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1.
RMD Open ; 8(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1608416

ABSTRACT

BACKGROUND: Scanty data on the immunogenicity of the BNT162b2 vaccine in patients with psoriatic arthritis (PsA) on Tumor Necrosis Factor inhibitors (TNFi) have been published. OBJECTIVE: To investigate the humoral response to BNT162b2 vaccination patients with PsA on TNFi, comparing immunogenicity with healthy controls. METHODS: Forty patients with classified PsA on TNFi undergoing vaccination with the BNT162b2 mRNA SARS-CoV-2 vaccine (BioNTech/Pfizer) were enrolled. Fifteen days after the second shot, serum IgG levels against SARS-CoV-2 (Abbott ARCHITECT i2000SR, positivity cut-off 50 AU/mL) were assayed in all patients. Clinimetrics and treatment data were gathered. TNFi treatment was not discontinued throughout the whole period, whereas methotrexate (MTX) was discontinued for 1 week after each shot in those on combination therapy. Sera from healthcare professionals were considered as healthy controls for 1:1 propensity score matching; any of them was taking medication.Student's t-test and logistic regression were used for investigating differences in immunogenicity between groups and predictors of antibody response. RESULTS: Clinical Disease Activity Index did not change before and after vaccination (7.06±5.23 to 7.10±5.27, p=0.92).Patients with PsA achieved a positive anti-SARS-CoV-2 IgG level with a mean (±SD) of 13794.44±15 815.42 AU/mL. Although lower, the antibody level was not significantly different from matched controls (19227.4±11.8460.45 AU/mL, p=0.08). In the overall sample, those on MTX (12/80, 15%) had a trend toward lower immune response (p=0.07); glucocorticoid therapy (11/80, 13.8%) predicted lower antibody levels (p=0.04). CONCLUSIONS: Continuing TNFi in patients with PsA throughout the vaccination did not hamper immunogenicity.


Subject(s)
Arthritis, Psoriatic , COVID-19 , Arthritis, Psoriatic/drug therapy , COVID-19 Vaccines , Humans , Immunogenicity, Vaccine , RNA, Messenger , SARS-CoV-2 , Tumor Necrosis Factor Inhibitors
5.
Int J Environ Res Public Health ; 18(21)2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1488585

ABSTRACT

Although direct contact is considered the main mode of transmission of SARS-CoV-2, environmental factors play an important role. In this study, we evaluated the presence of SARS-CoV-2 on bus and train surfaces. From the buses, we took samples from the following areas: handrails used to enter or exit the bus, stop request buttons and handles next to the seats. From the trains, the sampled surfaces were handrails used to enter or exit the train, door open/close buttons, handles next to the seats, tables and toilet handles. SARS-CoV-2 was detected on 10.7% of the tested surfaces overall, 19.3% of bus surfaces and 2% of train surfaces (p < 0.0001). On the buses, the most contaminated surfaces were the handles near the seats (12.8%), followed by door open/close buttons (12.5%) and handrails (10.5%). Of the five analyzed transport companies, bus companies were the most contaminated, in particular, companies C (40%) and B (23.3%). A greater number of positive samples were found among those taken at 10:00 a.m. and 10:55 a.m. (45% and 40%, respectively). The presence of the virus on many bus surfaces highlights how the sanitation systems on public transport currently in use are not sufficient to limit the spread of SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Motor Vehicles , Sanitation , Transportation
6.
Vaccines (Basel) ; 9(10)2021 Oct 07.
Article in English | MEDLINE | ID: covidwho-1463852

