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1.
Clin Infect Dis ; 2021 Nov 28.
Article in English | MEDLINE | ID: covidwho-2017777

ABSTRACT

BACKGROUND: Multisystem inflammatory syndrome in adults (MIS-A) was reported in association with the COVID-19 pandemic. MIS-A was included in the list of adverse events to be monitored as part of the emergency use authorizations issued for COVID-19 vaccines. METHODS: Reports of MIS-A patients received by the Centers for Disease Control and Prevention (CDC) after COVID-19 vaccines became available were assessed. Data collected on the patients included clinical and demographic characteristics and their vaccine status. The Vaccine Adverse Events Reporting System (VAERS) was also reviewed for possible cases of MIS-A. RESULTS: From December 14, 2020 to April 30, 2021, 20 patients who met the case definition for MIS-A were reported to CDC. Their median age was 35 years (range, 21-66 years), and 13 (65%) were male. Overall, 16 (80%) patients had a preceding COVID-19-like illness a median of 26 days (range 11-78 days) before MIS-A onset. All 20 patients had laboratory evidence of SARS-CoV-2 infection. Seven MIS-A patients (35%) received COVID-19 vaccine a median of 10 days (range, 6-45 days) before MIS-A onset; 3 patients received a second dose of COVID-19 vaccine 4, 17, and 22 days before MIS-A onset. Patients with MIS-A predominantly had gastrointestinal and cardiac manifestations and hypotension or shock. CONCLUSIONS: Although 7 patients were reported to have received COVID-19 vaccine, all had evidence of prior SARS-CoV-2 infection. Given the widespread use of COVID-19 vaccines, the lack of reporting of MIS-A associated with vaccination alone, without evidence of underlying SARS-CoV-2 infection, is reassuring.

2.
Open forum infectious diseases ; 2022.
Article in English | EuropePMC | ID: covidwho-2012014

ABSTRACT

A tree model identified adults aged ≤34 years, Johnson & Johnson primary series recipients, people from racial/ethnic minority groups, residents of non-large metro areas, and those living in socially vulnerable communities in the South as less likely to be boosted. These findings can guide clinical/public health outreach toward specific sub-populations.

3.
J Anal Test ; : 1-12, 2022 Aug 05.
Article in English | MEDLINE | ID: covidwho-1982424

ABSTRACT

Gold nanoparticles (AuNPs) colorimetric assays based on distance-dependent optical characteristics have been widely employed for bioanalysis. However, this assay is not effective for visually detecting low-concentration targets due to the faint color change. Here, we developed a handheld nano-centrifugal device which could separate the crosslinked and non-crosslinked AuNPs. Results showed that the handheld nano-centrifugal device could easily reach more than 6000 r/min within 10 s simply by stretching and tightening the coiled rope in an appropriate rhythm. Further, combined with the CRISPR/Cas12a nucleic acids recognition system, a field-deployable colorimetric platform termed handheld nano-centrifugal device assisted CRISPR/Cas12a (Hand-CRISPR) has been validated. Moreover, clinical diagnostics applications for Epstein-Barr virus (EBV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) detection with high sensitivity and accuracy (100% consistency with reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) test results) have been demonstrated. Overall, the Hand-CRISPR platform showed great promise in point-of-care-test (POCT) application, expected to become a powerful supplement to the standard nucleic acid testing method in remote or poverty-stricken areas. Supplementary Information: The online version contains supplementary material available at 10.1007/s41664-022-00232-0.

