Incidence Of COVID-19 Research Articles

Comparative Analysis of Epidemiological Outcome of Incidence, Mortality and Lethality by COVID-19 between the States of Espírito Santo and Minas Gerais, Brazil.

At the beginning of December 2019, a new type of coronavirus emerged, SARS-CoV-2. This virus causes COVID-19, a highly contagious disease that can initially present asymptomatically and can also lead to death. Our ecological study goal was to evaluate the incidence, mortality, and lethality rates for COVID-19 between the states of Espírito Santo and Minas Gerais, with time series analysis using secondary and public databases on COVID-19 from January 2020 to December 2022. Prais-Winsten linear regression was used for trend analyses. In 2020, the rate in Espírito Santo was 2.19 times greater than in Minas Gerais. This trend continued in 2021, with Espírito Santo's rate being 1.29 times greater. In 2022, Espírito Santo's rate remained 2.65 times higher than Minas Gerais. Furthermore, Espírito Santo had the highest mortality, with the exception of 2021. In turn, Minas Gerais had the highest fatality rate throughout the analyzed pandemic period. The state of Espírito Santo had a higher incidence of COVID-19, as well as higher mortality when compared to the state of Minas Gerais. Furthermore, both states showed similar trends for mortality, lethality, and incidence in the years 2020 and 2021.

Incidence and Determinants of COVID-19 Among People Who Smoke (2018–2021): Findings From the ITC EUREST-PLUS Spain Surveys

ObjectiveTo estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke. MethodsThis is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables. ResultsThe overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9–8.0%), with no significant differences between males (6.3%; 95% CI: 3.6–9.0%) and females (5.6%; 95% CI: 3.2–8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04–5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03–0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14–0.56). ConclusionThe correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.

Comparison of COVID-19 Infection in Operating Room Staff During Two COVID-19 Waves Using Different Preventive Strategies in a Tertiary Care Hospital in Pakistan.

To assess if limiting elective surgeries during specific pandemic phases significantly affected COVID-19 incidence among operating room (OR) staff. Retrospective cohort study. Place and Duration of the Study: Operation Theatre (OT), The Aga Khan University Hospital, Karachi, Pakistan, from May 2020 to 2021. This retrospective study compared two pandemic waves: Wave 1, during which elective surgeries were restricted (REL), and Wave 2, during which elective surgeries were continued routinely (EL). Exposure levels were measured based on OR activity. Incidence rates were calculated per 100 OR staff, per 100 ORs, and per 100 surgeries for both Groups. No statistically significant difference emerged in COVID-19 incidence among OR staff between REL (13.8 per 100 staff) and EL (14.4 per 100 staff) Groups (p = 0.825). However, the EL Group exhibited a significantly lower incidence risk per running OR (5.6 per 100 ORs vs. REL's 12 per 100 ORs, p <0.001). Additionally, the EL Group showed a lower incidence per 100 surgeries (1.5 vs. REL's 2.9, p <0.002). Restricting elective surgeries during the early pandemic phase did not significantly reduce COVID-19 incidence among OR staff. Infections were primarily linked to interactions with colleagues and the community, emphasising the need for a balanced pandemic response considering patient care and the consequences of surgery restrictions. COVID-19 infection, Operating room staff, COVID-19 waves, COVID-19 transmission, Hospital epidemiology, Pandemic response.

The 2020 Czech Regional Elections in the Shadow of the Covid-19 Pandemic: Electoral Participation in the Spread of the Pandemic

Abstract The aim of the paper is to analyze the 2020 Czech regional elections held after the most intensive phase of the election campaign occurred during an unprecedented outbreak of new COVID-19 cases. Shortly after the elections, the Czech government of premier Andrej Bahis officially announced a state of emergency, and the Czech Republic became one of the world’s COVID-19 hardest-hit countries within a few weeks. Our analysis focuses especially on trends in the association between the 7-day incidence of COVID-19 and voter turnout between September 19 and November 14 at the level of 206 Czech microregions. While our results show a considerable rise in COVID-19 incidence per 100,000 people in Czech microregions with higher turnout, this effect was partly modified by age as the rise of COVID-19 in microregions with older populations occurred much later.

