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1.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-319257

ABSTRACT

Background: Despite the importance of the COVID-19 vaccine, little is known about the effectiveness and side effects on available vaccines. The current study systematically reviewed, summarized and meta-analyzed the clinical features of the vaccines in phase I, II and III randomized clinical trials (RCT) to provide a better estimate of their efficacy, side effects and immunogenicity. Methods: All relevant publications were systematically searched and collected from major databases up to 12 March 2021. The total vaccine’s efficacy, sub-group antigen-specific efficacy, odds ratios (ORs) for side effects, and sub-group OR based on adjuvants for each vaccine pooled by random-effects model. Findings: A total of 25 RCTs (123 datasets), 58889 cases that received the COVID-19 vaccine and 46638 controls who received placebo were included in the meta-analysis. In total, mRNA-based and adenovirus-vectored COVID-19 vaccines had 94.6% (95% CI 0.936-0.954) and 80.2% (95% CI 0.96.4-0.92.7) efficacy in phase II/III RCTs, respectively. Efficacy of the adenovirus-vectored vaccine after the first 97.6% (95% CI 0.939-0.997) and second 98.2% (95% CI 0.980-0.984) doses was the highest against receptor-binding domain (RBD) antigen after 3 weeks of injections. The mRNA-based vaccines had the highest level of side effects reported except for the diarrhea and arthralgia that displayed the highest OR for the adenovirus-vectored vaccine. Aluminum-adjuvanted vaccines had the lowest systemic and local side effects between vaccines’adjuvant or without adjuvant, except for the injection site redness. Interpretation: The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after first and second doses, respectively. The mRNA-based vaccines had higher side effects. None experienced adverse effects and all stimulated robust immune responses. All RCTs followed up the vaccine and placebo groups after one month after both first and second doses, therefore all reports are related to short-term impacts. Due to the timeline, all the vaccines are missing longer-term assessments. Funding Statement: The author(s) received no specific funding for this work. Declaration of Interests: The authors declare no competing interests.

2.
Vaccines (Basel) ; 10(1)2021 Dec 25.
Article in English | MEDLINE | ID: covidwho-1580357

ABSTRACT

The high transmissibility, mortality, and morbidity rate of the SARS-CoV-2 Delta (B.1.617.2) variant have raised concerns regarding vaccine effectiveness (VE). To address this issue, all publications relevant to the effectiveness of vaccines against the Delta variant were searched in the Web of Science, Scopus, EMBASE, and Medline (via PubMed) databases up to 15 October 2021. A total of 15 studies (36 datasets) were included in the meta-analysis. After the first dose, the VE against the Delta variant for each vaccine was 0.567 (95% CI 0.520-0.613) for Pfizer-BioNTech, 0.72 (95% CI 0.589-0.822) for Moderna, 0.44 (95% CI 0.301-0.588) for AstraZeneca, and 0.138 (95% CI 0.076-0.237) for CoronaVac. Meta-analysis of 2,375,957 vaccinated cases showed that the Pfizer-BioNTech vaccine had the highest VE against the infection after the second dose, at 0.837 (95% CI 0.672-0.928), and third dose, at 0.972 (95% CI 0.96-0.978), as well as the highest VE for the prevention of severe infection or death, at 0.985 (95% CI 0.95-0.99), amongst all COVID-19 vaccines. The short-term effectiveness of vaccines, especially mRNA-based vaccines, for the prevention of the Delta variant infection, hospitalization, severe infection, and death is supported by this study. Limitations include a lack of long-term efficacy data, and under-reporting of COVID-19 infection cases in observational studies, which has the potential to falsely skew VE rates. Overall, this study supports the decisions by public health decision makers to promote the population vaccination rate to control the Delta variant infection and the emergence of further variants.

