Cumulative Incidence Of COVID-19 Research Articles

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.

The risk of COVID-19 in Cushing's disease is independently related to disease activity (hypercortisolism) and obesity.

To evaluate the cumulative incidence, risk factors, and outcomes of COVID-19 in patients with Cushing's disease (CD). In all, 60 patients with CD following up in our outpatient clinic answered via phone interview a questionnaire about the occurrence of COVID-19 infection documented by RT-PCR (including the diagnosis date and clinical outcome) and vaccination status. Clinical and biochemical data on disease activity (hypercortisolism) and comorbidities (obesity, diabetes mellitus, and hypertension) were obtained from the patients' electronic medical records. Risk ratios (RRs) of risk factors were obtained using univariate and multivariate analyses. The cumulative incidence of COVID-19 in patients with CD during the observation period was 31.7%, which was higher than that in the general reference population (9.5%). The cumulative incidence of COVID-19 was significantly higher in patients with hypercortisolism (57% versus 17% in those without hypercortisolism, p = 0.012) and obesity (54% versus 9% in those without obesity, p < 0.001) but not in patients with hypertension or diabetes mellitus. On multivariate analysis, hypercortisolism and obesity were each independent risk factors for COVID-19 (RR 2.18, 95% CI 1.06-4.46, p = 0.033 and RR 5.19, 95% CI 1.61-16.74, p = 0.006, respectively). The incidence of COVID-19 in patients with CD was associated with hypercortisolism, as expected, and obesity, a novel and unexpected finding. Thus, correction of hypercortisolism and obesity should be implemented in patients with CD during the current and future COVID-19 outbreaks.

Epidemiology of the COVID-19 pandemic in chilean children and cdolescents

to describe the pediatric epidemiological curve in Chile during 2020 and 2021 and compare it with the global curve. descriptive, analytical and prospective study based on data on the evolution of the Chilean epidemic published by the Chilean Ministry of Health and the Ministry of Sciences. the cumulative incidence of COVID-19 in children was 189,769 (8,9) and in adults 1,952,712 (91.1%). The epidemiological curve in children is similar to that in adults with contagion rates proportional to the size of susceptible populations. The ratio of the adult contagion rate to the pediatric contagion rate had an average of 3.3 (CI 2.97 to 3.6). With regard to the distribution by sex we observed a predominance of men in children 0 to 14 years of age and a predominance of women from the age of 15 onwards. Covid-19 mainly affects the adult population, however the epidemiological curve described in children is very similar to that of adults. Differences by sex are observed depending on the age group.

Timing of Vaccination Impacts Serological Response to COVID-19 Myeloma Patients after BCMA-Targeted CAR T