Evaluating COVID-19 vaccine effectiveness during pre-Delta, Delta and Omicron dominant periods among pregnant people in the U.S.: Retrospective cohort analysis from a nationally sampled cohort in National COVID Collaborative Cohort (N3C)

ObjectivesTo evaluate the effectiveness of COVID-19 vaccinations (initial and booster) during pre-Delta, Delta and Omicron dominant periods among pregnant people via (1) COVID-19 incident and severe infections among pregnant people...

Incidence, Risk Factors and Mortality of COVID-19 among Cancer Patients: A Meta-Analysis

Incidence, Risk Factors and Mortality of COVID-19 among Cancer Patients: A Meta-Analysis

Effectiveness against severe COVID-19 of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines in persons aged ≥60 years: Estimates over calendar time and by time since administration during prevalent circulation of different Omicron subvariants, Italy, 2022–2023

Evaluating how a COVID-19 seasonal vaccination program performed might help to plan future campaigns. This study aims to estimate the relative effectiveness (rVE) against severe COVID-19 of a seasonal booster dose over calendar time and by time since administration.We conducted a retrospective cohort analysis among 13,083,855 persons aged ≥60 years who were eligible to receive a seasonal booster at the start of the 2022–2023 vaccination campaign in Italy. We estimated rVE against severe COVID-19 (hospitalization or death) of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines by two-month calendar interval and at different times post-administration. We used multivariable Cox regression models, including vaccination as time-dependent exposure, to estimate adjusted hazard ratios (HR) and rVEs as [(1-HR)X100].The rVE of a seasonal booster decreased from 64.9% (95% CI: 59.8–69.4) in October-November 2022 to 22.0% (95% CI: 15.4–28.0) in April-May 2023, when the majority of vaccinated persons (67%) had received the booster at least 4–6 months earlier. During the epidemic phase with prevalent circulation of the Omicron BA.5 subvariant, rVE of a seasonal booster received ≤90 days earlier was 83.0% (95% CI: 79.1–86.1), compared to 37.4% (95% CI: 25.5–47.5) during prevalent circulation of the Omicron XBB subvariant. During the XBB epidemic phase, rVE was estimated at 15.8% (95% CI: 9.1–20.1) 181–369 days post-administration of the booster dose. In all the analyses we observed similar trends of rVE between persons aged 60–79 and those ≥80 years, although estimates were somewhat lower for the oldest group.A seasonal booster dose received during the vaccination campaign provided additional protection against severe COVID-19 up to April-May 2023, after which the incidence of severe COVID-19 was much reduced. The results also suggest that the Omicron XBB subvariant might have partly escaped the immunity provided by the seasonal booster targeting the original and Omicron BA.4-5 strains of SARS-CoV-2.

COVID-19 pandemic: the role of risk factors related to urban space (Analytical review)

Comfortable urban environment plays a key role in protecting health of people residing in large urban settlements. At the same time, urban space has some peculiarities including high population and building density, imperfect traffic infrastructure, irrational planning decisions, elevated levels of ambient air pollution, heat islands and lack of urban green spaces. All these features of any urban space are significant health risk factors able to facilitate spread of respiratory diseases. This was the most evident during the COVID-19 pandemic. The analytical review examines the results of studies focusing on impacts exerted by these unfavorable urban conditions on COVID-19 infection, incidence, hospitalization and mortality in cities across the globe. Influence of elevated population density on COVID-19 infection is shown to be ambiguous as compared to other risk factors. More reliable data are available on the impact of air pollutants, especially PM, on incidence and mortality rates from the infectious disease in question. Also, the COVID-19 virus and abnormally high temperatures were shown to produce combined effects on mental health during the pandemic. To reduce levels of infection in urban population, a suggestion is to further develop urban infrastructure providing people with retail and other necessary facilities within a walking distance (15 minutes). An important conclusion has been made by experts on elevated risks of infection in dense foot traffic as compared to public buildings. Therefore, it is important to improve communications about the necessity of social distancing. Urban development that aims to reduce infection with respiratory diseases should involve better street aeration. The results of these studies in various cities across the globe gave grounds for making management decisions on providing better mobility in suburban areas in a more comfortable natural environment, developing green areas in cities, and reducing negative effects of the warming climate on heat islands and elevated levels of ambient air pollution. Large open green spaces are the most effective in this respect.

