ABSTRACT
Introduction: The ongoing COVID-19 pandemic and its unprecedented global societal and economic disruptive impact, highlight the urgent need for the development of safe, effective, affordable, and deployable vaccines against COVID-19. Among the several vaccines approved by the World Health Organization, BBV-152 (COVAXIN) and AZD1222 (COVISHIELD) are approved in India. As on 1-Apr-2021, around 9 million people were fully vaccinated and around 59 million had received one dose of vaccine in India. Hence, this study was aimed to study the association between disease severity and disease progression from mild to moderate/severity. Methodology: This cross-sectional study was conducted in a private medical college at Tamil Nadu between April 2021 to May 2021 (one month period). The study included 100 participants who were aged more than 45 years admitted for COVID infection. Disease severity was assessed as per the guidelines issued by Ministry of Health and Family Welfare, and the patient vaccination status was ascertained based on the patient's testimony (also corroborated with a vaccine certificate). Result(s): The gender ratio observed was 1.6:1. The mean age at presentation was 59 years for mild disease, 60 years for moderate disease and 61 years for severe disease. The prevalence of moderate disease was 65% among non-vaccinated, and 15% among vaccinated individuals. The prevalence of severe disease was 25% among non-vaccinated individuals, and 5% among vaccinated individuals. Conclusion(s): Vaccination provides significant protection against moderate and severe COVID-19 disease.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
ABSTRACT
Multisystem inflammatory syndrome is a life-threatening condition associated with elevated inflammatory markers and multiple organ injury. A diagnosis of exclusion, it has been reported after severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) in children and adults; recently it has been described in some post-COVID-19 vaccinated individuals. The prognosis with supportive care and immunomodulatory therapy is good, although some individuals may require treatment in the intensive care unit (ICU). Here we report a case of a 58-year-old man who developed multi-organ failure after receiving the second dose of the Moderna mRNA-1273 COVID-19 vaccine. He required critical organ support in the ICU. An extensive workup was done to rule out alternative infectious and inflammatory processes. Following a period of gradual in-hospital convalescence, our patient made a full recovery. To our knowledge, this is the first comprehensively described case of multisystem inflammatory syndrome associated with Moderna mRNA-1273 COVID-19 vaccine in an adult over 50 years of age.
ABSTRACT
SARS-CoV-2 breakthrough infections have been reported because of the reduced efficacy of vaccines against the emerging variants globally. However, an accurate model to predict SARS-CoV-2 breakthrough infection is still lacking. In this retrospective study, 6,189 vaccinated individuals, consisting of SARS-CoV-2 test-positive cases (n = 219) and test-negative controls (n = 5970) during the outbreak of the Delta variant in September 2021 in Xiamen and Putian cities, Fujian province of China, were included. The vaccinated individuals were randomly split into a training (70%) cohort and a validation (30%) cohort. In the training cohort, a visualized nomogram was built based on the stepwise multivariate logistic regression. The area under the curve (AUC) of the nomogram in the training and validation cohorts was 0.819 (95% CI, 0.780-0.858) and 0.838 (95% CI, 0.778-0.897). The calibration curves for the probability of SARS-CoV-2 breakthrough infection showed optimal agreement between prediction by nomogram and actual observation. Decision curves indicated that nomogram conferred high clinical net benefit. In conclusion, a nomogram model for predicting SARS-CoV-2 breakthrough infection based on the real-world setting was successfully constructed, which will be helpful in the management of SARS-CoV-2 breakthrough infection.
Subject(s)
COVID-19 , COVID-19/diagnosis , COVID-19/epidemiology , Humans , Nomograms , Retrospective Studies , SARS-CoV-2ABSTRACT
Determination of neutralizing antibody titers is still considered the gold standard for infection protection. A full virus neutralization test (VNT) with replication-competent, infectious SARS-CoV-2, is labor-intensive and requires Biosafety Level 3 certified laboratories. Therefore, several commercial SARS-CoV-2 surrogate virus neutralization tests (sVNTs) have been developed that aim to detect neutralizing antibodies targeting the receptor binding domain (RBD) of the viral spike glycoprotein (S). Neutralizing antibodies to the RBD block its interaction with the angiotensin-converting enzyme 2 (ACE2) receptor protein. Here, we compared a full virus neutralization test (VNT) with two SARS-CoV-2 surrogate virus neutralization tests (sVNT) and validated them in two cohorts of i) convalescent SARS-CoV-2-infected individuals and ii) COVID vaccinated individuals. The sVNTs showed highly different results both, compared to the VNT-titers and also between the two cohorts. This indicates that currently, sVNT provide a qualitative instead of a quantitative measurement of neutralizing antibodies. The findings in this work show that the cutoff levels for sVNTs might need to be readjusted for convalescent and vaccinated individuals.