Characterization of SARS-CoV-2-Specific Humoral and Cellular Immune Responses Induced by Inactivated COVID-19 Vaccines in a Real-World Setting

While the immunogenicity of inactivated vaccines against coronavirus disease 2019 (COVID-19) has been characterized in several well-conducted clinical trials, real-world evidence concerning immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised by such vaccines is currently missing. Here, we comprehensively characterized various parameters of SARS-CoV-2-specific cellular and humoral immune responses induced by inactivated COVID-19 vaccines in 126 individuals under real-world conditions. After two doses of vaccination, S-receptor binding domain IgG (S-RBD IgG) and neutralizing antibody (NAb) were detected in 87.06% (74/85) and 78.82% (67/85) of individuals, respectively. Female participants developed higher concentrations of S-RBD IgG and NAb compared to male vaccinees. Interestingly, a longer dosing interval between the first and second vaccination resulted in a better long-term SARS-CoV-2 S-RBD IgG response. The frequencies of CD4+ T cells that produce effector cytokines (IFN-gamma, IL-2, and TNF-alpha) in response to stimulation with peptide pools corresponding to the SARS-CoV-2 spike (S), nucleocapsid (N) or membrane (M) protein were significantly higher in individuals received two doses of vaccine than those received one dose of vaccine and unvaccinated individuals. S, N, or M-specific CD4+ and CD8+ T cell responses were detectable in 95.83% (69/72) and 54.16% (39/72) of double-vaccinated individuals, respectively. The longitudinal analysis demonstrated that CD4+ T cell responses recognizing S, N, and M waned quickly after a single vaccine dose, but were boosted and became more sustained following a second dose. Overall, we provide a comprehensive characterization of immune responses induced by inactivated COVID-19 vaccines in real-world settings, suggesting that both humoral and cellular SARS-CoV-2 specific immunity are elicited in the majority of individuals after two doses of inactivated COVID-19 vaccines.

[Characteristics of liver function changes in 111 elderly patients with COVID-19 pneumonia].

Objective: To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia. Methods: 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group (n=40), normal group (n=71), abnormal liver function group (n=86) and normal liver function group (n=25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Results: Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group (P<0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group (P>0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group (P<0.05). Conclusion: Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

Added value of home virtual exercise in cardiac rehabilitation during covid-19

Objectives: Cardiac rehabilitation is the key component in optimizing physical function, reducing the cardiovascular risk and mortality for cardiac patients. However, as the coronavirus disease 2019 (COVID- 19) pandemic has begun since the end of 2019, usual service is affected. Patients' compliance and attendance to exercise training is worth concern and the general recommendation of 150-minute per week of moderate intensity exercise is almost unachievable. The limitation of routine health care delivery is explored. In order to increase patients' physical activity and prevent secondary complication, the Cardiac Society of Australia and New Zealand (CSANZ) recommended health care profession continued to deliver evidencedbased strategies with the use of electronic health platforms as it was more accessible during the pandemic. This study sought to examine the value of home virtual exercise in cardiac rehabilitation during COVID-19. Methods: Twenty-eight patients were recruited from the Cardiac Rehabilitation program (CRP) in Tseung Kwan O Hospital between December 2019 and August 2020. Patients who attended the CRP were under usual care receiving 1.5-hour center-based training 1-2 times per week. The home virtual exercise which was circuit training was given via QR code. All patients completed 12-sessions of CRP. Patients' safety, body weight and body mass index (BMI), 6 Minutes Walk Test (6MWT) distance, Five Times Sit To Stand (FTSTS) and Cardiac Exercise Self-Efficacy Instrument (CESEI) were measured at baseline and at end of 12th session. Results: No adverse events were reported in relation to home virtual exercise. Although there were no statistically changes in body weight and BMI (p>0.109), there were significant improvement in 6MWT distance (p=0.000), FTSTS (p=0.000) and CESEI (p=0.007). Conclusion: Home virtual exercise appears to be safe and effective for patients to exercise at home during COVID-19. Improvement in functional capacity and self-efficacy were observed, therefore, suggesting that home virtual exercise could be used in addition to center-based training to improve cardiovascular risk. Cardiac rehabilitation specialists should consider using electronic platforms during the pandemic to deliver exercise regimes. Future study is needed to explore the long-term effects of virtual exercise after program completion.