ABSTRACT

To combat the COVID-19 pandemic, a mass vaccination campaign was initiated in Italy on 27 December 2020. The vaccine available to immunize Italian healthcare workers (HCWs) was the BNT162b2 mRNA COVID-19 vaccine (Comirnaty). This study evaluated the effectiveness of the vaccine against documented SARS-CoV-2 infection and symptomatic diseases in the medium- to long-term. HCWs at Bari Policlinico University-Hospital (Italy) who completed the vaccination schedule were matched with HCWs who had refused vaccination; the two groups were followed-up for 5 months (January-May 2021). Vaccine effectiveness (VE) against infection was 97.7% (95.4-99.0%) at 14-34 days after the first dose, and 94.8% (87.0-97.8%), 83.0% (65.0-92.0%), and 81.0% (42.0-94.0%) at 14-41, 42-69, and >69 days, respectively, after the second dose. The estimated VE for documented symptomatic disease was 99.2% (96.4-99.8%) at 14-34 days after the first dose and 97.2% (90.3-99.2%), 85.0% (63.0-94.2%), and 88.0% (42.0-97.6%) at 14-41, 42-69, and >69 days, respectively, after the second dose. Efforts to increase vaccination rates should be strengthened, including mandatory vaccination for HCWs and greater incentives to increase vaccine acceptance by the general population.

7.
Int J Environ Res Public Health ; 18(19)2021 Sep 29.
Article in English | MEDLINE | ID: covidwho-1444203

ABSTRACT

As a complement to clinical disease surveillance, the monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in wastewater can be used as an early warning system for impending epidemics. This study investigated the dynamics of SARS-CoV-2 in untreated wastewater with respect to the trend of coronavirus disease 2019 (COVID-19) prevalence in Southern Italy. A total of 210 wastewater samples were collected between May and November 2020 from 15 Apulian wastewater treatment plants (WWTP). The samples were concentrated in accordance with the standard of World Health Organization (WHO, Geneva, Switzerland) procedure for Poliovirus sewage surveillance, and molecular analysis was undertaken with real-time reverse-transcription quantitative PCR (RT-(q) PCR). Viral ribonucleic acid (RNA) was found in 12.4% (26/210) of the samples. The virus concentration in the positive samples ranged from 8.8 × 102 to 6.5 × 104 genome copies/L. The receiver operating characteristic (ROC) curve modeling showed that at least 11 cases/100,000 inhabitants would occur after a wastewater sample was found to be positive for SARS-CoV-2 (sensitivity = 80%, specificity = 80.9%). To our knowledge, this is the first study in Italy that has applied wastewater-based epidemiology to predict COVID-19 prevalence. Further studies regarding methods that include all variables (meteorological phenomena, characteristics of the WWTP, etc.) affecting this type of wastewater surveillance data would be useful to improve data interpretation.


Subject(s)
COVID-19 , Humans , Italy/epidemiology , SARS-CoV-2 , Sewage , Waste Water
8.
J Clin Med ; 10(18)2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1409883

ABSTRACT

BACKGROUND: Long COVID is a syndrome characterized by the persistence of SARS-CoV-2 infection symptoms. Among HCWs, prolonged COVID symptoms could lead to the inability to perform work tasks. The aim of this study is to investigate 35-day long-COVID (35-LC) characteristics and risk factors in a one-year period. METHODS: We carried out a retrospective cohort study during the COVID-19 pandemic at University Hospital of Bari. A total of 5750 HCWs were tested for close contact with a confirmed case, in the absence of personal protective equipment, or for symptom development. RESULTS: Each positive HCW was investigated for cardiovascular risk factors or respiratory diseases. An amount of 352 HCWs (6.1%) were infected by SARS-CoV-2, and 168 cases evolved to long COVID. The 35-LC group showed mean BMI values higher than the non-35-LC group (25.9 kg/m2 vs. 24.8 kg/m2, respectively), and this difference was significant (p-value: 0.020). Moreover, HCWs who suffered from pulmonary disease (OR = 3.7, CL 95%: 1.35-10.53; p-value = 0.007) or overweight (OR = 1.6 CL 95%: 1.05-2.56; p-value = 0.029) had an increased risk of developing 35-LC. CONCLUSIONS: Long COVID is an emerging problem for hospital managers as it may reduce the number of HCWs deployed in the fight against COVID-19. High BMI and previous pulmonary disease could be risk factors for 35-LC development in exposed HCWs.