Роль факторов риска городского пространства в пандемии COVID-19 (Аналитический обзор)

Comfortable urban environment plays a key role in protecting health of people residing in large urban settlements. At the same time, urban space has some peculiarities including high population and building density, imperfect traffic infrastructure, irrational planning decisions, elevated levels of ambient air pollution, heat islands and lack of urban green spaces. All these features of any urban space are significant health risk factors able to facilitate spread of respiratory diseases. This was the most evident during the COVID-19 pandemic. The analytical review examines the results of studies focusing on impacts exerted by these unfavorable urban conditions on COVID-19 infection, incidence, hospitalization and mortality in cities across the globe. Influence of elevated population density on COVID-19 infection is shown to be ambiguous as compared to other risk factors. More reliable data are available on the impact of air pollutants, especially PM, on incidence and mortality rates from the infectious disease in question. Also, the COVID-19 virus and abnormally high temperatures were shown to produce combined effects on mental health during the pandemic. To reduce levels of infection in urban population, a suggestion is to further develop urban infrastructure providing people with retail and other necessary facilities within a walking distance (15 minutes). An important conclusion has been made by experts on elevated risks of infection in dense foot traffic as compared to public buildings. Therefore, it is important to improve communications about the necessity of social distancing. Urban development that aims to reduce infection with respiratory diseases should involve better street aeration. The results of these studies in various cities across the globe gave grounds for making management decisions on providing better mobility in suburban areas in a more comfortable natural environment, developing green areas in cities, and reducing negative effects of the warming climate on heat islands and elevated levels of ambient air pollution. Large open green spaces are the most effective in this respect.

Shedding Light on Dark Chemical Matter: The Discovery of a SARS-CoV-2 Mpro Main Protease Inhibitor through Intensive Virtual Screening and In Vitro Evaluation.

The development of specific antiviral therapies targeting SARS-CoV-2 remains fundamental because of the continued high incidence of COVID-19 and limited accessibility to antivirals in some countries. In this context, dark chemical matter (DCM), a set of drug-like compounds with outstanding selectivity profiles that have never shown bioactivity despite being extensively assayed, appears to be an excellent starting point for drug development. Accordingly, in this study, we performed a high-throughput screening to identify inhibitors of the SARS-CoV-2 main protease (Mpro) using DCM compounds as ligands. Multiple receptors and two different docking scoring functions were employed to identify the best molecular docking poses. The selected structures were subjected to extensive conventional and Gaussian accelerated molecular dynamics. From the results, four compounds with the best molecular behavior and binding energy were selected for experimental testing, one of which presented inhibitory activity with a Ki value of 48 ± 5 μM. Through virtual screening, we identified a significant starting point for drug development, shedding new light on DCM compounds.

Cancer Care During the COVID-19 Pandemic: A Retrospective Study From a Najran Oncology Center.

