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1.
Epidemiol Infect ; 150: e186, 2022 Nov 13.
Article in English | MEDLINE | ID: covidwho-2185373

ABSTRACT

Healthcare workers (HCWs) have increased exposure and subsequent risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This case-control study was conducted to investigate the contemporaneous risks associated with confirmed SARS-CoV-2 infection amongst HCWs following in-work exposure to a confirmed coronavirus disease-2019 (COVID-19) case. We assessed the influence of demographic (age, sex, nationality, high risk co-morbidities and vaccination status) and work-related factors (job role, exposure location, contact type, personal protective equipment (PPE) use) on infection risk following nosocomial SARS-CoV-2 exposure. All contact tracing records within the hospital site during waves 1-3 of the COVID-19 pandemic in Ireland were screened to identify exposure events, cases and controls. In total, 285 cases and 1526 controls were enrolled, as a result of 1811 in-work exposure events with 745 index cases. We demonstrate that male sex, Eastern European nationality, exposure location, PPE use and vaccination status all impact the likelihood of SARS-CoV-2 infection following nosocomial SARS-CoV-2 exposure. The findings draw attention to the need for continuing emphasis on PPE use and its persisting benefit in the era of COVID-19 vaccinations. We suggest that non-work-related factors may influence infection risk seen in certain ethnic groups and that infection risk in high-risk HCW roles (e.g. nursing) may be the result of repeated exposures rather than risks inherent to a single event.


Subject(s)
COVID-19 , Cross Infection , Male , Humans , Pandemics , COVID-19/epidemiology , SARS-CoV-2 , Case-Control Studies , Ireland/epidemiology , Cross Infection/epidemiology , Health Personnel , Risk Factors , Hospitals
2.
Nicotine Tob Res ; 23(10): 1787-1792, 2021 08 29.
Article in English | MEDLINE | ID: covidwho-2189444

ABSTRACT

INTRODUCTION: It is unclear whether smokers are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to evaluate the association between smoking and the risk of SARS-CoV-2 infection. METHODS: A matched case-control study was conducted using a large nationwide database. The case group included patients with SARS-CoV-2 infection confirmed by the Korea Centers for Disease Control and Prevention, and the control group was randomly sampled from the general Korean population in the National Health Insurance Service database by matching sex, age, and region of residence. Conditional logistic regression models were used to investigate whether the risk of infection with SARS-CoV-2 was affected by smoking status. RESULTS: A total of 4167 patients with SARS-CoV-2 infection and 20 937 matched controls were enrolled. The proportion of ex-smokers and current smokers was 26.6% of the total participants. In multivariate analysis, smoking was not associated with an increased risk of SARS-CoV-2 infection (odds ratio [OR] = 0.56, confidence interval [CI] = 0.50-0.62). When ex-smokers and current smokers were analyzed separately, similar results were obtained (current smoker OR = 0.33, CI = 0.28-0.38; ex-smoker OR = 0.81, CI = 0.72-0.91). CONCLUSIONS: This study showed that smoking may not be associated with an increased risk of SARS-CoV-2 infection. Smoking tends to lower the risk of SARS-CoV-2 infection; however, these findings should be interpreted with caution. IMPLICATIONS: It is unclear whether smokers are more vulnerable to coronavirus disease 2019. In this large nationwide study in South Korea, smoking tended to lower the risk of infection with severe acute respiratory syndrome coronavirus 2. However, these findings should be interpreted with caution, and further confirmatory studies are required.


Subject(s)
COVID-19 , SARS-CoV-2 , Smoking , COVID-19/epidemiology , Case-Control Studies , Humans , Korea/epidemiology , Logistic Models , Risk Factors , Smoking/adverse effects , Smoking/epidemiology
3.
Front Public Health ; 10: 1008521, 2022.
Article in English | MEDLINE | ID: covidwho-2154849