Whereas COVID-19 mRNA vaccines have shown remarkable efficacy in the prevention of severe disease and mortality in healthy individuals, the effectiveness in cancer patients has been more variable. Patients with multiple myeloma (MM) are at a high risk for severe infection due to disease- or treatment-related immune suppression. Our prior work demonstrated that the immune response to SARS-CoV-2 immunization in MM patients with 2 doses of mRNA vaccine was suboptimal and that a 3rd dose significantly improved neutralization of viral variants. MM patients undergoing treatment targeting BCMA were among those at a higher risk of ineffective immune responses. As BCMA-targeted (CAR T) treatment becomes more widely available, guidance on initiation of vaccination after treatment is needed. To assess the impact of BCMA-targeted CAR T (BCMA CAR T) on the serological immune response to COVID-19, we studied 45 MM patients who received ≥1 dose of a COVID-19 mRNA vaccine after prior BCMA CAR T. We collected demographics, disease/treatment characteristics, and COVID-19 infection/vaccination data via retrospective chart review. We analyzed SARS-CoV-2 spike-binding (anti-spike) IgG level using a validated assay (FDA/EUA approved Kantaro). Cumulative incidence of COVID-19 was analyzed using Kaplan-Meier statistics. All subjects were enrolled to studies approved by the Institutional Review Board at a single US academic hospital. Our cohort consisted of 16 women and 29 men with a median age of 61 years. The patients had received a median 6 lines of treatment and 33/45 (73%) had an ongoing response to BCMA CAR T. Patients received dose 1 at median 567 days after CAR T infusion (range 73-1,374 days). 36 patients (80%) received ≥3 doses and 17 (38%) received ≥4 doses. Across the cohort, anti-spike IgG levels increased from median 8 AU/mL after a single dose to 91, 474 and 612 AU/mL after 2, 3 or 4 mRNA vaccine doses respectively. After 2 doses, 6 patients (of 28 for which the timepoint was available, 21%) had no detectable anti-spike IgG levels, whereas all patients in the cohort had a detectable serological response after ≥3 vaccine doses. We compared the 13 patients (29%) that initiated mRNA vaccination at &amp;lt;12 months (mo) after CAR T infusion (i.e. “early vaccination”) with those who received the first dose after &amp;gt;12 mo. In the early vaccination group, anti-spike IgG levels were significantly lower when measured 0-3 months after 2 vaccine doses (p&amp;lt;0.01). Serological responses were not different when measured after 3 or 4 doses respectively (Fig A). Nevertheless, after 3 vaccine doses, 30% of patients (3/10) in the early vaccination group had anti-spike IgG &amp;lt;100 AU/mL, a level previously shown to be associated with less effective viral neutralization, versus only 5% (1/20) of patients in the group that started vaccination &amp;gt; 12 mo after CAR T. Twenty-four patients (52%) developed a documented COVID-19 infection after vaccination. Of these, 21 (88%) were characterized as mild (i.e. not requiring hospital admission); two patients required hospitalization and recovered, and 1 patient in the early vaccination group passed away from COVID-19. Of note, in the early vaccination group, there was a non-significant trend towards earlier breakthrough infections (Fig B, p=0.16), consistent with the finding of a delayed serological response with suboptimal antibody levels after 2 doses. In this study, all MM patients who initiated mRNA vaccination after prior BCMA CAR T therapy had detectable anti-spike IgG after ≥3 vaccine doses. However, starting vaccination against COVID-19 early (i.e. within 1 year) after CAR T therapy does not result in protective levels of antibody as quickly and to the same extent as when vaccinated &amp;gt;1 year post CAR T infusion. Patients starting vaccination within 12 months need ≥3 doses to achieve comparable serological efficacy to later initiation. A trend towards earlier breakthrough infections suggests that study of neutralizing titers against variants and comprehensive immune phenotyping may be needed to confirm effective immunity in these vulnerable patients. For the first year after CAR T cell therapy, adherence to preventive measures and passive immunization with IVIG with higher titers of anti-spike IgG may be warranted. Analyses comparing this cohort with MM patients receiving other modalities of BCMA-targeted therapy incl. bispecific antibodies are ongoing and will be presented at the meeting.

The impact of socioeconomic vulnerability on the incidence of COVID-19 in school students

Abstract Inequalities have been observed in the spread of COVID-19 due to higher incidence rates in environments with greater socioeconomic deprivation. The objective of this study was to analyse the relationship between socioeconomic level and the incidence of COVID-19 in students of schools in the city of Barcelona, in different epidemic waves. Cross-sectional ecological study on compulsory education students (N = 176,390). Unit of analysis: the 780 schools in the city. Study period: second (autumn 2020), third (winter 2020-21) and sixth epidemic waves (winter 2021-22). Dependent variable: Cumulative Incidence (CI) of COVID-19 among school students. Independent variables: complexity and ownership of the school, indexes in quartiles (being Q4 the most disadvantaged) of vulnerable students of the school and the Available Family Income (AFI) of the neighbourhood of the school. Stratified by sex and educational stage (Primary/Secondary). A bivariate and multivariate analysis was performed using Poisson regression to calculate crude Relative Risks and adjusted (aRR). As an impact measure, the Population Attributable Risk was calculated. In the second wave, 41% of the CI in primary boys was attributed to the vulnerability of the school (Q4: aRR=1.96 [1.10-3.50]), and 36% to a lower AFI in the neighbourhood of the school in secondary boys (Q4: aRR=3.18 [1.25-8.13]). Instead, in the sixth wave, taking Q4 as a reference, 35% of the CI in primary girls was attributed to lower vulnerability indices of the school (Q1: aRR=1.82 [1.52-2.20]), and 38% higher AFI from the neighbourhood of the school in secondary girls (Q1: aRR=1.99 [1.33-2.98]). In the third wave, the results are mixed and less significant in the models. The results obtained show that there was an inversion of the impact of social inequalities in the CI of COVID-19 in the second wave compared to the sixth. This reflects the need to delve into the contextual factors that favour the spread of communicable diseases. Key messages • The socioeconomic vulnerability of school students has been associated with a higher Cumulative Incidence of COVID-19 in the second wave, but this pattern has been reversed in the sixth wave. • Between 18 and 41% - depending on gender, educational level and epidemic wave- of the Cumulative Incidence of COVID-19 in Barcelona schools can be attributed to factors of socioeconomic deprivation.