Background The COVID-19 pandemic significantly impacted healthcare systems globally, with cancer patients representing a particularly vulnerable group. This study aims to evaluate the influence of COVID-19 on cancer, focusing on infection rates, types of care, therapy adjustments, and factors associated with COVID-19 infection. Materials and methods This single-center retrospective analysis included adult cancer patients who underwent anticancer therapy at King Khalid Hospital in Najran, Saudi Arabia, from December 20, 2020, to January 23, 2022. Data on patient and cancer characteristics, COVID-19 specifics, treatment delays, outcomes, and factors associated with COVID-19 were collected and analyzed. Results A total of 257 chemotherapy recipients were interviewed. The mean age was 52.6 ± 14.4 years, with 44 (17.1%) over 65 years old. Females comprised 160 (62.3%) of the patients. The most common malignancies were gastrointestinal (71, 27.6%), breast (70, 27.2%), and hematological (50, 19.5%). Metastasis was present in 116 patients (45.1%). Common comorbidities included diabetes (68, 26.5%) and hypertension (55, 21.4%). Most patients (226, 87.9%) were vaccinated against COVID-19. COVID-19 tested positive in 22 patients (8.6%), with a lower infection rate in vaccinated patients (7 vs. 15, p < 0.001). Most cases were mild (18, 81.8%), with fever (19, 7.4%) and cough and fatigue (17, 6.6%) being the most common symptoms. The median time to resume treatment post-infection was 30 days. Factors associated with higher infection rates included diabetes (OR: 4.73, 95% CI: 1.94-12.03, p = 0.001), coronary artery disease (OR: 4.13, 95% CI: 1.07-13.30, p = 0.049), chronic lung disease (OR: 15.58, 95% CI: 5.37-45.79, p < 0.001), chronic liver disease (OR: 7.64, 95% CI: 2.38-22.98, p < 0.001), and multiple comorbidities (OR: 2.04, 95% CI: 1.46-2.90, p < 0.001), cancer patients who received chemotherapy (OR: 1.02, 95% CI: 0.12-12.79, p = 0.027), and immunotherapy (OR: 3.37, 95% CI:1.27-8.43, p = 0.012). Conclusion The incidence of COVID-19 in cancer patients is proportional to the prevalence in the general population of similar geographic areas. Diabetes, coronary artery disease, chronic lung disease, chronic liver disease, receiving chemotherapy or immunotherapy, and multiple comorbidities were associated with higher COVID-19 infection rates.

Epidemiology of bloodstream infections caused by extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae in Switzerland, 2015–2022: secular trends and association with the COVID-19 pandemic

The association between the COVID-19 pandemic and the incidence of invasive infections caused by multidrug-resistant organisms remains a topic of debate. To analyse the national incidence rates of bloodstream infections (BSI) caused by Escherichia coli (EC) and Klebsiella pneumoniae (KP) with extended-spectrum cephalosporin resistance (ESCR) in two distinct regions in Switzerland, each exhibiting varying antimicrobial resistance patterns and that were impacted differently by the pandemic. Data was analysed from positive blood cultures prospectively collected by the nationwide surveillance system (ANRESIS) from January 1st, 2015, to August 31st, 2022. To explore the potential relationship between COVID-19 patient occupancy and ESCR incidence rates, an in-depth analysis was conducted over the two-year pandemic period fromApril 1st, 2020, to March 30th, 2022, using Quasi-Poisson and logistic regression analyses. During the study period, 40,997EC-BSI and 8537KP-BSI episodes were collected and reported to ANRESIS by the participating hospitals. ESCR was observed in 11% (N= 4313) of E.coli and 8% (N= 664) of K.pneumoniae, respectively. A significant reduction in ESCR-EC BSI incidence occurred during the pandemic in the region with the highest COVID-19 incidence. Conversely, ESCR-KP BSI incidence initially fell considerably and then increased during the pandemic in both regions, though this effect was not statistically significant. No association between hospital occupancy from COVID-19 patients and these trends was observed. In the early phase of the COVID-19 pandemic, a decrease in ESCR rates was observed, particularly in ESCR-EC BSI within the most heavily impacted region.

Limited impact of lifting universal masks on SARS-CoV-2 transmission in schools: The crucial role of outcome measurements.

Amid the COVID-19 pandemic, education systems globally implemented protective measures, notably mandatory mask wearing. As the pandemic's dynamics changed, many municipalities lifted these mandates, warranting a critical examination of these policy changes' implications. This study examines the effects of lifting mask mandates on COVID-19 transmission within Massachusetts school districts. We first replicated previous research that utilized a difference-in-difference (DID) model for COVID-19 incidence. We then repeated the DID analysis by replacing the outcome measurement with the reproductive number (Rt ), reflecting the transmissibility. Due to the data availability, the Rt we estimated only measures the within school transmission. We found a similar result in the replication using incidence with an average treatment effect on treated (ATT) of 39.1 (95% CI: 20.4 to 57.4) COVID-19 cases per 1,000 students associated with lifting masking mandates. However, when replacing the outcome measurement to Rt , our findings suggest that no significant association between lifting mask mandates and reduced Rt (ATT: 0.04, 95% CI: -0.09 to 0.18), except for the first 2 weeks postintervention. Moreover, we estimated Rt below 1 at 4 weeks before lifting mask mandates across all school types, suggesting nonsustainable transmission before the implementation. Our reanalysis suggested no evidence of lifting mask mandates in schools impacted the COVID-19 transmission in the long term. Our study highlights the importance of examining the transmissibility outcome when evaluating interventions against transmission.