ABSTRACT

Background: There is a need to establish the effectiveness of the coronavirus disease 2019 (COVID-19) vaccines in reducing COVID-19-related hopitalization of patients in Jordan. As the vaccination program accelerates, it is important to determine whether the vaccines' effectiveness (VE) has successfully reduced the number of acute cases admitted to hospital. Methods: To determine the efficacy of Pfizer-BioNTech and Sinopharm COVID-19 vaccines among Jordanian patients admitted to Prince Hamza hospital, a single center case-control study was performed. The study analyzed the hospitalization rates of vaccinated (n = 536) and unvaccinated (n = 585) individuals across the 2-month period from February 6 to April 6, 2022. The cases were patients who tested positive for SARS-CoV-2 ("case-patients"), whilst the control group were hospital patients who did not test positive for SARS-CoV-2 ("control-patients"). Results: This study found that among 1,121 total participants (561 cases and 560 control), the overall vaccine effectiveness (VE) among the participants was 84% (95% Cl 79-88%). VE was higher in females (88%, 95% Cl 84-93%) than in males (77%, 95% Cl 67-84%) (p < 0.001), and it was highest in those between the ages of 18 and 28-years-old (95%, 95% CI 86-98%). For patients with pre-existing conditions, including chronic heart disease, chronic lung disease, and diabetes, VE was higher compared to patients with no comorbidities, though the difference was not statistically significant. Finally, in comparing all vaccinated participants, VE was higher for those who received the Pfizer vaccine (VE = 92%, 95% CI 88-94%) (OR 0.08, 95% CI 0.06-0.12) than for those who received the Sinopharm vaccine (VE = 67%, 95% CI 52-78%) (OR 0.33, 95% CI 0.22-0.48); (p = 0.011). Conclusion: Overall, Pfizer and Sinopharm vaccines were found to be effective in limiting hospitalizations for acute cases of coronavirus among Jordanian adult's patient's cohort between February 6 and April 6, 2022, especially among patients with comorbidities.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Case-Control Studies , Female , Hospitalization , Hospitals , Humans , Jordan/epidemiology , Male , SARS-CoV-2 , Young Adult
4.
BMJ Open ; 12(11): e066029, 2022 11 21.
Article in English | MEDLINE | ID: covidwho-2153001

ABSTRACT

INTRODUCTION: There is concern that survivors of adult cancers may be at increased risk of respiratory infections and of exacerbations of pre-existing respiratory conditions. Considering the high prevalence of respiratory disease in the general population, increased respiratory disease risk in survivors of adult cancers could translate into an important impact on morbidity and mortality. The aim of this systematic review is to summarise and assess the quality of all studies comparing respiratory outcomes between adult cancer survivors and individuals with no history of cancer. METHODS AND ANALYSIS: This systematic literature review will be conducted using Medline, EMBASE and Cochrane. We will include cohort or case-control studies that provide a comparative estimate of the risk of a respiratory disease of interest in survivors of adult cancer against a comparator cohort of cancer-free individuals. No geographic, time or language restrictions will be applied. We will assess the risk of bias using the Scottish Intercollegiate Guidelines Network methodology checklists. Results will be summarised by type of respiratory outcome, cancer type and cancer survivorship definition. If sufficient numbers of homogeneous studies are found, summary measures of association will be calculated using random effects meta-analysis models. ETHICS AND DISSEMINATION: Ethical approval is not applicable to our study. The results will be used to identify evidence gaps and priorities for future research to understand respiratory morbidity in survivors of adult cancers and identify possible mitigation strategies. Results from this review will be disseminated to clinical audiences and submitted to a peer-reviewed journal when completed. TRIAL REGISTRATION NUMBER: This study has been registered on PROSPERO (registration number: CRD42022311557).


Subject(s)
Neoplasms , Respiration Disorders , Adult , Humans , Research Design , Neoplasms/complications , Neoplasms/epidemiology , Case-Control Studies , Survivors , Systematic Reviews as Topic , Meta-Analysis as Topic
5.
Sci Immunol ; 5(54)2020 12 23.
Article in English | MEDLINE | ID: covidwho-2161788

ABSTRACT

Understanding the nature of immunity following mild/asymptomatic infection with SARS-CoV-2 is crucial to controlling the pandemic. We analyzed T cell and neutralizing antibody responses in 136 healthcare workers (HCW) 16-18 weeks after United Kingdom lockdown, 76 of whom had mild/asymptomatic SARS-CoV-2 infection captured by serial sampling. Neutralizing antibodies (nAb) were present in 89% of previously infected HCW. T cell responses tended to be lower following asymptomatic infection than in those reporting case-definition symptoms of COVID-19, while nAb titers were maintained irrespective of symptoms. T cell and antibody responses were sometimes discordant. Eleven percent lacked nAb and had undetectable T cell responses to spike protein but had T cells reactive with other SARS-CoV-2 antigens. Our findings suggest that the majority of individuals with mild or asymptomatic SARS-CoV-2 infection carry nAb complemented by multispecific T cell responses at 16-18 weeks after mild or asymptomatic SARS-CoV-2 infection.