Turning point in COVID-19 severity and fatality during the pandemic: a national cohort study in Qatar

ObjectiveTo assess the evolution of COVID-19 severity and fatality in a unique setting that consistently applied, throughout the pandemic, rigorous and standardised criteria for defining severe COVID-19 outcomes.Methods and analysisWe...

Risk and outcomes of COVID-19 in patients with oxygen-dependent chronic respiratory failure– a national cohort study

BackgroundWe aimed to evaluate cumulative occurrence and impact of COVID-19 in patients with chronic respiratory failure (CRF) treated with long-term oxygen therapy (LTOT). Material and methodsData were obtained from the SCIFI-PEARL study on the entire Swedish population and on patients with oxygen-dependent CRF and no COVID-19 diagnosis before start of LTOT. Analyses were performed for three time periods; pre-alpha (Jan–Dec 2020), alpha (Jan–Mar 2021) and delta/omicron (Apr 2021–May 2022). Cumulative incidence of laboratory-verified COVID-19 was compared between patients with CRF and the general population. Risk factors for severe (hospitalised) to critical (intensive care, or death ≤30 days after infection) COVID-19, and the impact of COVID-19 on one-year mortality, were analysed using multivariable Cox regression. ResultsCumulative incidence of COVID-19 was higher in patients with CRF than in the general population during the pre-alpha period (6.4%/4.9%, p = 0.002), but less common during the alpha and delta/omicron periods (2.9%/3.8% and 7.8%/15.5%, p < 0.0001 for both). The risk of severe/critical COVID-19 was much higher in CRF patients during all periods (4.9%/0.5%, 3.8%/0.2% and 15.5%/0.5%, p < 0.0001 for all). Risk factors for COVID-19 infection in people with CRF were higher age, cardiovascular and renal disease, and COVID-19 was associated with increased one-year mortality following infection in the pre-alpha (HR 1.79; [95% CI] 1.27–2.53) and alpha periods (1.43; 1.03–1.99). ConclusionPatients with CRF had higher risk of severe/critical COVID-19 than the general population. COVID-19 infection was associated with excess one-year mortality.

Incidence and Determinants of COVID-19 in Patients Seeking Treatment for Substance Use Disorder: A Patient-Based Linkage Study

Introduction: People with substance use disorder (SUD) may be at increased risk of COVID-19 infection. However, there is little evidence regarding the incidence of and determinants associated with infection in this group. The aims of the study were to determine the cumulative incidence of COVID-19 among people who sought treatment for heroin, cocaine, cannabis, and alcohol use disorder in Catalonia; to identify sociodemographic, substance, and clinical determinants associated with COVID-19 infection among SUD patients; and to compare the cumulative incidence of COVID-19 infection in the population with SUD with that of the general population. Methods: A patient-based retrospective observational study was conducted. The study population comprised people who sought treatment for heroin, cocaine, cannabis, or alcohol use disorder in Catalonia in 2018 and 2019. We analysed cumulative incidence of COVID-19 (confirmed by PCR test) from 25 February to 31 December 2020. Additionally, we used a log-link binomial generalized linear model for COVID-19 infection, using the substance as the exposition, adjusting for sociodemographic and clinical variables. Results: Of the 23,092 individuals who sought treatment for SUD, 38.15% were considered suspected cases of COVID-19, and 2.60% (95% CI = 2.41–2.82) were confirmed positive for COVID-19 by PCR test during the study period. Those who sought treatment for alcohol use (cumulative incidence of COVID-19 of 3% [95% CI = 2.70–3.34]) had a higher risk ratio than, those who sought treatment for heroin use (cumulative incidence of 1.94% [95% CI = 1.47–2.56]). Being born outside of Spain, living in an institutionalized residence, having HIV, and being in a high morbidity group were associated with higher risk of COVID-19 infection. Meanwhile, the cumulative incidence of COVID-19 in the general population, according to public COVID-19 test data, was 3.86% (95% CI = 3.85–3.87). Conclusion: This study did not find higher cumulative incidence of COVID-19 infection among people with SUD in Catalonia in 2020, despite the clinical vulnerability of this population and their social disadvantage. However, differences were seen in the cumulative incidence of COVID-19 according to the substance for which treatment was sought. For example, those with alcohol dependence had a higher rate than those dependent on heroin. Further studies are needed to determine the factors contributing to these differences.