4.
American Journal of Preventive Medicine ; 2022.
Article in English | ScienceDirect | ID: covidwho-1936001

ABSTRACT

Introduction Little is known about how drivers of COVID-19 vaccination vary across the U.S. To inform vaccination outreach efforts, this study explores geographic variation in correlates of COVID-19 non-vaccination among adults. Methods Participants were a nationally representative sample of U.S. adults identified through random-digit-dialing for the National Immunization Survey-Adult COVID Module. Analyses examined the geographic and temporal landscape of constructs in the Behavioral and Social Drivers of vaccination (BeSD) Framework among unvaccinated respondents from May to December 2021 (n=531,798) and sociodemographic and geographic disparities and BeSD predictors of COVID-19 non-vaccination from October to December 2021 (n=187,756). Results National coverage with at least 1 dose of COVID-19 vaccine was 79.3% by December 2021, with substantial geographic heterogeneity. Regions with the largest proportion of unvaccinated persons who would probably get a COVID-19 vaccine or were unsure resided in the Southeast and Midwest (Health and Human Services Regions 4 and 5). Both regions had similar temporal trends regarding concerns about COVID-19 and confidence in vaccine importance, though Region 4 had especially low confidence in vaccine safety in December 2021, lowest in Florida (5.5%) and highest in North Carolina (18.0%). The strongest BeSD correlate of not receiving a COVID-19 vaccination was lower confidence in COVID-19 vaccine importance (aPR=5.19, 95% CI=4.93, 5.47;strongest in the Northeast, Southwest, and Mountain West, and weakest in the Southeast and Midwest). Other BeSD correlates also varied by region. Conclusions Contributors to non-vaccination showed substantial geographic heterogeneity. Strategies to improve COVID-19 vaccination uptake may need to be tailored regionally.

5.
Emerg Infect Dis ; 28(8): 1633-1641, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1924010

ABSTRACT

To identify demographic factors associated with delaying or not receiving a second dose of the 2-dose primary mRNA COVID-19 vaccine series, we matched 323 million single Pfizer-BioNTech (https://www.pfizer.com) and Moderna (https://www.modernatx.com) COVID-19 vaccine administration records from 2021 and determined whether second doses were delayed or missed. We used 2 sets of logistic regression models to examine associated factors. Overall, 87.3% of recipients received a timely second dose (≤42 days between first and second dose), 3.4% received a delayed second dose (>42 days between first and second dose), and 9.4% missed the second dose. Persons more likely to have delayed or missed the second dose belonged to several racial/ethnic minority groups, were 18-39 years of age, lived in more socially vulnerable areas, and lived in regions other than the northeastern United States. Logistic regression models identified specific subgroups for providing outreach and encouragement to receive subsequent doses on time.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Ethnicity , Humans , Minority Groups , RNA, Messenger , United States/epidemiology , Vaccination
6.
MMWR Morb Mortal Wkly Rep ; 71(26): 847-851, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1912314

ABSTRACT

COVID-19 can lead to severe outcomes in children, including multisystem inflammatory syndrome, hospitalization, and death (1,2). On November 2, 2021, the Advisory Committee on Immunization Practices issued an interim recommendation for use of the BNT162b2 (Pfizer-BioNTech) vaccine in children aged 5-11 years for the prevention of COVID-19; however, vaccination coverage in this age group remains low (3). As of June 7, 2022, 36.0% of children aged 5-11 years in the United States had received ≥1 of COVID-19 vaccine (3). Among factors that might influence vaccination coverage is the availability of vaccine providers (4). To better understand how provider availability has affected COVID-19 vaccination coverage among children aged 5-11 years, CDC analyzed data on active COVID-19 vaccine providers and county-level vaccine administration data during November 1, 2021-April 25, 2022. Among 2,586 U.S. counties included in the analysis, 87.5% had at least one active COVID-19 vaccine provider serving children aged 5-11 years. Among the five assessed active provider types, most counties had at least one pharmacy (69.1%) or public health clinic (61.3%), whereas fewer counties had at least one pediatric clinic (29.7%), family medicine clinic (29.0%), or federally qualified health center (FQHC)* (22.8%). Median county-level vaccination coverage was 14.5% (IQR = 8.9%-23.6%). After adjusting for social vulnerability index (SVI)† and urbanicity, the analysis found that vaccination coverage among children aged 5-11 years was higher in counties with at least one active COVID-19 vaccine provider than in counties with no active providers (adjusted rate ratio [aRR] = 1.66). For each provider type, presence of at least one provider in the county was associated with higher coverage; the largest difference in vaccination coverage was observed between counties with and without pediatric clinics (aRR = 1.37). Ensuring broad access to COVID-19 vaccines, in addition to other strategies to address vaccination barriers, could help increase vaccination coverage among children aged 5-11 years.