9.
Int J Environ Res Public Health ; 18(17)2021 09 06.
Article in English | MEDLINE | ID: covidwho-1390650

ABSTRACT

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in March 2020 in Italy, leading to the pandemic of coronavirus disease 2019 (COVID-19) that continues to cause high global morbidity and mortality in human populations. Numerous studies have focused on the spread and persistence of the virus in the hospital setting. New scientific evidence shows that SARS-CoV-2 is present in different community environments. Although aerosol is one of the main routes of transmission for SARS-CoV-2, indirect contact through virus-contaminated surfaces could also play a key role. The survival and persistence of SARS-CoV-2 on surfaces appear to be influenced by the characteristics of the material, temperature, and humidity. In this study, we investigated the presence of SARS-CoV-2 RNA on surfaces in 20 supermarkets throughout the Apulia region during the lockdown period. We collected a total of 300 swab samples from various surfaces including supermarket scales, trolley handles, refrigerator and freezer handles, and keyboards. In total, 13 (4.3%) surfaces were positive for SARS-CoV-2 RNA contamination, with shopping trolley handles being the most frequently contaminated. This study showed that contamination in public spaces can occur, so we remark the importance to adopt adequate preventive measures, including environment ventilation, careful surfaces sanitation, hand hygiene, and correct usage of masks, to reduce the likelihood of virus transmission.


Subject(s)
COVID-19 , SARS-CoV-2 , Communicable Disease Control , Humans , RNA, Viral , Supermarkets
10.
Children (Basel) ; 8(9)2021 Sep 06.
Article in English | MEDLINE | ID: covidwho-1390550

ABSTRACT

Understanding the potential risks of patients with inherited metabolic disorder (IMD) exposed to the COVID-19 pandemic is an unmet need for those involved in their management. Here, we report on the incidence of COVID-19 in a cohort of patients with IMD treated at a children's hospital and compare them with a matched control group. Among the total number of 272 patients actively followed at a referral center, 19 (7%) tested positive for SARS-CoV-2 between March 2020 and March 2021. Their median age was 16.2 years (range 1.4-32.8 years). In two-thirds of the cases, the source of infection was a family member; 12/19 patients (63%) were asymptomatic, only one required hospitalization, and none of them died. In our single-center experience, COVID-19 had a moderate impact on a relatively large cohort of patients with IMD, including children and young adults. The clinical course was very mild in all but one case. The proportion of symptomatic cases and the clinical course were comparable in patients with IMD and in a group of matched, non-IMD COVID-19 controls from the general population.

11.
J Infect Dis ; 224(3): 431-434, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1233856

ABSTRACT

In the preregistration trial, data on efficacy of BNT162b2 mRNA vaccine against SARS-CoV-2 infection were not collected. This study aimed to evaluate vaccine effectiveness (VE) against documented infection. Bari Policlinico University Hospital health care workers (HCWs) who completed the vaccination schedule were matched with HCWs who had refused vaccination. VE for documented infection was 61.9% (95% confidence interval [CI], 19.2%-82.0%) 14-20 days after first dose, 87.9% (95% CI, 51.7%-97.0%) 21-27 days after first dose, and 96.0% (95% CI, 82.2%-99.1%) 7 or more days after second dose. Unvaccinated HCWs remain a concern in the context of the pandemic emergency.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Adult , Aged , Cohort Studies , Female , Health Personnel , Humans , Male , Middle Aged , Treatment Outcome , Young Adult
12.
Vaccines (Basel) ; 9(5)2021 Apr 23.
Article in English | MEDLINE | ID: covidwho-1201941

ABSTRACT

During the COVID-19 outbreak, the lack of official recommendations on the treatment has led healthcare workers to use multiple drugs not specifically tested and approved for the new insidious disease. After the availability of the first COVID-19 vaccines (Comirnaty Pfizer-BioNTech and Moderna COVID19 vaccine), an authorization was issued by national and international Drug Regulatory Agencies in order to speed up their introduction on the market and their administration on a large scale. Despite the authorization, the off-label use of these vaccines may still be possible especially to answer specific concerns as the lack of vaccine doses, the delay in the delivery of planned doses or the pressure from public opinion and political influence also in relation to the evolution of the pandemic. This paper aims to assess the possible off-label use of COVID-19 vaccines and the ethical and medico-legal implications of this eventuality. The scope of this paper is to point out the possible consequences of off-label use of COVID-19 vaccines and possible mitigation and preventive measures to be taken by healthcare workers involved in vaccination procedures.