Subject(s)
Antibodies, Neutralizing/immunology , Asymptomatic Infections , COVID-19/immunology , T-Lymphocytes/immunology , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Antibodies, Viral/immunology , Case-Control Studies , Cross-Sectional Studies , Humans , SARS-CoV-2/immunology
6.
Ann Clin Microbiol Antimicrob ; 21(1): 51, 2022 Nov 19.
Article in English | MEDLINE | ID: covidwho-2139308

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes life-threatening pneumonia. Convalescent plasma therapy (CPT) is expected to be the effective COVID-19 treatment for passive immunity. The high neutralizing antibodies titer of CPT is needed to prove the benefit in early developed severe COVID-19. OBJECTIVE: This case-control study evaluated transfusion efficacy and adverse events with high-titer (≥ 1:320) COVID-19 convalescent plasma compared with standard care alone in severe COVID-19 pneumonia. RESULTS: Among 107 severe COVID-19 patients, 55 received CPT plus standard care, and 52 received standard care alone. All-cause mortality was 15.3% in the CPT group compared with 85.4% in the standard care group (p < 0.001). Univariate and multivariate analyses revealed reduced mortality with CPT (HR 0.14; 95% CI 0.07-0.31; p < 0.001 and HR 0.26; 95% CI 0.08-0.79; p = 0.018, respectively). CPT resulted in decreased use of mechanical ventilation, duration of supplemental oxygen, and high-flow oxygen requirement. Clinical and radiological outcomes improved. CONCLUSIONS: Immediate high neutralizing antibody titer CPT is safe and reduces mortality in early developed severe COVID-19 patients. The benefit of CPT in the early course of illness is challenging and requires additional study. Trial registration Thai clinical trials registry (TCTR) no. 20220101003.


Subject(s)
Antibodies, Neutralizing , COVID-19 , Humans , COVID-19/therapy , Case-Control Studies , Immunization, Passive
7.
BMC Public Health ; 22(1): 2137, 2022 11 21.
Article in English | MEDLINE | ID: covidwho-2139227

ABSTRACT

BACKGROUND: What leads healthy people to enter in a volunteer register for clinical trials? This study aimed to investigate the relationship between the decision to volunteer in clinical trials for a COVID-19 vaccine and social capital, in a sample of healthy volunteers in Italy. Since social capital is characterized by trust, reciprocity, and social and political participation, we claim that it is key in leading individuals to actively take action to protect public health, and to take a risk for the (potential) benefit not only of themselves but for the entire community. METHODS: This study was conducted through the administration of a questionnaire to healthy volunteers registered for a phase 1 clinical trial for a COVID-19 vaccine in the Unit Research Centre of ASST-Monza, in September 2020. The primary purpose of a phase 1 study is to evaluate the safety of a new drug candidate before it proceeds to further clinical studies. To approximate a case-control study, we randomly matched the 318 respondents to healthy volunteers (cases) with 318 people randomly selected by Round 9 of the European Social Survey (controls), using three variables, which we considered to be associated with the decision to volunteer: gender, age, and education level. To execute this matching procedure, we used the "ccmatch" module in STATA. RESULTS: The findings highlight the positive impact of social capital in the choice of healthy individuals to volunteer in COVID-19 vaccine clinical trials. Controlling for possible confounding factors, some exemplary results show that people with a high level of general trust have a greater likelihood of volunteering compared to people with low trust (OR = 2.75, CI = 1.58-4.77); we also found that it is more probable that volunteers are people who have actively taken action to improve things compared with people who have not (for individuals who did three or more actions: OR = 7.54, CI = 4.10-13.86). People who reported voting (OR = 3.91, CI = 1.70-8.99) and participating in social activities more than other people of their age (OR = 2.89, CI = 1.82-4.60) showed a higher probability to volunteer. CONCLUSIONS: Together with the adoption of urgent health measures in response to COVID-19, government policymakers should also promote social capital initiatives to encourage individuals to actively engage in actions aimed at protecting collective health. Our findings make an empirical contribution to the research on vaccines and its intersection with social behaviour, and they provide useful insights for policymakers to manage current and future disease outbreaks and to enhance the enrolment in vaccine trials.


Subject(s)
COVID-19 , Social Capital , Humans , COVID-19 Vaccines/therapeutic use , Case-Control Studies , COVID-19/prevention & control , Trust
8.
BMC Geriatr ; 22(1): 887, 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2139164

ABSTRACT

BACKGROUND: Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB. METHODS: This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants. RESULTS: The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB. DISCUSSION: This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.