Subject(s)
COVID-19 , Vaccines , Ambulatory Care Facilities , BNT162 Vaccine , COVID-19/complications , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Child , Humans , Systemic Inflammatory Response Syndrome , United States/epidemiology , Vaccination , Vaccination Coverage
7.
Am J Prev Med ; 2022 Jun 27.
Article in English | MEDLINE | ID: covidwho-1906704

ABSTRACT

INTRODUCTION: Individuals with certain medical conditions are at substantially increased risk for severe illness from COVID-19. The purpose of this study is to assess COVID-19 vaccination among U.S. adults with reported medical conditions. METHODS: Data from the National Immunization Survey-Adult COVID Module collected during August 1-September 25, 2021 were analyzed in 2022 to assess COVID-19 vaccination status, intent, vaccine confidence, behavior, and experience among adults with reported medical conditions. Unadjusted and age-adjusted prevalence ratios (PRs and APRs) were generated using logistic regression and predictive marginals. RESULTS: Overall, COVID-19 vaccination coverage with ≥1 dose was 81.8% among adults with reported medical conditions, and coverage was significantly higher compared with those without such conditions (70.3%) Among adults aged ≥18 years with medical conditions, COVID-19 vaccination coverage was significantly higher among those with a provider recommendation (86.5%) than those without (76.5%). Among all respondents, 9.2% of unvaccinated adults with medical conditions reported they were willing or open to vaccination. Adults who reported high risk medical conditions were more likely to report receiving a provider recommendation, often or always wearing masks during the last 7 days, concerning about getting COVID-19, thinking the vaccine is safe, and believing a COVID-19 vaccine is important for protection from COVID-19 infection than those without such conditions. CONCLUSIONS: Approximately 18.0% of those with reported medical conditions were unvaccinated. Receiving a provider recommendation was significantly associated with vaccination, reinforcing that provider recommendation is an important approach to increase vaccination coverage. Ensuring access to vaccine, addressing vaccination barriers, and increasing vaccine confidence can improve vaccination coverage among unvaccinated adults.

9.
Clin Infect Dis ; 2022 Apr 20.
Article in English | MEDLINE | ID: covidwho-1806307

ABSTRACT

BACKGROUND: Multisystem inflammatory syndrome in adults (MIS-A) is a severe condition temporally associated with SARS-CoV-2 infection. METHODS: In this retrospective cohort study, we applied the U.S. Centers for Disease Control and Prevention (CDC) case definition to identify diagnosed and undiagnosed MIS-A cases among adults discharged April 2020-January 2021 from four Atlanta, Georgia hospitals affiliated with a single medical center. Non-MIS-A COVID-19 hospitalizations were identified using International Classification of Diseases, Tenth Revision encounter code U07.1. We calculated the ratio of MIS-A to COVID-19 hospitalizations, compared demographic characteristics of the two cohorts, and described clinical characteristics of MIS-A patients. RESULTS: We identified 11 MIS-A cases, none of which were diagnosed by the treatment team, and 5,755 COVID-19 hospitalizations (ratio 1: 523). Compared with patients with COVID-19, patients with MIS-A were more likely to be younger than 50 years (72.7% vs. 26.1%, p < 0.01) and to be non-Hispanic Black persons (81.8% vs. 50.0%, p = 0.04). Ten patients with MIS-A (90.9%) had at least one underlying medical condition. Two MIS-A patients (18.2%) had a previous episode of laboratory-confirmed COVID-19, occurring 37 and 55 days prior to admission. All MIS-A patients developed left ventricular systolic dysfunction. None had documented mucocutaneous involvement. All required intensive care, all received systemic corticosteroids, eight (72.7%) required mechanical ventilation, two (18.2%) required mechanical cardiovascular circulatory support, and none received intravenous immunoglobulin. Two (18.2%) died or were discharged to hospice. CONCLUSIONS: MIS-A is severe but likely underrecognized complication of SARS-CoV-2 infection. Improved recognition of MIS-A is needed to quantify its burden and identify populations at highest risk.

10.
Clin Infect Dis ; 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1769229

ABSTRACT

Background: Multisystem inflammatory syndrome in children (MIS-C) is a novel severe postinfectious condition associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The purpose of this report is to describe nationwide trends in the evolving clinical management of MIS-C. Methods: Patients with MIS-C were reported from state and local jurisdictions to the Centers for Disease Control and Prevention's (CDC's) MIS-C national surveillance system. Patients' case reports were reviewed to ensure that they met the CDC MIS-C case definition and had sufficient data for analysis. The prevalence of use of treatments for MIS-C, temporal trends in use of these treatments, and frequency of administration of different treatment combinations were analyzed. Results: There were 4470 patients meeting the MIS-C case definition with onset dates from 19 February 2020 to 31 July 2021. The proportion of patients admitted to an intensive care unit (ICU) has declined over time, from 78.7% in April 2020 to 57.5% in June 2021 (P = .001). The most common treatments were intravenous immunoglobulin (IVIG), given to 85.6% of patients; steroids (77.7%), and antiplatelet medications (73.7%); use of each of these treatments has increased over time, particularly in patients not requiring admission to an ICU (all P < .001). Older patients and non-Hispanic Black patients were more likely to receive additional modes of therapy including vasoactive medication, noninvasive respiratory support, anticoagulation medication, and intubation/mechanical ventilation. Conclusions: IVIG, steroids, and antiplatelet medication have become increasingly utilized as standard treatment for MIS-C patients, while the use of other treatments may be contingent on the type and severity of clinical findings.