COVID-19 testing, incidence, and positivity trends among school age children during the academic years 2020–2022 in the State of Qatar: special focus on using CDC indicators for community transmission to evaluate school attendance policies and public health response

BackgroundThere exists a gap in our understanding of the age-dependent epidemiological dynamics of SARS-CoV-2 among school-age children in comparison to adults within the State of Qatar. Additionally, there has been limited assessment of the timely implementation of physical distancing interventions, notably national school closures, and their impact on infection trends.MethodsWe used the national database to capture all records of polymerase-chain-reaction (PCR) testing, and rapid antigen tests (RAT) conducted at all health care venues in Qatar and administered between August 26, 2020, and August 21, 2022, across all age groups (≥ 5 years old). Study participants under 18 years old were categorized into two age brackets: (5–11) and (12–17), aligning with the Primary and Preparatory/Secondary grade levels in Qatar, respectively. We assessed age group testing rates, incidence rates, and positivity rates in relation to adults. These epidemiological metrics were compared with the CDC’s thresholds for COVID-19 community transmission.ResultsThroughout the school years of 2020–2021 and 2021–2022, a total of 5,063,405 and 6,130,531 tests were respectively conducted. In the 2020–2021 school year, 89.6% of the tests were administered to adults, while 13.7% were conducted on children in the following year. The overall test positivity rates for the 2020–2021 and 2021–2022 school years were 5.8% and 8.1%, respectively. Adolescents underwent the fewest tests during the full study period compared to both adults and young children. Using the CDC indicators, we found that children and adolescents can significantly contribute to elevated infection rates, potentially driving community transmission upon relaxation of social restrictions.ConclusionIt is crucial to acknowledge the potential for higher transmission among youth and adolescents when formulating transmission control strategies and making decisions regarding school closures. Employing data-driven indicators and thresholds to monitor COVID-19 community levels is important for informing decision-making. These approaches also enable the prompt implementation of infection control transmission mitigation measures in future pandemics.

Hesperidin, a Potential Antiviral Agent against SARS-CoV-2: The Influence of Citrus Consumption on COVID-19 Incidence and Severity in China.

This review examines hesperidin, a citrus bioflavonoid, as a potential antiviral agent against SARS-CoV-2. The COVID-19 pandemic has demanded an urgent need to search for effective antiviral compounds, including those of natural origin, such as hesperidin. The review provides a comprehensive analysis of the chemical properties, bioavailability and antiviral mechanisms of hesperidin, particularly its potential efficacy against SARS-CoV-2. A review of databases, including PubMedPico, Scopus and Web of Science, was conducted using specific keywords and search criteria in accordance with PRISMA (Re-porting Items for Systematic Reviews and Meta-Analysis) guidelines between 2020 and 2024. Of the 207 articles, 37 were selected for the review. A key aspect is the correlation of in vitro, in silico and clinical studies on the antiviral effects of hesperidin with epidemiological data on citrus consumption in China during 2020-2024. The importance of integrating laboratory findings with actual consumption patterns to better understand the role of hesperidin in mitigating COVID-19 was highlighted, and an attempt was made to analyze epidemiological studies to examine the association between citrus juice consumption as a source of hesperidin and the incidence and severity of COVID-19 using China as an example. The review identifies consistencies and discrepancies between experimental and epidemiological data, highlighting the need to correlate the two fields to better understand the potential of hesperidin as an agent against SARS-CoV-2. Challenges and limitations in interpreting the results and future research perspectives in this area are discussed. The aim of this comprehensive review is to bridge the gap between experimental studies and epidemiological evidence and to contribute to the understanding of their correlation.

Correlation between Genomic Variants and Worldwide COVID-19 Epidemiology.