Subject(s)
COVID-19 , Health Status , Humans , Aged , Middle Aged , Case-Control Studies , COVID-19/epidemiology , Socioeconomic Factors , Surveys and Questionnaires
9.
BMC Anesthesiol ; 22(1): 179, 2022 06 09.
Article in English | MEDLINE | ID: covidwho-2139145

ABSTRACT

BACKGROUND: Neuraxial blocks is the recommended mode of analgesia and anesthesia in parturients with Coronavirus 19 (COVID-19). There is limited data on the hemodynamic responses to neuraxial blocks in COVID-19 patients. We aim to compare the hemodynamic responses to neuraxial blocks in COVID-19 positive and propensity-matched COVID-19 negative parturients. METHODS: We conducted retrospective, cross-sectional case-control study of hemodynamic changes associated with neuraxial blocks in COVID-19 positive parturients in a Tertiary care academic medical center. Fifty-one COVID-19 positive women confirmed by nasopharyngeal reverse transcription-polymerase chain reaction (RT-PCR), were compared with propensity-matched COVID negative controls (n = 51). Hemodynamic changes after neuraxial block were recorded by electronic medical recording system and analyzed using paired and unpaired T- test and Wilcoxon-Mann-Whitney Rank Sum tests. The primary outcome was ≥ 20% change in MAP and HR after neuraxial block placement. RESULTS: In the epidural group, 7% COVID-19 positive parturients had > 20% decrease in mean arterial pressure (MAP) from baseline compared to 15% COVID-19 negative parturients (P = 0.66). In the spinal group, 83% of COVID-19 positive parturients had a decrease in MAP more than 20% from baseline compared to 71% in control (P = 0.49). MAP drop of more than 40% occurred in 29% COVID positive parturients in the spinal group versus 17% in COVID-19 negative parturients (P = 0.5465). In COVID-19 positive spinal group, 54% required vasopressors whereas 38% in COVID-19 negative spinal group required vasopressors (P = 0.387). We found a significant correlation between body mass index (BMI) > 30 and hypotension in COVID ( +) parturient with odds ratio (8.63; 95% CI-1.93 - 37.21) (P = 0.007). CONCLUSION: Incidence and severity of hypotension after neuraxial blocks were similar between COVID-19 positive and COVID-19 negative parturients. BMI > 30 was a significant risk factor for hypotension as described in preexisting literature, this correlation was seen in COVID-19 positive parturients. The likely reason for parturients with BMI > 30 in COVID negative patients not showing similar correlation, is that the sample size was small.


Subject(s)
Anesthesia, Obstetrical , Anesthesia, Spinal , COVID-19 , Hypotension , Case-Control Studies , Cross-Sectional Studies , Female , Hemodynamics , Humans , Hypotension/epidemiology , Pregnancy , Pregnant Women , Retrospective Studies
10.
J Psychosom Obstet Gynaecol ; 43(4): 495-501, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2133999

ABSTRACT

INTRODUCTION: COVID-19 has negative and sometimes irreversible effects on infertile women. This study aimed to investigate hopelessness and depression in infertile women whose treatment has been delayed due to COVID-19. METHODS: This case-control study was conducted online on 172 infertile women. The case group included infertile women under treatment whose treatment was delayed during the COVID-19 pandemic, and the control group was selected from infertile women who were not under infertile treatment. This study was conducted between April and December 2021 in Jahrom, Iran. Beck hopelessness standard questionnaire (BHS) and Beck Depression Inventory (BDI) were used to collect data, and p < 0.05 was considered significant. RESULTS: The mean score of hopelessness in women in the case group was 9.48 ± 1.80 compared to the control group 8.66 ± 1.34 (OR = 1.39 95% CI = 1.13-1.71), and its areas (OR = 1.33 95% CI = 1.003-2.43), Emotions and expectations score (OR = 1.59 95% CI = 1.07-2.37), Motivation loss score (OR = 2.02 95% CI = 1.49-2.73), Hope score, and depression in women in the case group was 40.33 ± 10.87to 36.72 ± 11.40 compared to the control (OR = 1.17 95% CI = 1.11-1.23). All these variables showed an increase in the case group compared to the control group (p < 0.05). CONCLUSION: The results showed that infertile women whose treatment was delayed were more frustrated and depressed than women in the control group. COVID-19 epidemic and discontinuation of infertile treatments in infertile women seem to have negative psychological effects. Therefore, the psychological effects of this epidemic on infertile women should not be ignored, so planners should put social and family support at the top of the program.