11.
MMWR Morb Mortal Wkly Rep ; 71(9): 335-340, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1727014

ABSTRACT

Higher COVID-19 incidence and mortality rates in rural than in urban areas are well documented (1). These disparities persisted during the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant surges during late 2021 and early 2022 (1,2). Rural populations tend to be older (aged ≥65 years) and uninsured and are more likely to have underlying medical conditions and live farther from facilities that provide tertiary medical care, placing them at higher risk for adverse COVID-19 outcomes (2). To better understand COVID-19 vaccination disparities between urban and rural populations, CDC analyzed county-level vaccine administration data among persons aged ≥5 years who received their first dose of either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccine or a single dose of the Ad.26.COV2.S (Janssen [Johnson & Johnson]) COVID-19 vaccine during December 14, 2020-January 31, 2022, in 50 states and the District of Columbia (DC). COVID-19 vaccination coverage with ≥1 doses in rural areas (58.5%) was lower than that in urban counties (75.4%) overall, with similar patterns across age groups and sex. Coverage with ≥1 doses varied among states: 46 states had higher coverage in urban than in rural counties, one had higher coverage in rural than in urban counties. Three states and DC had no rural counties; thus, urban-rural differences could not be assessed. COVID-19 vaccine primary series completion was higher in urban than in rural counties. However, receipt of booster or additional doses among primary series recipients was similarly low between urban and rural counties. Compared with estimates from a previous study of vaccine coverage among adults aged ≥18 years during December 14, 2020-April 10, 2021, these urban-rural disparities among those now eligible for vaccination (aged ≥5 years) have increased more than twofold through January 2022, despite increased availability and access to COVID-19 vaccines. Addressing barriers to vaccination in rural areas is critical to achieving vaccine equity, reducing disparities, and decreasing COVID-19-related illness and death in the United States (2).


Subject(s)
COVID-19 Vaccines/administration & dosage , Healthcare Disparities , Vaccination Coverage , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Rural Population , United States/epidemiology , Urban Population
12.
Open Forum Infect Dis ; 9(3): ofac070, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1722566

ABSTRACT

BACKGROUND: The serologic and cytokine responses of children hospitalized with multisystem inflammatory syndrome (MIS-C) vs coronavirus disease 2019 (COVID-19) are poorly understood. METHODS: We performed a prospective, multicenter, cross-sectional study of hospitalized children who met the Centers for Disease Control and Prevention case definition for MIS-C (n = 118), acute COVID-19 (n = 88), or contemporaneous healthy controls (n = 24). We measured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD) immunoglobulin G (IgG) titers and cytokine concentrations in patients and performed multivariable analysis to determine cytokine signatures associated with MIS-C. We also measured nucleocapsid IgG and convalescent RBD IgG in subsets of patients. RESULTS: Children with MIS-C had significantly higher SARS-CoV-2 RBD IgG than children with acute COVID-19 (median, 2783 vs 146; P < .001), and titers correlated with nucleocapsid IgG. For patients with MIS-C, RBD IgG titers declined in convalescence (median, 2783 vs 1135; P = .010) in contrast to patients with COVID-19 (median, 146 vs 4795; P < .001). MIS-C was characterized by transient acute proinflammatory hypercytokinemia, including elevated levels of interleukin (IL) 6, IL-10, IL-17A, and interferon gamma (IFN-γ). Elevation of at least 3 of these cytokines was associated with significantly increased prevalence of prolonged hospitalization ≥8 days (prevalence ratio, 3.29 [95% CI, 1.17-9.23]). CONCLUSIONS: MIS-C was associated with high titers of SARS-CoV-2 RBD IgG antibodies and acute hypercytokinemia with IL-6, IL-10, IL-17A, and IFN-γ.