COVID-19 is a systemic disease caused by the etiologic agent SARS-CoV-2, first reported in Hubei Province in Wuhan, China, in late 2019. The SARS-CoV-2 virus has evolved over time with distinct transmissibility subvariants from ancestral lineages. The clinical manifestations of the disease vary according to their severity and can range from asymptomatic to severe. Due to the rapid evolution to a pandemic, epidemiological studies have become essential to understand and effectively combat COVID-19, as the incidence and mortality of this disease vary between territories and populations. This study correlated epidemiological data on the incidence and mortality of COVID-19 with frequencies of important SNPs in GWAS studies associated with the susceptibility and mortality of this disease in different populations. Our results indicated significant correlations for 11 genetic variants (rs117169628, rs2547438, rs2271616, rs12610495, rs12046291, rs35705950, rs2176724, rs10774671, rs1073165, rs4804803 and rs7528026). Of these 11 variants, 7 (rs12046291, rs117169628, rs1073165, rs2547438, rs2271616, rs12610495 and rs35705950) were positively correlated with the incidence rate, these variants were more frequent in EUR populations, suggesting that this population is more susceptible to COVID-19. The rs2176724 variant was inversely related to incidence rates; therefore, the higher the frequency of the allele is, the lower the incidence rate. This variant was more frequent in the AFR population, which suggests a protective factor against SARS-CoV-2 infection in this population. The variants rs10774671, rs4804803, and rs7528026 showed a significant relationship with mortality rates. SNPs rs10774671 and rs4804803 were inversely related to mortality rates and are more frequently present in the AFR population. The rs7528026 variant, which is more frequent in the AMR population, was positively related to mortality rates. The study has the potential to identify and correlate the genetic profile with epidemiological data, identify populations that are more susceptible to severe forms of COVID-19, and relate them to incidence and mortality.

Indirect Effects of PM2.5 Exposure on COVID-19 Mortality in Greater Jakarta, Indonesia: An Ecological Study.

Air pollution, including PM2.5, was suggested as one of the primary contributors to COVID-19 fatalities worldwide. Jakarta, the capital city of Indonesia, was recognized as one of the ten most polluted cities globally. Additionally, the incidence of COVID-19 in Jakarta surpasses that of all other provinces in Indonesia. However, no study has investigated the correlation between PM2.5 concentration and COVID-19 fatality in Jakarta. To investigate the correlation between short-term and long-term exposure to PM2.5 and COVID-19 mortality in Greater Jakarta area. An ecological time-trend study was implemented. The data of PM2.5 ambient concentration obtained from Nafas Indonesia and the National Institute for Aeronautics and Space (LAPAN)/National Research and Innovation Agency (BRIN). The daily COVID-19 death data obtained from the City's Health Office. Our study unveiled an intriguing pattern: while short-term exposure to PM2.5 showed a negative correlation with COVID-19 mortality, suggesting it might not be the sole factor in causing fatalities, long-term exposure demonstrated a positive correlation. This suggests that COVID-19 mortality is more strongly influenced by prolonged PM2.5 exposure rather than short-term exposure alone. Specifically, our regression analysis estimate that a 50 µg/m3 increase in long-term average PM2.5 could lead to an 11.9% rise in the COVID-19 mortality rate. Our research, conducted in one of the most polluted areas worldwide, offers compelling evidence regarding the influence of PM2.5 exposure on COVID-19 mortality rates. It emphasizes the importance of recognizing air pollution as a critical risk factor for the severity of viral respiratory infections.

Treatment with immunosuppressants did not increase the risk of COVID-19 in pemphigus patients: A single-center survey-based study