Subject(s)
COVID-19 , Infertility, Female , Female , Humans , Pandemics , Infertility, Female/psychology , Depression/epidemiology , Depression/psychology , Case-Control Studies
11.
Georgian Med News ; (330): 65-69, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2125580

ABSTRACT

Since chronic diseases make up the majority of health care costs, it is essential to prevent or delay the onset of chronic diseases through preventive services and early detection of impaired physical health indicators. The aims of this study were to evaluate the correlations and infrastructure of some physical health indicators before and during the COVID-19 pandemic in the Armenian population. A case-control study of 778 was conducted in Armenia before and during the pandemic. Bioimpedance testing was applied using the Multiscan BS-OXI instrument. As the results of the study showed, during the COVID-19 pandemic indicators of stress resistance, endothelium and wellness decreased significantly, while the average score of the body composition index did not change. Before the COVID-19 pandemic, a significant direct correlation was found between stress resistance and endothelium, stress resistance and wellness, endothelium and body composition, endothelium and wellness, and body composition and wellness indicators. During the pandemic, a reliable correlation was established between stress resistance and endothelium, stress resistance and body composition, stress resistance and wellness, endothelium and wellness indicators.; Thus, we conclude, that during COVID-19 pandemic significantly decreased stress resistance, endothelium function, and wellness indicators. It is a priority to create programs to improve health during and after the pandemic and focus on programs to increase stress resistance, endothelial function, and wellness indicators (for example, physical activity and fitness).


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Case-Control Studies , Exercise , Body Composition
12.
Viruses ; 14(10)2022 09 30.
Article in English | MEDLINE | ID: covidwho-2143661

ABSTRACT

Interferon gamma (IFN-γ) may be potential adjuvant immunotherapy for COVID-19 patients. In this work, we assessed gene expression profiles associated with the IFN-γ pathway in response to SARS-CoV-2 infection. Employing a case-control study from SARS-CoV-2-positive and -negative patients, we identified IFN-γ-associated pathways to be enriched in positive patients. Bioinformatics analyses showed upregulation of MAP2K6, CBL, RUNX3, STAT1, and JAK2 in COVID-19-positive vs. -negative patients. A positive correlation was observed between STAT1/JAK2, which varied alongside the patient's viral load. Expression of MX1, MX2, ISG15, and OAS1 (four well-known IFN-stimulated genes (ISGs)) displayed upregulation in COVID-19-positive vs. -negative patients. Integrative analyses showcased higher levels of ISGs, which were associated with increased viral load and STAT1/JAK2 expression. Confirmation of ISGs up-regulation was performed in vitro using the A549 lung cell line treated with Poly (I:C), a synthetic analog of viral double-stranded RNA; and in different pulmonary human cell lines and ferret tracheal biopsies infected with SARS-CoV-2. A pre-clinical murine model of Coronavirus infection confirmed findings displaying increased ISGs in the liver and lungs from infected mice. Altogether, these results demonstrate the role of IFN-γ and ISGs in response to SARS-CoV-2 infection, highlighting alternative druggable targets that can boost the host response.


Subject(s)
COVID-19 , Humans , Animals , Mice , Interferon-gamma/genetics , SARS-CoV-2 , Case-Control Studies , RNA, Double-Stranded , Ferrets , MAP Kinase Kinase 6/genetics
13.
Front Public Health ; 10: 1010130, 2022.
Article in English | MEDLINE | ID: covidwho-2142344

ABSTRACT

Background: To safely resume in-person activities during the COVID-19 pandemic, Sapienza University of Rome implemented rigorous infection prevention and control measures, a successful communication campaign and a free SARS-CoV-2 testing program. In this study, we describe the University's experience in carrying out such a program in the context of the COVID-19 response and identify risk factors for infection. Methods: Having identified resources, space, supplies and staff, from March to June 2021 Sapienza offered to all its enrollees a molecular test service (8.30 AM to 4 PM, Monday to Thursday). A test-negative case-control study was conducted within the program. Participants underwent structured interviews that investigated activity-related exposures in the 2 weeks before testing. Multivariable conditional logistic regression analyses were performed. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 8,959 tests were administered, of which 56 were positive. The detection trend followed regional tendencies. Among 40 cases and 80 controls, multivariable analysis showed that a known exposure to a COVID-19 case increased the likelihood of infection (aOR: 8.39, 95% CI: 2.38-29.54), while having a job decreased it (aOR: 0.23, 95% CI: 0.06-0.88). Of factors that almost reached statistical significance, participation in activities in the university tended to reduce the risk (aOR: 0.32, 95% CI: 0.09-1.06), while attendance at private gatherings showed an increasing risk trend (aOR: 3.48, 95% CI: 0.95-12.79). Age, gender, activities in the community, visiting bars or restaurants, and use of public transportation were not relevant risk factors. When those students regularly attending the university campus were excluded from the analysis, the results were comparable, except that attending activities in the community came close to having a statistically significant effect (aOR: 8.13, 95% CI: 0.91-72.84). Conclusions: The testing program helped create a safe university environment. Furthermore, promoting preventive behavior and implementing rigorous measures in public places, as was the case in the university setting, contributed to limit the virus transmission.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , SARS-CoV-2 , Pandemics/prevention & control , COVID-19 Testing , Prevalence , Case-Control Studies
14.
Front Immunol ; 13: 947401, 2022.
Article in English | MEDLINE | ID: covidwho-2141978

