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1.
ACS Nano ; 16(5): 7512-7524, 2022 05 24.
Article in English | MEDLINE | ID: covidwho-1805554

ABSTRACT

The key to controlling the spread of the coronavirus disease 2019 (COVID-19) and reducing mortality is highly dependent on the safe and effective use of vaccines for the general population. Current COVID-19 vaccination practices (intramuscular injection of solution-based vaccines) are limited by heavy reliance on medical professionals, poor compliance, and laborious vaccination recording procedures, resulting in a waste of health resources and low vaccination coverage, etc. In this study, we developed a smart mushroom-inspired imprintable and lightly detachable (MILD) microneedle platform for the effective and convenient delivery of multidose COVID-19 vaccines and decentralized vaccine information storage. The mushroom-like structure allows the MILD system to be easily pressed into the skin and detached from the patch base, acting as a "tattoo" to record the vaccine counts in situ without any storage equipment, offering quick accessibility and effortless readout, saving a great deal of valuable time and energy for both patients and health professionals. After loading inactivated SARS-CoV-2 virus-based vaccines, MILD system induced a high level of antibodies against the SARS-CoV-2 receptor-binding domain (RBD) in vivo without eliciting systemic toxicity and local damage. Collectively, this smart delivery platform serves as a promising carrier to improve COVID-19 vaccination efficacy through its dual capabilities of vaccine delivery and in situ data storage, thus exhibiting great potential for helping to contain the COVID-19 pandemic or a resurgence.


Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , COVID-19 Vaccines , Pandemics/prevention & control , SARS-CoV-2 , Vaccination/methods , Information Storage and Retrieval , Antibodies, Viral
2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-330643

ABSTRACT

Background: Biologic therapies that target B-cell function are effective for a range of medical conditions. Patients treated with such therapies do not reliably generate robust humoral responses which may increase their risk for severe viral infections, including SARS-CoV2.This study sought to characterize outcomes for patients previously treated with B-cell depleting drugs who were hospitalized with COVID-19 compared to similar patients by demographic background, comorbidities, clinical status and COVID19-specific treatment received. Methods: Registry data was reviewed to identify patients treated with B-cell depletion therapy who were hospitalized with COVID-19 from March 1, 2020 to November 30, 2021. 30-day mortality was the primary outcome, secondary outcomes included time to severe illness or death and time to clinical improvement. Overlap weighting method was applied to adjust for treatment bias, and Cox proportional-hazards models were used to analyze outcomes of interest. Age, BMI and COVID-19 specific medications were included in regression models as covariates. A prespecified subgroup analysis was conducted to examine effects in patients with B-cell treatment ≤ 90 days prior to COVID-19 hospitalization. Results 9,233 patients were admitted to the Johns Hopkins Medicine health system between March 1, 2020 and November 2021. 50 patients were identified that had been treated with B-cell depletion therapy who were hospitalized with COVID-19. 212 were selected as the control group via matching across selected variables. B-cell treated patients experienced a 30-day mortality of 6.0% compared to 4.2% in controls which was not statistically significant in overlap weight adjusted regression analysis, adjusted hazard ratio 1.13 (95%CI 0.23 to 5.48). The time to severe illness or death was 2.4 days (IQR 0.5 to 4.0 days) in the B-cell treated patients and 2.1 days (IQR 0.9 to 4.3 days) among controls, adjusted hazard ratio 1.01 (95% CI 0.47 to 2.18). Patients treated with B-cell depletion experienced a statistically significant longer time to clinical improvement, adjusted HR 0.66 (95% CI 0.47-0.94). The median time to improve or discharge was 6.3 days in B-cell depleted group (IQR 3.3 to 11.2 days) and 4.1 days in the matched control (IQR 2.1 to 7.7 days). These results were similar in subgroup analysis for patients who received B-cell depletion in the 90 days prior to hospitalization. Interpretation Patients treated with B-cell depletion were found to have more prolonged hospital courses however they did not experience higher mortality or a time to severe illness compared to controls. With appropriate close follow-up and clinical care, individuals can still receive life-saving B-cell depleting therapies in the middle of a pandemic. Further work should be devoted to characterizing the course of these patients considering new therapies and variants.

3.
Am J Transplant ; 22(4): 1253-1260, 2022 04.
Article in English | MEDLINE | ID: covidwho-1583700

ABSTRACT

Vaccine-induced SARS-CoV-2 antibody responses are attenuated in solid organ transplant recipients (SOTRs) and breakthrough infections are more common. Additional SARS-CoV-2 vaccine doses increase anti-spike IgG in some SOTRs, but it is uncertain whether neutralization of variants of concern (VOCs) is enhanced. We tested 47 SOTRs for clinical and research anti-spike IgG, pseudoneutralization (ACE2 blocking), and live-virus neutralization (nAb) against VOCs before and after a third SARS-CoV-2 vaccine dose (70% mRNA, 30% Ad26.COV2.S) with comparison to 15 healthy controls after two mRNA vaccine doses. We used correlation analysis to compare anti-spike IgG assays and focused on thresholds associated with neutralization. A third SARS-CoV-2 vaccine dose increased median total anti-spike (1.6-fold), pseudoneutralization against VOCs (2.5-fold vs. Delta), and neutralizing antibodies (1.4-fold against Delta). However, neutralization activity was significantly lower than healthy controls (p < .001); 32% of SOTRs had zero detectable nAb against Delta after third vaccination compared to 100% for controls. Correlation with nAb was seen at anti-spike IgG >4 Log10 (AU/ml) on the Euroimmun ELISA and >4 Log10 (AU/ml) on the MSD research assay. These findings highlight benefits of a third vaccine dose for some SOTRs and the need for alternative strategies to improve protection in a significant subset of this population.


Subject(s)
COVID-19 , Organ Transplantation , Ad26COVS1 , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Organ Transplantation/adverse effects , SARS-CoV-2 , Transplant Recipients , Vaccines, Synthetic , mRNA Vaccines
4.
J Nurs Manag ; 2021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1371833

ABSTRACT

AIMS: To explore the incidence of workplace violence against nurses in Chinese hospitals. BACKGROUND: Previous systematic reviews on the incidence of workplace violence against Chinese health care workers did not include many articles published in Chinese. Although several studies have investigated cases of violence against health care providers in China, no meta-analysis has been conducted to assess the incidence of violence against Chinese nurses. EVALUATION: In this study, relevant data were retrieved from studies published up to July 2020. A meta-analysis was conducted using R software (Version 4.0). KEY FINDINGS: The 12-month incidence of workplace violence among Chinese nurses was 71% (95% CI 67%-75%), and verbal violence was the most common sub-type of violence (63%, 95% CI 58%-67%). CONCLUSION: Chinese nurses are at a high risk of violence at workplace. Hospital managers should explore ways to reduce violence against their employees, especially the younger nurses who work in secondary hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study highlight the need to enhance the legal system in terms of laws meant to effectively mitigate violence against nurses in Chinese hospitals. Measures should be particularly taken to protect younger nurses who work in secondary hospitals.

5.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-1300

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has become a global health emergency. However, there are limited studies focusing on the occurrence of COVID-19

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