BackgroundThe prevalence and outcomes of coronavirus 2019 (COVID-19) among patients using glucocorticoids and immunosuppressants remain controversial. AimThe study aims to investigate the impact of immunosuppressants especially glucocorticoids on patients in the Autoimmune Bullous Diseases Cohort of West China Hospital (AIBDWCH) during COVID-19. MethodsWe conducted a cross-sectional survey from December 7, 2022, to February 8, 2023, using questionnaires administered either face-to-face or by phone. COVID-19 cases were classified as confirmed, probable, or suspected according to World Health Organization criteria. Patients were divided into Group A (confirmed and probable cases) and Group B (suspected and other cases). The impact of glucocorticoids and immunosuppressive agents on COVID-19 disease and progression was evaluated with logistic regression models. ResultsThis study included 111 patients with pemphigus. Overweight patients had a reduced risk of confirmed COVID-19 (odds ratio [OR] 0.35 [95 % CI 0.13–0.97], p = 0.045). Patients treated with a medium dose of prednisone during the pandemic had a lower incidence of COVID-19 compared to those on low doses, though the difference was not statistically significant. No independent effects of age, sex, comorbidities, and therapies were observed. No significant differences were found in COVID-19 symptoms among different therapy groups. ConclusionsTreatment with immunosuppressants, particularly glucocorticoids at low-to-medium doses, did not elevate COVID-19 risk in pemphigus patients. Consistent outcomes across treatments confirm the safety of these therapies during the pandemic.

An Efficient Approach to Nowcasting the Time-varying Reproduction Number.

Estimating the instantaneous reproduction number ( ) in near real time is crucial for monitoring and responding to epidemic outbreaks on a daily basis. However, such estimates often suffer from bias due to reporting delays inherent in surveillance systems. We propose a fast and flexible Bayesian methodology to overcome this challenge by estimating while taking into account reporting delays. Furthermore, the method naturally takes into account the uncertainty associated with the nowcasting of cases to get a valid uncertainty estimation of the nowcasted reproduction number. We evaluate the proposed methodology through a simulation study and apply it to COVID-19 incidence data in Belgium.

#2681 Impact of sharing anti-SARS-CoV-2 antibody levels with Kidney Transplant Recipients on adherence to preventive measures and incidence of COVID-19

Abstract Background and Aims Preventive measures are effective against COVID-19 in kidney transplant recipients (KTR). We analysed whether sharing the antibody level after COVID-19 vaccination with these patients is associated with a change in adherence to preventive measures and if so, with the incidence of COVID-19. Method We included adult KTR who participated in the Long-term Efficacy and Safety of SARS-CoV-2 (LESS CoV-2) cohort study. Anti-RBD IgG levels were measured using ELISA (Sanquin, Amsterdam) one month after the third COVID-19 vaccination. Adherence to nine preventive measures was self-reported on a 5-point Likert scale, before and after the antibody level was shared. Based on their antibody level, patients were classified as high-responders (&amp;gt;300 BAU/mL), low-responders (50-300 BAU/mL), or non-responders (&amp;lt;50 BAU/mL) to COVID-19 vaccination. Information about incidence of COVID-19 was collected until 6 months after sharing the antibody level. For analysis, we calculated average adherence to all preventive measures with a range from 1 to 5. Multivariable logistic regression analysis was performed to assess an association between change of adherence and incidence of COVID-19. Results We included 1928 KTR, of whom 1058 high-responders, 548 low-responders, and 322 non-responders. After sharing antibody levels, adherence to preventive measures decreased in the total population (before: 4.11 [3.60-4.44] versus after: 4.00 [3.23-4.44], p &amp;lt; 0.001). This change of adherence was more pronounced in high-responders than in low- and non-responders (0.21 ± 0.68, 0.11 ± 0.56, and 0.14 ± 0.56 respectively, p = 0.02). During follow-up, COVID-19 was diagnosed in 627 of 1928 KTR (33%). In high-responders, the incidence of COVID-19 was higher in patients with decreased adherence compared to patients with increased adherence (decreased: 196 of 617 [32%] versus increased: 114 of 441 [26%], p = 0.04). The change of adherence in high-responders was associated with COVID-19 (OR 0.73 per unit increase [0.60-0.89], p = 0.002), but not after correction for confounding (aOR: 0.86 [0.68-1.07], p = 0.2). Conclusion Sharing anti-SARS-CoV-2 antibody levels with KTR was associated with a decrease in adherence to preventive measures, especially in KTR with a high antibody response to vaccination. In these high-responders, the risk of COVID-19 increased with decreasing adherence to preventive measures. This was not observed in low- or non-responders. Sharing antibody levels with KTR influences adherence to preventive measures and risk of COVID-19, and therefore requires careful communication.