ABSTRACT

Finding cytokine storm initiator factors associated with uncontrolled inflammatory immune response is necessary in COVID-19 patients. The aim was the identification of Fas/Fas Ligand (FasL) role in lung involvement and mortality of COVID-19 patients. In this case-control study, mild (outpatient), moderate (hospitalized), and severe (ICU) COVID-19 patients and healthy subjects were investigated. RNA isolated from PBMCs for cDNA synthesis and expression of mFas/mFasL mRNA was evaluated by RT-PCR. Serum sFas/sFasL protein by ELISA and severity of lung involvement by CT-scan were evaluated. Also, we docked Fas and FasL via Bioinformatics software (in silico) to predict the best-fit Fas/FasL complex and performed molecular dynamics simulation (MDS) in hyponatremia and fever (COVID-19 patients), and healthy conditions. mFasL expression was increased in moderate and severe COVID-19 patients compared to the control group. Moreover, mFas expression showed an inverse correlation with myalgia symptom in COVID-19 patients. Elevation of sFasL protein in serum was associated with reduced lung injury and mortality. Bioinformatics analysis confirmed that blood profile alterations of COVID-19 patients, such as fever and hyponatremia could affect Fas/FasL complex interactions. Our translational findings showed that decreased sFasL is associated with lung involvement; severity and mortality in COVID-19 patients. We think that sFasL is a mediator of neutrophilia and lymphopenia in COVID-19. However, additional investigation is suggested. This is the first report describing that the serum sFasL protein is a severity and mortality prognostic marker for the clinical management of COVID-19 patients.


Subject(s)
COVID-19 , Hyponatremia , Case-Control Studies , DNA, Complementary , Fas Ligand Protein , Humans , Prognosis , RNA , RNA, Messenger , fas Receptor/metabolism
15.
JMIR Public Health Surveill ; 7(9): e30406, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-2141343

ABSTRACT

BACKGROUND: Data on how SARS-CoV-2 enters and spreads in a population are essential for guiding public policies. OBJECTIVE: This study seeks to understand the transmission dynamics of SARS-CoV-2 in small Brazilian towns during the early phase of the epidemic and to identify core groups that can serve as the initial source of infection as well as factors associated with a higher risk of COVID-19. METHODS: Two population-based seroprevalence studies, one household survey, and a case-control study were conducted in two small towns in southeastern Brazil between May and June 2020. In the population-based studies, 400 people were evaluated in each town; there were 40 homes in the household survey, and 95 cases and 393 controls in the case-control study. SARS-CoV-2 serology testing was performed on participants, and a questionnaire was applied. Prevalence, household secondary infection rate, and factors associated with infection were assessed. Odds ratios (ORs) were calculated by logistic regression. Logistics worker was defined as an individual with an occupation focused on the transportation of people or goods and whose job involves traveling outside the town of residence at least once a week. RESULTS: Higher seroprevalence of SARS-CoV-2 was observed in the town with a greater proportion of logistics workers. The secondary household infection rate was 49.1% (55/112), and it was observed that in most households (28/40, 70%) the index case was a logistics worker. The case-control study revealed that being a logistics worker (OR 18.0, 95% CI 8.4-38.7) or living with one (OR 6.9, 95% CI 3.3-14.5) increases the risk of infection. In addition, having close contact with a confirmed case (OR 13.4, 95% CI 6.6-27.3) and living with more than four people (OR 2.7, 95% CI 1.1-7.1) were also risk factors. CONCLUSIONS: Our study shows a strong association between logistics workers and the risk of SARS-CoV-2 infection and highlights the key role of these workers in the viral spread in small towns. These findings indicate the need to focus on this population to determine COVID-19 prevention and control strategies, including vaccination and sentinel genomic surveillance.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Communicable Diseases, Imported/epidemiology , Occupations/statistics & numerical data , Transportation/statistics & numerical data , Adolescent , Adult , Brazil/epidemiology , Case-Control Studies , Child , Child, Preschool , Cities/epidemiology , Family Characteristics , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Risk Factors , Seroepidemiologic Studies , Young Adult
16.
Immunobiology ; 227(6): 152301, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2119151