13.
Morbidity and Mortality Weekly Report ; 70(50):1735-1739, 2021.
Article in English | GIM | ID: covidwho-1716989

ABSTRACT

What is already known about this topic? Although COVID-19 vaccines are highly effective, vaccine effectiveness wanes over time, and adults aged 65 years are at increased risk for severe COVID-19-associated illness. Booster and additional primary vaccine doses increase protection. What is added by this report? During August 13-November 19, 2021, 18.7 million persons aged 65 years received a booster or additional primary dose of COVID-19 vaccine, constituting 44.1% of eligible persons aged 65 years. Coverage differed by primary series vaccine product and race/ethnicity. What are the implications for public health practice? Strategic efforts are needed to encourage eligible persons aged 18 years, especially those aged 65 years and those who are immunocompromised, to receive a booster and/or additional primary dose to ensure maximal protection against COVID-19.

14.
Emerg Infect Dis ; 28(5): 986-989, 2022 05.
Article in English | MEDLINE | ID: covidwho-1714955

ABSTRACT

We analyzed first-dose coronavirus disease vaccination coverage among US children 5-11 years of age during November-December 2021. Pediatric vaccination coverage varied widely by jurisdiction, age group, and race/ethnicity, and lagged behind vaccination coverage for adolescents aged 12-15 years during the first 2 months of vaccine rollout.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Humans , SARS-CoV-2 , United States/epidemiology , Vaccination , Vaccination Coverage
15.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328726

ABSTRACT

Enveloped viruses, including human immunodeficiency virus (HIV) and SARS-CoV-2, target cells through membrane fusion process. The detailed understanding of the process is sought after for vaccine development but remains elusive due to current technique limitations for direct three-dimensional (3D) imaging of an individual virus during its viral entry. Recently, we developed a simple specimen preparation method for real-time imaging of metal dynamic liquid-vaper interface at nanometer resolution by transmission electron microscopy (TEM). Here, we extended this method to study biology sample through snapshot 3D structure of a single HIV (pseudo-typed with the envelope glycoprotein of vesicular stomatitis virus, VSV-G) at its intermediate stage of viral entry to HeLa cells in a liquid-phase environment. By individual-particle electron tomography (IPET), we found the viral surface release excess lipids with unbound viral spike proteins forming ~50-nm nanoparticles instead of merging cell membrane. Moreover, the spherical-shape shell formed by matrix proteins underneath the viral envelope does not disassemble into a cone shape right after fusion. The snapshot 3D imaging of a single virus provides us a direct structure-based understanding of the viral entry mechanism, which can be used to examine other viruses to support the development of vaccines combatting the current ongoing pandemic.

16.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323601

ABSTRACT

Background: The COVID-19 pandemic has been considered a great threat to global public health. We aimed to clarify the risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death and construct a risk prediction model. Methods: : In this single-centered, retrospective, and observational study, 796 COVID-19 patients developed ARDS and 735 COVID-19 patients without ARDS were matched by propensity score at an approximate ratio of 1:1 based on age, sex and comorbidities. Demographic data, symptoms, radiological findings, laboratory examinations, and clinical outcomes were compared between those with or without ARDS. Univariable and multivariable logistic regression models were applied to explore the risk factors for development of ARDS and progression from ARDS to death and establish a comprehensive risk model. Results: : Higher SOFA, qSOFA, APACHE II and SIRS scores, elevated inflammatory cytokines, dysregulated multi-organ damage biomarkers, decreased immune cell subsets were associated with higher proportion of death (34.17% vs 1.22%;P <0.001) and increased risk odds of death (OR=57.216, 95%CI=28.373-115.378;P <0.001) in COVID-19 patients with ARDS. In addition to previous reported risk factors related to ARDS development and death, such as neutrophils, IL-6, D-Dimer, leukocytes and platelet, we identified elevated TNF-α (OR=1.146, 95%CI=1.100-1.194;P <0.001), CK-MB (OR=1.350, 95%CI=1.180-1.545;P <0.001), declined ALB (OR=0.834, 95%CI=0.799-0.872;P <0.001), CD8 + T cells (OR=0.983, 95%CI=0.976-0.990;P <0.001) and CD3 - CD19 + B cells (OR=0.992, 95%CI=0.988-0.997;P =0.003) as novel risk factors. Most importantly, the predictive accuracy of the combined model integrating four score systems and these risk factors demonstrated highest among all models for the development of ARDS (AUC= 0.904) and the progression from ARDS to death (AUC= 0.959). Conclusion: COVID-19 patients with ARDS were more likely to develop into death. The potential risk factors and the comprehensive prediction model could be helpful to identify patients that are at risk of developing ARDS with poor prognosis at an early stage, which might help physicians to formulate a timely therapeutic strategy.