Temperature and COVID-19 Incidence: An Ecologic Study

Background: According to the hypothesis, COVID-19 is less prevalent in regions with warm climates. Contradictory results have led us to investigate the correlation between temperature and the cumulative COVID-19 incidence rate. Methods: We obtained COVID-19 data from CRONALAB, COVID-DASHBOARD, and MCMC databases of Fars Province, Iran, linked the data and finalized daily COVID-19 cases. The daily data on the temperature was gotten from meteorological stations’ reports from March 21, 2020, to March 21, 2021, for each county of Fars Province, Southern Iran. The daily weighted cumulative incidence rate of COVID-19 cases was calculated for all counties, separately. Initially, for uniform data visualization, the average air temperature data were transformed into ranked percentiles. Then, to visually assess the study hypothesis, the distribution of COVID-19 cumulative incidence was visualized on percentiles of temperature. Given the non-linear distribution of the data, we performed exploratory analyses using the generalized additive models and locally weighted (polynomial) regressions to choose the best response function. Then, the generalized linear models were used to parametrically build the model. Results: The generalized additive models showed a small decreasing, near horizontal, linear pattern for COVID-19 incidence rate as the function of temperature (pseudo R2: 0.001, deviance explained: 0.13%, coefficient: -0.02). The GLMs showed head-to-head results (deviance explained: 0.13%, coefficient: -0.02], supported by similar Akaike information criteria (AICs) (34945). However, according to the locally weighted regressions model’s curve, lower COVID-19 incidence rates were recorded on days when the temperatures ranged from 60 to 80 percentiles, equal to 20°C to 25°C in a cold climate and 25°C to 35°C in a warm climate. This is while the rates increased at lower and upper temperatures. Conclusion: Daily COVID-19 incidence rate cannot be explained as a function of daily temperature in Southern parts of Iran. Higher rates of disease transmission out of the range of 20°C to 25°C for cold temperatures and 25°C to 35°C for warm climates might be linked to people’s indoor gatherings, coupled with insufficient ventilation.

Routine vaccination for influenza and pneumococcal disease and its effect on COVID-19 in a population of Dutch older adults

ObjectivesProtective heterologous beneficial effects of vaccines have been reported, and in this study we aimed to assess the impact of routine pneumococcal and influenza vaccination on the incidence and symptom duration of COVID-19 in a population of Dutch older adults. MethodsThis cohort study is a secondary analysis of the BCG-CORONA-ELDERLY study, a randomised controlled trial on the effect of BCG vaccination on the cumulative incidence of respiratory tract infections requiring medical intervention in adults ≥60 years. The primary outcome was the cumulative incidence of a self-reported positive SARS-CoV-2 PCR test, and was assessed using a Fine-Gray competing risks model adjusted for baseline characteristics at enrolment. We analysed data from November 1st 2020 until the end of the main study in May 2021. ResultsRoutine vaccination data 2020/2021 were available for 1963/2014 (97.5 %) participants; 44/1963 (2.2 %) were excluded due to COVID-19 before vaccination. 1076/1919 (56.1 %) had received the influenza vaccine and 289/1919 (15.1 %) the pneumococcal vaccine. The cumulative incidence of COVID-19 was 0.030 (95 %CI 0.021–0.041) in those vaccinated against influenza compared to 0.029 (95 %CI 0.019–0.041) in the unvaccinated group (subdistribution hazard ratio (SDHR) 1.018; 95 %CI 0.602–1.721). For pneumococcal vaccination the cumulative incidence was 0.031 (95 %CI 0.015–0.056) for the vaccinated and 0.029 (95 %CI 0.022–0.038) for non-vaccinated individuals (SDHR 0.961; 95 %CI 0.443–2.085). BCG vaccination in the previous year and sex were not significant effect modifiers in the primary analysis. Duration of fever, cough and dyspnoea was also not significantly different between treatment arms. ConclusionNeither influenza nor pneumococcal vaccination was associated with a lower incidence or shorter duration of COVID-19 symptoms in older adults.