ABSTRACT

Coronavirus disease-19 (COVID-19) has recently emerged as a respiratory infection with a significant impact on health and society. The pathogenesis is primarily attributed to a dysregulation of cytokines, especially those with pro-inflammatory and anti-inflammatory effects. Interleukin-38 (IL-38) is a recently identified anti-inflammatory cytokine with a proposed involvement in mediating COVID-19 pathogenesis, while the association between IL38 gene variants and disease susceptibility has not been explored. Therefore, a pilot study was designed to evaluate the association of three gene variants in the promoter region of IL38 gene (rs7599662 T/A/C/G, rs28992497 T/C and rs28992498 C/A/T) with COVID-19 risk. DNA sequencing was performed to identify these variants. The study included 148 Iraqi patients with COVID-19 and 113 healthy controls (HC). Only rs7599662 showed a significant negative association with susceptibility to COVID-19. The mutant T allele was presented at a significantly lower frequency in patients compared to HC. Analysis of recessive, dominant and codominant models demonstrated that rs7599662 TT genotype frequency was significantly lower in patients than in HC. In terms of haplotypes (in order: rs7599662, rs28992497 and rs28992498), frequency of CTC haplotype was significantly increased in patients compared to HC, while TTC haplotype showed significantly lower frequency in patients. The three SNPs influenced serum IL-38 levels and homozygous genotypes of mutant alleles were associated with elevated levels. In conclusion, this study indicated that IL38 gene in terms of promoter variants and haplotypes may have important implications for COVID-19 risk.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/genetics , Genotype , Pilot Projects , Iraq , Case-Control Studies , Promoter Regions, Genetic/genetics , Polymorphism, Single Nucleotide , Alleles , Haplotypes , Cytokines/genetics , Interleukins/genetics , Genetic Predisposition to Disease , Gene Frequency
17.
Ann Med ; 54(1): 3299-3305, 2022 12.
Article in English | MEDLINE | ID: covidwho-2120943

ABSTRACT

BACKGROUND: It is unclear whether unintentional ingestion of povidone-iodine following its application to the oropharyngeal space could affect thyroid function. OBJECTIVE: To examine thyroid function among individuals who regularly apply povidone-iodine throat spray for SARS-CoV-2 prophylaxis. METHODS: We designed a case-control study to compare thyroid function among participants who received povidone-iodine throat spray three times a day for 42 days ('cases') and those who received vitamin C ('controls'). Thyroid function was assessed by profiling serum TSH, free T3, and free T4; iodine status was estimated using serum thyroglobulin level, while infection status was determined by measuring anti-SARS-CoV-2 antibody against the nucleocapsid antigen. All measurements were performed in pairs, at baseline and 42 days later. Pre-post changes in thyroid function were compared between groups, before and after stratification according to baseline TSH quartiles. RESULTS: A total of 177 men (117 cases and 60 controls) (mean age, 32.2 years) were included. Despite comparable demographics and clinical profiles, no clinically or statistically significant differences were observed in thyroid indices between 'cases' and 'controls' before and after stratification according to TSH quartiles. None of the participants developed symptomatic hypo- or hyperthyroidism throughout the study. Post-hoc analysis did not reveal differences in thyroid function according to infection status. CONCLUSIONS: Data from this study support the overall safety of povidone-iodine use in the oropharyngeal space for SARS-CoV-2 prophylaxis among individuals with normal thyroid function and subclinical thyroid disease.


Subject(s)
COVID-19 , Povidone-Iodine , Male , Humans , Adult , Povidone-Iodine/adverse effects , Thyroid Gland , SARS-CoV-2 , Case-Control Studies , Pharynx , COVID-19/prevention & control , Thyrotropin
18.
PLoS One ; 17(11): e0268849, 2022.
Article in English | MEDLINE | ID: covidwho-2119358

ABSTRACT

Measures to restrict physical inter-personal contact in the community have been widely implemented during the COVID-19 pandemic. We studied determinants for infection with SARS-CoV-2 with the aim of informing future public health measures. We conducted a national matched case-control study among unvaccinated not previously infected adults aged 18-49 years. Cases were selected among those testing positive for SARS-CoV-2 by RT-PCR over a five-day period in June 2021. Controls were selected from the national population register and were individually matched on age, sex and municipality of residence. Cases and controls were interviewed via telephone about contact with other persons and exposures in the community. We determined matched odds ratios (mORs) and 95% confidence intervals (95%CIs) by conditional logistical regression with adjustment for household size and immigration status. For reference, we provide a timeline of non-pharmaceutical interventions in place in Denmark from February 2020 to March 2022. We included 500 cases and 529 controls. We found that having had contact with another individual with a known infection was the main determinant for SARS-CoV-2 infection: reporting close contact with an infected person who either had or did not have symptoms resulted in mORs of 20 (95%CI:9.8-39) and 8.5 (95%CI 4.5-16) respectively. Community exposures were generally not associated with disease; several exposures were negatively associated. Consumption of alcohol in restaurants or cafés, aOR = 2.3 (95%CI:1.3-4.2) and possibly attending fitness centers, mOR = 1.4 (95%CI:1.0-2.0) were weakly associated with SARS-CoV-2 infection. Apart from these two factors, no community activities were more common amongst cases under the community restrictions in place during the study. The strongest risk factor for transmission was contact to an infected person. Results were in agreement with findings of our similar study conducted six month earlier.


