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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a global pandemic. Safe and effective vaccination is critical to ending the epidemic of COVID-19. Although randomized clinical trials are considered the "gold standard" for evaluating intervention effects of vaccines, they have notable limitations. As mass vaccination campaigns against COVID-19 commence worldwide, vaccine effectiveness needs to be assessed for a range of outcomes across diverse populations in a noncontrolled setting. Meanwhile, SARS-CoV-2 variants continue to emerge during the global pandemic and may facilitate escape from current vaccine immune protection. Hence, COVID19 vaccines faced many challenges, such as safety, immunogenicity, and efficacy of the COVID-19 Vaccine in special populations, the duration of protective effectiveness, viral mutations and breakthrough infection, antibody-dependent enhancement effect, and pathogenic autoimmune and so on. This article summarizes th.
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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic. It presents a global public health threat, infecting an immunologically naive population and causing significant morbidity and mortality, changing social behaviors and habits, and leading to a global economic burden. However, no effective drug therapy against SARS-CoV-2 has been developed. Therefore, adaptive immune responses to SARS-CoV-2 induced by natural infection have been a focus of many researchers. Natural SARS-CoV-2 infection may elicit robust humoral immune responses and cellular immune responses in the great majority of adults, including production of highly spike-specific antibodies of the IgM, IgG, and IgA classes, high levels of neutralizing antibodies, and a strong CD4+ T cell response. Immune protection from SARS-CoV-2 infection is likely, although the durability of this protection is not well defined. These findings play an important role in the diagnosis of infection, serosurveys, strategies to increase immunity, protection against infection and the development of vaccines.
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BACKGROUND: Coronavirus disease 2019 (COVID-19) broke out in Wuhan, the People's Republic of China, in December 2019 and now is a pandemic all around the world. Some orthopaedic surgeons in Wuhan were infected with COVID-19. METHODS: We conducted a survey to identify the orthopaedic surgeons who were infected with COVID-19 in Wuhan. A self-administered questionnaire was distributed to collect information such as social demographic variables, clinical manifestations, exposure history, awareness of the outbreak, infection control training provided by hospitals, and individual protection practices. To further explore the possible risk factors at the individual level, a 1:2 matched case-control study was conducted. RESULTS: A total of 26 orthopaedic surgeons from 8 hospitals in Wuhan were identified as having COVID-19. The incidence in each hospital varied from 1.5% to 20.7%. The onset of symptoms was from January 13 to February 5, 2020, and peaked on January 23, 8 days prior to the peak of the public epidemic. The suspected sites of exposure were general wards (79.2%), public places at the hospital (20.8%), operating rooms (12.5%), the intensive care unit (4.2%), and the outpatient clinic (4.2%). There was transmission from these doctors to others in 25% of cases, including to family members (20.8%), to colleagues (4.2%), to patients (4.2%), and to friends (4.2%). Participation in real-time training on prevention measures was found to have a protective effect against COVID-19 (odds ratio [OR], 0.12). Not wearing an N95 respirator was found to be a risk factor (OR, 5.20 [95% confidence interval (CI), 1.09 to 25.00]). Wearing respirators or masks all of the time was found to be protective (OR, 0.15). Severe fatigue was found to be a risk factor (OR, 4 [95% CI, 1 to 16]) for infection with COVID-19. CONCLUSIONS: Orthopaedic surgeons are at risk during the COVID-19 pandemic. Common places of work could be contaminated. Orthopaedic surgeons have to be more vigilant and take more precautions to avoid infection with COVID-19. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.