CATCH-UP vaccines: protocol for a randomized controlled trial using the multiphase optimization strategy (MOST) framework to evaluate education interventions to increase COVID-19 vaccine uptake in Oklahoma

BackgroundOklahoma’s cumulative COVID-19 incidence is higher in rural than urban counties and higher than the overall US incidence. Furthermore, fewer Oklahomans have received at least one COVID-19 vaccine compared to the US average. Our goal is to conduct a randomized controlled trial using the multiphase optimization strategy (MOST) to test multiple educational interventions to improve uptake of COVID-19 vaccination among underserved populations in Oklahoma.MethodsOur study uses the preparation and optimization phases of the MOST framework. We conduct focus groups among community partners and community members previously involved in hosting COVID-19 testing events to inform intervention design (preparation). In a randomized clinical trial, we test three interventions to improve vaccination uptake: (1) process improvement (text messages); (2) barrier elicitation and reduction (electronic survey with tailored questions/prompts); and (2) teachable moment messaging (motivational interviewing) in a three-factor fully crossed factorial design (optimization).DiscussionBecause of Oklahoma’s higher COVID-19 impact and lower vaccine uptake, identifying community-driven interventions is critical to address vaccine hesitancy. The MOST framework provides an innovative and timely opportunity to efficiently evaluate multiple educational interventions in a single study.Trial RegistrationClinicalTrials.gov: NCT05236270, First Posted: February 11, 2022, Last Update Posted: August 31, 2022.

Effectiveness of the Coronavirus Disease 2019 Bivalent Vaccine.

The purpose of this study was to evaluate whether a bivalent coronavirus disease 2019 (COVID-19) vaccine protects against COVID-19. The study included employees of Cleveland Clinic in employment when the bivalent COVID-19 vaccine first became available. Cumulative incidence of COVID-19 over the following 26 weeks was examined. Protection provided by vaccination (analyzed as a time-dependent covariate) was evaluated using Cox proportional hazards regression, with change in dominant circulating lineages over time accounted for by time-dependent coefficients. The analysis was adjusted for the pandemic phase when the last prior COVID-19 episode occurred and the number of prior vaccine doses. Among 51 017 employees, COVID-19 occurred in 4424 (8.7%) during the study. In multivariable analysis, the bivalent-vaccinated state was associated with lower risk of COVID-19 during the BA.4/5-dominant (hazard ratio, 0.71 [95% confidence interval, .63-79]) and the BQ-dominant (0.80 [.69-.94]) phases, but decreased risk was not found during the XBB-dominant phase (0.96 [.82-.1.12]). The estimated vaccine effectiveness was 29% (95% confidence interval, 21%-37%), 20% (6%-31%), and 4% (-12% to 18%), during the BA.4/5-, BQ-, and XBB-dominant phases, respectively. The risk of COVID-19 also increased with time since the most recent prior COVID-19 episode and with the number of vaccine doses previously received. The bivalent COVID-19 vaccine given to working-aged adults afforded modest protection overall against COVID-19 while the BA.4/5 lineages were the dominant circulating strains, afforded less protection when the BQ lineages were dominant, and effectiveness was not demonstrated when the XBB lineages were dominant.

Real-life evaluation of incidence and clinical outcomes of COVID-19 among healthcare workers during pre-vaccination and post-vaccination periods: A cross-sectional impact study.

We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods. In addition, we determined factors associated with the development of COVID-19 after vaccination. In this analytical cross-sectional epidemiological study, HCWs who were vaccinated between January 14, 2021, and March 21, 2021, were included. HCWs were followed up for 105 days after the 2 doses of CoronaVac. Pre-vaccination and post-vaccination periods were compared. A total of 1,000 HCWs were included, 576 patients (57.6%) were male, and the mean age was 33.2 ± 9.6 years. In the last 3 months during the pre-vaccination period, 187 patients had COVID-19, and the cumulative incidence of COVID-19 was 18.7%. Six of these patients were hospitalized. Severe disease was observed in three patients. In the first 3 months post-vaccination period, COVID-19 was detected in 50 patients, and the cumulative incidence of the disease was determined to be 6.1%. Hospitalization and severe disease were not detected. Age (p = 0.29), sex (OR = 1.5, p = 0.16), smoking (OR = 1.29, p = 0.43), and underlying diseases (OR = 1.6, p = 0.26) were not associated with post-vaccination COVID-19. A history of COVID-19 significantly reduced the likelihood of the development of post-vaccination COVID-19 in multivariate analysis (p = 0.002, OR = 0.16, 95% CI = 0.05-0.51). CoronaVac significantly reduces the risk of SARS-CoV-2 infection and alleviates the severity of COVID-19 in the early period. Additionally, HCWs who have been infected and vaccinated with CoronaVac are less likely to be reinfected with COVID-19.