Subject(s)
COVID-19 , Adult , Humans , COVID-19/epidemiology , SARS-CoV-2 , Pandemics/prevention & control , Case-Control Studies , Denmark/epidemiology
19.
Euro Surveill ; 27(45)2022 11.
Article in English | MEDLINE | ID: covidwho-2117963

ABSTRACT

BackgroundDifferential SARS-CoV-2 exposure between vaccinated and unvaccinated individuals may confound vaccine effectiveness (VE) estimates.AimWe conducted a test-negative case-control study to determine VE against SARS-CoV-2 infection and the presence of confounding by SARS-CoV-2 exposure.MethodsWe included adults tested for SARS-CoV-2 at community facilities between 4 July and 8 December 2021 (circulation period of the Delta variant). The VE against SARS-CoV-2 infection after primary vaccination with an mRNA (Comirnaty or Spikevax) or vector-based vaccine (Vaxzevria or Janssen) was calculated using logistic regression adjusting for age, sex and calendar week (Model 1). We additionally adjusted for comorbidity and education level (Model 2) and SARS-CoV-2 exposure (number of close contacts, visiting busy locations, household size, face mask wearing, contact with SARS-CoV-2 case; Model 3). We stratified by age, vaccine type and time since vaccination.ResultsVE against infection (Model 3) was 64% (95% CI: 50-73), only slightly lower than in Models 1 (68%; 95% CI: 58-76) and 2 (67%; 95% CI: 56-75). Estimates stratified by age group, vaccine and time since vaccination remained similar: mRNA VE (Model 3) among people ≥ 50 years decreased significantly (p = 0.01) from 81% (95% CI: 66-91) at < 120 days to 61% (95% CI: 22-80) at ≥ 120 days after vaccination. It decreased from 83% to 59% in Model 1 and from 81% to 56% in Model 2.ConclusionSARS-CoV-2 exposure did not majorly confound the estimated COVID-19 VE against infection, suggesting that VE can be estimated accurately using routinely collected data without exposure information.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Humans , Middle Aged , Netherlands/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Case-Control Studies , Vaccine Efficacy , SARS-CoV-2 , RNA, Messenger
20.
Clin Infect Dis ; 75(10): 1688-1697, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2117296

ABSTRACT

BACKGROUND: Fatigue is the most prevalent and debilitating long-COVID (coronavirus disease) symptom; however, risk factors and pathophysiology of this condition remain unknown. We assessed risk factors for long-COVID fatigue and explored its possible pathophysiology. METHODS: This was a nested case-control study in a COVID recovery clinic. Individuals with (cases) and without (controls) significant fatigue were included. We performed a multidimensional assessment evaluating various parameters, including pulmonary function tests and cardiopulmonary exercise testing, and implemented multivariable logistic regression to assess risk factors for significant long-COVID fatigue. RESULTS: A total of 141 individuals were included. The mean age was 47 (SD: 13) years; 115 (82%) were recovering from mild coronavirus disease 2019 (COVID-19). Mean time for evaluation was 8 months following COVID-19. Sixty-six (47%) individuals were classified with significant long-COVID fatigue. They had a significantly higher number of children, lower proportion of hypothyroidism, higher proportion of sore throat during acute illness, higher proportions of long-COVID symptoms, and of physical limitation in daily activities. Individuals with long-COVID fatigue also had poorer sleep quality and higher degree of depression. They had significantly lower heart rate [153.52 (22.64) vs 163.52 (18.53); P = .038] and oxygen consumption per kilogram [27.69 (7.52) vs 30.71 (7.52); P = .036] at peak exercise. The 2 independent risk factors for fatigue identified in multivariable analysis were peak exercise heart rate (OR: .79 per 10 beats/minute; 95% CI: .65-.96; P = .019) and long-COVID memory impairment (OR: 3.76; 95% CI: 1.57-9.01; P = .003). CONCLUSIONS: Long-COVID fatigue may be related to autonomic dysfunction, impaired cognition, and decreased mood. This may suggest a limbic-vagal pathophysiology. CLINICAL TRIALS REGISTRATION: NCT04851561.


Subject(s)
COVID-19 , Fatigue , Humans , Middle Aged , Case-Control Studies , COVID-19/complications , Fatigue/epidemiology , Risk Factors , Adult
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