Text Database, PubMed, and Scopus as well as preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. We included studies with the relevant outcomes of interest. All included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity between included studies was assessed using the I 2 and Cochran’s Q statistics and publication bias was assessed using Doi plots. Results Fifty-four studies, from 18 countries, with a total of 12 011 447 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of detectable SARS-CoV-2 specific immunological memory remained high;IgG – 90.4% (95%CI 72.2-99.9, I 2 =89.0%, 5 studies), CD4+ - 91.7% (95%CI 78.2 – 97.1, one study), and memory B cells 80.6% (95%CI 65.0-90.2, one study) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0 – 0.7, I 2 = 98.8, 9 studies). Individuals who recovered from COVID-19 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1 - 0.3, I 2 = 90.5%, 5 studies). Conclusion Around 90% of people previously infected with SARS-CoV-2 had evidence of immunological memory to SARS-CoV-2, which was sustained for at least 6-8 months after recovery, and had a low risk of reinfection. Registration PROSPERO: CRD42020201234

8.
Epidemiol Infect ; 149: e193, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1366777

ABSTRACT

There is a paucity of evidence about the prevalence and risk factors for symptomatic infection among children. This study aimed to describe the prevalence of symptomatic coronavirus disease 2019 (COVID-19) and its risk factors in children and adolescents aged 0-18 years in Qatar. We conducted a cross-sectional study of all children aged 0-18 years diagnosed with COVID-19 using polymerase chain reaction in Qatar during the period 1st March to 31st July 2020. A generalised linear model with a binomial family and identity link was used to assess the association between selected factors and the prevalence of symptomatic infection. A total of 11 445 children with a median age of 8 years (interquartile range (IQR) 3-13 years) were included in this study. The prevalence of symptomatic COVID-19 was 36.6% (95% confidence interval (CI) 35.7-37.5), and it was similar between children aged <5 years (37.8%), 5-9 years (34.3%) and 10 + years (37.3%). The most frequently reported symptoms among the symptomatic group were fever (73.5%), cough (34.8%), headache (23.2%) and sore throat (23.2%). Fever (82.8%) was more common in symptomatic children aged <5 years, while cough (38.7%) was more prevalent in those aged 10 years or older, compared to other age groups. Variables associated with an increased risk of symptomatic infection were; contact with confirmed cases (RD 0.21; 95% CI 0.20-0.23; P = 0.001), having visited a health care facility (RD 0.54; 95% CI 0.45-0.62; P = 0.001), and children aged under 5 years (RD 0.05; 95% CI 0.02-0.07; P = 0.001) or aged 10 years or older (RD 0.04; 95% CI 0.02-0.06; P = 0.001). A third of the children with COVID-19 were symptomatic with a higher proportion of fever in very young children and a higher proportion of cough in those between 10 and 18 years of age.


Subject(s)
COVID-19/epidemiology , Cough/epidemiology , Fever/epidemiology , Headache/epidemiology , Pharyngitis/epidemiology , Adolescent , COVID-19/virology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Qatar/epidemiology , Risk Factors
9.
BMJ Open ; 10(12): e041761, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-978807

ABSTRACT

OBJECTIVE: People with diabetes mellitus have a high risk of acquiring respiratory tract infections (RTIs), yet little is known about their utilisation of healthcare services compared with people without diabetes. This study aimed to compare the utilisation of healthcare services for RTIs between individuals with and without diabetes attending primary healthcare centres (PHCCs) in Qatar. DESIGN: A retrospective cross-sectional study was conducted using an electronic database of all individuals who had a diagnosis of RTI. SETTING: PHCCs in Qatar from July 2015 to December 2017. PARTICIPANTS: Participants in the study were all adult individuals (aged ≥18 years) who visited the primary healthcare facilities and were diagnosed with an RTI during the study period. PRIMARY AND OUTCOME MEASURES: For each participant, visits to the healthcare facility, antibiotic use and use of other medications were extracted from the electronic database and compared between participants with and without a diabetes diagnosis. RESULTS: A total of 32 857 participants were included, of whom 7407 (22.5%) had a diabetes diagnosis. Results from a negative binomial regression indicate that diabetes diagnosis was significantly associated with increased visits to the healthcare facility (incidence rate ratio (IRR) 1.10, 95% CI 1.076 to 1.134, p<0.001), antibiotic use (IRR 1.09, 95% CI 1.046 to 1.145, p<0.001) and use of other medications (IRR 1.11, 95% CI 1.078 to 1.143, p<0.001). CONCLUSIONS: A diabetes diagnosis among patients with RTI was associated with higher utilisation of healthcare services. Given the added costs to the healthcare system, prevention of diabetes will have additional benefits to the healthcare system, apart from diabetes-associated costs alone.


Subject(s)
Diabetes Mellitus , Respiratory Tract Infections , Adolescent , Adult , Cross-Sectional Studies , Delivery of Health Care , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Humans , Qatar/epidemiology , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/epidemiology , Retrospective Studies
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