Modeling the Climatic Suitability of COVID-19 Cases in Brazil

Studies have shown that climate may affect the distribution of coronavirus disease (COVID-19) and its incidence and fatality rates. Here, we applied an ensemble niche modeling approach to project the climatic suitability of COVID-19 cases in Brazil. We estimated the cumulative incidence, mortality rate, and fatality rate of COVID-19 between 2020 and 2021. Seven statistical algorithms (MAXENT, MARS, RF, FDA, CTA, GAM, and GLM) were selected to model the climate suitability for COVID-19 cases from diverse climate data, including temperature, precipitation, and humidity. The annual temperature range and precipitation seasonality showed a relatively high contribution to the models, partially explaining the distribution of COVID-19 cases in Brazil based on the climatic suitability of the territory. We observed a high probability of climatic suitability for high incidence in the North and South regions and a high probability of mortality and fatality rates in the Midwest and Southeast regions. Despite the social, viral, and human aspects regulating COVID-19 cases and death distribution, we suggest that climate may play an important role as a co-factor in the spread of cases. In Brazil, there are regions with a high probability that climatic suitability will contribute to the high incidence and fatality rates of COVID-19 in 2020 and 2021.

COVID-19 and non-Hodgkin's lymphoma: A common susceptibility pattern?

To explore the link between COVID-19 incidence, socio-economic covariates, and NHL incidence. Ecological study design. Sardinia, Italy. We used official reports on the total cases of COVID-19 in 2020, published data on NHL incidence, and socio-economic indicators by administrative unit, covering the whole regional population. We used multivariable regression analysis to explore the association between the natural logarithm (ln) of the 2020 cumulative incidence of COVID-19 and the ln-transformed NHL incidence in 1974-2003, weighing by population size and adjusting by socioeconomic deprivation and other covariates. The cumulative incidence of COVID-19 increased in relation to past incidence of NHL (p < 0.001), socioeconomic deprivation (p = 0.006), and proportion of elderly residents (p < 0.001) and decreased with urban residency (p = 0.001). Several sensitivity analyses confirmed the finding of an association between COVID-19 and NHL. This ecological study found an ecological association between NHL and COVID-19. If further investigation would confirm our findings, shared susceptibility factors should be investigated among the plausible underlying mechanisms.

Epidemic Diffusion Network of Spain: A Mobility Model to Characterize the Transmission Routes of Disease.

Human mobility drives the geographical diffusion of infectious diseases at different scales, but few studies focus on mobility itself. Using publicly available data from Spain, we define a Mobility Matrix that captures constant flows between provinces by using a distance-like measure of effective distance to build a network model with the 52 provinces and 135 relevant edges. Madrid, Valladolid and Araba/Álaba are the most relevant nodes in terms of degree and strength. The shortest routes (most likely path between two points) between all provinces are calculated. A total of 7 mobility communities were found with a modularity of 63%, and a relationship was established with a cumulative incidence of COVID-19 in 14 days (CI14) during the study period. In conclusion, mobility patterns in Spain are governed by a small number of high-flow connections that remain constant in time and seem unaffected by seasonality or restrictions. Most of the travels happen within communities that do not completely represent political borders, and a wave-like spreading pattern with occasional long-distance jumps (small-world properties) can be identified. This information can be incorporated into preparedness and response plans targeting locations that are at risk of contagion preventively, underscoring the importance of coordination between administrations when addressing health emergencies.

Malaria and the incidence of COVID-19 in Africa: an ecological study

BackgroundIt has been shown that stimulation of innate immunity may provide temporary protection against a variety of infectious diseases. Malaria has been shown to induce a robust innate immune response. This study was conducted to test the hypothesis that if the cumulative number of cases diagnosed with COVID-19 per 100,000 population was correlated with the prevalence of malaria in African countries where both malaria and COVID-19 were prevalent.MethodsIn this ecological study, the cumulative incidence of COVID-19 and the prevalence of malaria were compared in 53 African countries. A negative binomial regression analysis with the cumulative incidence of COVID-19 as the dependent variable, and the human development index (HDI) and the prevalence of malaria, as independent variables, were used.ResultsThe mean cumulative incidence of COVID-19 was 522 cases per 100,000. Each 0.1 unit increase in HDI was associated with 2.4-fold (95% confidence interval 1.8–3.1) increase in the cumulative incidence of COVID-19. Prevalence of malaria was also independently associated with the cumulative incidence; each 10% increase in the prevalence was associated with 28% (10–41%) decrease in the cumulative incidence of COVID-19.ConclusionsMalaria might protect people against SARS-CoV-2 through the stimulation of innate immunity. Stimulation of the innate immune system could be the first line of defense in the pandemic preparedness arsenal.