3.
Vaccines (Basel) ; 9(5)2021 May 06.
Article in English | MEDLINE | ID: covidwho-1224272

ABSTRACT

The current study systematically reviewed, summarized and meta-analyzed the clinical features of the vaccines in clinical trials to provide a better estimate of their efficacy, side effects and immunogenicity. All relevant publications were systematically searched and collected from major databases up to 12 March 2021. A total of 25 RCTs (123 datasets), 58,889 cases that received the COVID-19 vaccine and 46,638 controls who received placebo were included in the meta-analysis. In total, mRNA-based and adenovirus-vectored COVID-19 vaccines had 94.6% (95% CI 0.936-0.954) and 80.2% (95% CI 0.56-0.93) efficacy in phase II/III RCTs, respectively. Efficacy of the adenovirus-vectored vaccine after the first (97.6%; 95% CI 0.939-0.997) and second (98.2%; 95% CI 0.980-0.984) doses was the highest against receptor-binding domain (RBD) antigen after 3 weeks of injections. The mRNA-based vaccines had the highest level of side effects reported except for diarrhea and arthralgia. Aluminum-adjuvanted vaccines had the lowest systemic and local side effects between vaccines' adjuvant or without adjuvant, except for injection site redness. The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after first and second doses, respectively. The mRNA-based vaccines had higher side effects. Remarkably few experienced extreme adverse effects and all stimulated robust immune responses.

4.
Int J Mol Med ; 47(1): 326-334, 2021 01.
Article in English | MEDLINE | ID: covidwho-945986

ABSTRACT

RNA­dependent RNA­polymerase (RdRp) and 3C­like proteinase (3CLpro) are two main enzymes that play a key role in the replication of SARS­CoV­2. Zinc (Zn) has strong immunogenic properties and is known to bind to a number of proteins, modulating their activities. Zn also has a history of use in viral infection control. Thus, the present study models potential Zn binding to RdRp and the 3CLpro. Through molecular modeling, the Zn binding sites in the aforementioned two important enzymes of viral replication were found to be conserved between severe acute respiratory syndrome (SARS)­coronavirus (CoV) and SARS­CoV­2. The location of these sites may influence the enzymatic activity of 3CLpro and RdRp in coronavirus disease 2019 (COVID­19). Since Zn has established immune health benefits, is readily available, non­expensive and a safe food supplement, with the comparisons presented here between SARS­CoV and COVID­19, the present study proposes that Zn could help ameliorate the disease process of COVID­19 infection.


Subject(s)
Coronavirus 3C Proteases/chemistry , Coronavirus RNA-Dependent RNA Polymerase/chemistry , Models, Molecular , SARS-CoV-2/chemistry , Zinc/chemistry , Binding Sites , COVID-19/metabolism , Coronavirus 3C Proteases/metabolism , Coronavirus RNA-Dependent RNA Polymerase/metabolism , SARS-CoV-2/physiology , Virus Replication , Zinc/metabolism
5.
Rev Med Virol ; 31(3): e2179, 2021 05.
Article in English | MEDLINE | ID: covidwho-842504

ABSTRACT

We compared clinical symptoms, laboratory findings, radiographic signs and outcomes of COVID-19 and influenza to identify unique features. Depending on the heterogeneity test, we used either random or fixed-effect models to analyse the appropriateness of the pooled results. Overall, 540 articles included in this study; 75,164 cases of COVID-19 (157 studies), 113,818 influenza type A (251 studies) and 9266 influenza type B patients (47 studies) were included. Runny nose, dyspnoea, sore throat and rhinorrhoea were less frequent symptoms in COVID-19 cases (14%, 15%, 11.5% and 9.5%, respectively) in comparison to influenza type A (70%, 45.5%, 49% and 44.5%, respectively) and type B (74%, 33%, 38% and 49%, respectively). Most of the patients with COVID-19 had abnormal chest radiology (84%, p < 0.001) in comparison to influenza type A (57%, p < 0.001) and B (33%, p < 0.001). The incubation period in COVID-19 (6.4 days estimated) was longer than influenza type A (3.4 days). Likewise, the duration of hospitalization in COVID-19 patients (14 days) was longer than influenza type A (6.5 days) and influenza type B (6.7 days). Case fatality rate of hospitalized patients in COVID-19 (6.5%, p < 0.001), influenza type A (6%, p < 0.001) and influenza type B was 3%(p < 0.001). The results showed that COVID-19 and influenza had many differences in clinical manifestations and radiographic findings. Due to the lack of effective medication or vaccine for COVID-19, timely detection of this viral infection and distinguishing from influenza are very important.