13.
Environ Res ; 195: 110793, 2021 04.
Article in English | MEDLINE | ID: covidwho-1051629

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) are highly exposed to SARS-CoV-2 infection given their specific tasks. The IgG-IgM serological assay has demonstrated good accuracy in early detection in symptomatic patients, but its role in the diagnosis of asymptomatic patients is uncertain. The aim of our study was to assess IgM and IgG prevalence in sera in a large cohort of HCWs previously subjected to Nasopharyngeal swab test (NST) after accurate risk assessment due to positive COVID-19 patient exposure during an observation period of 90 days. METHODS: 2407 asymptomatic HCWs that had close contact with COVID-19 patients in the period between April 8th and June 7th were screened with NST based on the RT-PCR method. In parallel, they underwent large-scale chemiluminescence immunoassays involving IgM-IgG serological screening to determine actual viral spread in the same cohort. RESULTS: During the 90-day observation period, 18 workers (0.75%) resulted positive for SARS-CoV-2 infection at the NST, whereas the positivity rates for IgM and IgG were 11.51% and 2.37%, respectively (277 workers). Despite high specificity, serological tests were inadequate for detecting SARS-CoV-2 infection in patients with previous positive NST results (IgM and IgG sensitivities of 27.78% and 50.00%, respectively). CONCLUSIONS: These findings indicate a widespread low viral load of SARS-CoV-2 among hospital workers. However, serological screening showed very low sensitivity with respect to NST in identifying infected workers, and negative IgG and IgM results should not exclude the diagnosis of COVID-19. IgG-IgM chemiluminescence immunoassays could increase the diagnosis of COVID-19 only in association with NST, and this association is considered helpful for decision-making regarding returning to work.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Health Personnel , Hospitals , Humans , Immunoglobulin G , Immunoglobulin M , Italy/epidemiology , Prevalence , Public Health , Sensitivity and Specificity
14.
Int J Infect Dis ; 102: 532-537, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-907182

ABSTRACT

OBJECTIVES: To determine the prevalence of SARS-CoV-2 infection among exposed healthcare workers (HCWs) after preventive protocol implementation. METHODS: A total of 5750 HCWs were included in the study. Those in contact with COVID-19 patients were allocated into a high-risk or a low-risk group based on contact type (PPE- or non-PPE-protected); high-risk workers underwent nasopharyngeal swab tests, while among low-risk workers, swab tests were carried out only for symptomatic workers (active surveillance). The prevalence was determined by real-time reverse transcriptase-polymerase chain reaction on nasopharyngeal samples. RESULTS: 3570 HCWs had contact with 1065 COVID-19 patients. Among them, 3494 were subjected to active surveillance (low-risk group); 2886 (82.60%) were subjected to a swab test; and 15 were positive (0.52%). Seventy-six HCWs (2.13% of exposed) were included in the high-risk group, and a swab test was mandatory for each participant. Overall, 66 (86.84% of high-risk) were negative, and 10 were positive (13.16%), resulting in a higher risk of infection than in the low-risk group [OR = 29.00; 95% CI:12.56-66.94; p < 0.0001]. CONCLUSION: To date, the SARS-CoV-2 infection prevalence is 0.70% among exposed HCWs and 0.435% among all HCWs working at the examined university hospital. The correct use of PPE and the early identification of symptomatic workers are essential factors to avoiding nosocomial clusters.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Cross Infection/epidemiology , Health Personnel/statistics & numerical data , Adult , Aged , COVID-19/virology , Cohort Studies , Cross Infection/transmission , Cross Infection/virology , Disease Outbreaks , Female , Frail Elderly/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Italy/epidemiology , Male , Middle Aged , Prevalence , Risk Factors , SARS-CoV-2/physiology
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