17.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-317971

ABSTRACT

Jianhui Nie, Qianqian Li, and Jiajing Wu contributed equally to this work. Pseudotyped viruses are useful virological tools due to their safety and versatility. Based on a VSV pseudotyped virus production system, we developed a pseudotyped virus-based neutralization assay against SARS-CoV-2 in biosafety level 2 facilities. This protocol includes production, titration of the SARS-CoV-2 S pseudotyped virus and neutralization assay based on it. Various types of samples targeting virus attachment and entry could be evaluated for their potency, including serum samples derived from animals and humans, monoclonal antibodies, fusion inhibitors (peptides or small molecules). If the pseudotyped virus stock has been prepared in advance, it will take 2 days to get the potency data for the candidate samples. Experience of handling cells is needed before implementing this protocol.

18.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313435

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) has caused global pandemic, resulting in considerable mortality. The risk factors, clinical treatments and especially comprehensive risk models for COVID-19 death are urgently warranted. Methods In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex and comorbidities were enrolled from January 13, 2020 to March 31, 2020. Results Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cells subsets and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, outperforming previous risk models, which was significant for early clinical management for COVID-19. Conclusions The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.

19.
MMWR Morb Mortal Wkly Rep ; 70(50): 1735-1739, 2021 Dec 17.
Article in English | MEDLINE | ID: covidwho-1625175

ABSTRACT

Vaccination against SARS-CoV-2 (the virus that causes COVID-19) is highly effective at preventing hospitalization due to SARS-CoV-2 infection and booster and additional primary dose COVID-19 vaccinations increase protection (1-3). During August-November 2021, a series of Emergency Use Authorizations and recommendations, including those for an additional primary dose for immunocompromised persons and a booster dose for persons aged ≥18 years, were approved because of reduced immunogenicity in immunocompromised persons, waning vaccine effectiveness over time, and the introduction of the highly transmissible B.1.617.2 (Delta) variant (4,5). Adults aged ≥65 years are at increased risk for COVID-19-associated hospitalization and death and were one of the populations first recommended a booster dose in the U.S. (5,6). Data on COVID-19 vaccinations reported to CDC from 50 states, the District of Columbia (DC), and eight territories and freely associated states were analyzed to ascertain coverage with booster or additional primary doses among adults aged ≥65 years. During August 13-November 19, 2021, 18.7 million persons aged ≥65 years received a booster or additional primary dose of COVID-19 vaccine, constituting 44.1% of 42.5 million eligible* persons in this age group who previously completed a primary vaccination series.† Coverage was similar by sex and age group, but varied by primary series vaccine product and race and ethnicity, ranging from 30.3% among non-Hispanic American Indian or Alaska Native persons to 50.5% among non-Hispanic multiple/other race persons. Strategic efforts are needed to encourage eligible persons aged ≥18 years, especially those aged ≥65 years and those who are immunocompromised, to receive a booster and/or additional primary dose to ensure maximal protection against COVID-19.


Subject(s)
COVID-19 Vaccines/administration & dosage , Vaccination/statistics & numerical data , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Immunization Schedule , Male , United States/epidemiology
20.
Morbidity and Mortality Weekly Report ; 70(35):1206-1213, 2021.
Article in English | GIM | ID: covidwho-1573349

ABSTRACT

What is already known about this topic? Although more common among adults, severe COVID-19 illness and hospitalization occur among adolescents. What is added by this report? As of July 31, 2021, coverage with 1 dose of COVID-19 vaccine among adolescents aged 12-17 years was 42%, and 32% had completed the series. Series completion rates varied widely by state, ranging from 11% to 60%, and was 25% for adolescents aged 12-13 years, 30% for those aged 14-15 years, and 40% for those aged 16-17 years. What are the implications for public health practice? Improving adolescent COVID-19 vaccination coverage is crucial to reduce COVID-19-associated morbidity and mortality among adolescents and can help facilitate safer reopening of schools for in-person learning.

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