Subject(s)
COVID-19/physiopathology , Influenza, Human/physiopathology , Respiratory Tract Infections/physiopathology , COVID-19/diagnostic imaging , COVID-19/epidemiology , COVID-19/mortality , Cough/diagnosis , Cough/physiopathology , Dyspnea/diagnosis , Dyspnea/physiopathology , Electronic Health Records , Fever/diagnosis , Fever/physiopathology , Humans , Infectious Disease Incubation Period , Influenza A virus/pathogenicity , Influenza A virus/physiology , Influenza B virus/pathogenicity , Influenza B virus/physiology , Influenza, Human/diagnostic imaging , Influenza, Human/epidemiology , Influenza, Human/mortality , Pharyngitis/diagnosis , Pharyngitis/physiopathology , Respiratory Tract Infections/diagnostic imaging , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/mortality , Rhinorrhea/diagnosis , Rhinorrhea/physiopathology , SARS-CoV-2/pathogenicity , SARS-CoV-2/physiology , Severity of Illness Index , Survival Analysis , Tomography, X-Ray Computed
6.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-1437

ABSTRACT

Introduction: Due to concurrency, high transmissibility, and importance of influenza and COVID-19 infections;within this large-scale study, we compared clin

9.
Microb Pathog ; 147: 104390, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-650874

ABSTRACT

INTRODUCTION: In the current time where we face a COVID-19 pandemic, there is no vaccine or effective treatment at this time. Therefore, the prevention of COVID-19 and the rapid diagnosis of infected patients is crucial. METHOD: We searched all relevant literature published up to February 28, 2020. We used Random-effect models to analyze the appropriateness of the pooled results. RESULT: Eighty studies were included in the meta-analysis, including 61,742 patients with confirmed COVID-19 infection. 62.5% (95% CI 54.5-79, p < 0.001) of patients had a history of recent travel endemic area or contact with them. The most common symptoms among COVID-19 infected patients were fever 87% (95% CI 73-93, p < 0.001), and cough 68% (95% CI 55.5-74, p < 0.001)), respectively. The laboratory analysis showed that thrombocytosis was present in 61% (95% CI 41-78, p < 0.001) CRP was elevated in 79% (95% CI 65-91, p < 0.001), and lymphopenia in 57.5% (95% CI 42-79, p < 0.001). The most common radiographic signs were bilateral involvement in 81% (95% CI 62.5-87, p < 0.001), consolidation in 73.5% (95% CI 50.5-91, p < 0.001), and ground-glass opacity 73.5% (95% CI 40-90, p < 0.001) of patients. Case fatality rate (CFR) in <15 years old was 0.6%, in >50 years old was 39.5%, and in all range group was 6%. CONCLUSIONS: Fever and cough are the most common symptoms of COVID-19 infection in the literature published to date. Thombocytosis, lymphopenia, and increased CRP were common lab findings although most patients included in the overall analysis did not have laboratory values reported. Among Chinese patients with COVID-19, rates of hospitalization, critical condition, and hospitalization were high in this study, but these findings may be biased by reporting only confirmed cases.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Betacoronavirus , COVID-19 , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Cough/virology , Fever/virology , Hospitalization , Humans , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , SARS-CoV-2 , Travel
10.
Rev Med Virol ; 30(4): e2112, 2020 07.
Article in English | MEDLINE | ID: covidwho-538242

ABSTRACT

INTRODUCTION: Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features. METHOD: We searched all relevant literature published up to February 28, 2020. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Study has been registered in the PROSPERO database (ID 176106). RESULT: Overall 114 articles included in this study; 52 251 COVID-19 confirmed patients (20 studies), 10 037 SARS (51 studies), and 8139 MERS patients (43 studies) were included. The most common symptom was fever; COVID-19 (85.6%, P < .001), SARS (96%, P < .001), and MERS (74%, P < .001), respectively. Analysis showed that 84% of Covid-19 patients, 86% of SARS patients, and 74.7% of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 (5.6%, P < .001) was lower than SARS (13%, P < .001) and MERS (35%, P < .001) between all confirmed patients. CONCLUSIONS: At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than in SARS- and MERS-infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and this should be considered when interpreting the data.


Subject(s)
Betacoronavirus , Coronavirus Infections , Middle East Respiratory Syndrome Coronavirus , Pandemics , Pneumonia, Viral , Severe Acute Respiratory Syndrome , Blood Cell Count , COVID-19 , China , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Cough , Dyspnea , Female , Fever , Hospitalization , Humans , Lung/diagnostic imaging , Male , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Risk Factors , SARS-CoV-2 , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/mortality , Severe Acute Respiratory Syndrome/physiopathology , Travel
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