COVID-19 Incidence and Disease Course Among Patients at an Allergy Department.

Since the coronavirus pandemic in 2020, there is not much reported about the disease course of COVID-19 in patients with allergic diseases. The aim of this study was to investigate the cumulative incidence and severity of COVID-19 among patients from the allergy department compared with the general Dutch population and people from their household. We conducted a comparative longitudinal cohort study. In this study patients of the allergy department were included with their household members as a control group. Data from the beginning of the pandemic were systematically obtained through questionnaires by telephonic interviews and retrieved from electronic patient files between October 15, 2020 and January 29, 2021. Main outcomes were confirmed SARS-CoV-2 infection, disease duration, hospitalization, intensive care admission, and mortality. Questions regarding applied social distancing measures were inventoried as well. Three hundred and eighty nine patients (median age 39.1 (18.7-84.7) years, 69.9% female) and 441 household members (median age 42.0 (18.0-91.5), 44.1% female) were included. The cumulative COVID-19 incidence in patients was higher compared with the general population (10.5% vs 5.6%, P < .001). In total, 41 (10.5%) patients attending the allergy clinic compared to 38 (8.6%) household members were infected with SARS-CoV-2 (P = .407). Median disease duration was 11.0 (0.0-61.0) days in patients compared to 10.5(1.0-232.0) days in household members (P = .996). The cumulative COVID-19 incidence in patients from the allergy cohort was higher compared with the general Dutch population, but similar compared with household members. There was no difference in symptoms, disease duration, or hospitalization rate between the allergy cohort and their household members.

Evaluation of the Effectiveness of Immunization Saint-Petersburg Population against COVID-19

Relevance. Vaccination is being replaced by the primary and most effective means of protecting the world's population from a new coronavirus infection.Aim. Evaluation of the effectiveness of COVID-19 immunization in Saint-Petersburg.Materials and methods: We retrospectively studied the epidemiological data on the cumulative incidence of COVID-19 in St. Petersburg among adults vaccinated (1,558,030 people) and unvaccinated (2,863,050 people) for period from December 01, 2020 to November 30, 2021 on 12.01.2021. We analyzed the data presented in the Federal Register of Persons with COVID-19 and the Federal Register of Those Vaccinated against COVID-19.Results. The risk of COVID-19 infection among vaccinated is statistically significantly lower than among unvaccinated RR = 0.11 (95% CI 0.109–0.110; p &lt; 0.001). Infected COVID-19 Vaccinated patients were less likely to need for emergency care/hospitalization RR = 0.30 (95% CI 0.29–0.30; p &lt; 0.001). Also among the vaccinated mortality was lower RR = 0.35 (95% CI 0.33–0.37; p &lt; 0.001).Conclusion: We have established reliable preventive effectiveness of the use of domestic vaccines by reducing morbidity, the frequency of development of forms of the disease requiring inpatient treatment; reducing mortality among vaccinated and, accordingly, reducing the burden on the healthcare system of St. Petersburg.

Clinical characteristics and outcomes of incident cases of COVID-19 in unvaccinated adult cystic fibrosis patients in southern Brazil: a prospective cohort study conducted during the first year of the COVID-19 pandemic.

There is still limited information on the clinical characteristics and outcomes of cystic fibrosis (CF) patients with COVID-19 in Brazil. The objective of this study was to describe the cumulative incidence of COVID-19 in CF patients, as well as their clinical characteristics and outcomes. This was a prospective cohort study involving unvaccinated adult CF patients and conducted during the first year of the SARS-CoV-2 pandemic in the city of Porto Alegre, in southern Brazil. The clinical course of the disease was rated on the WHO Ordinal Scale for Clinical Improvement. The primary outcome was the number of incident cases of COVID-19. Between April 30, 2020 and April 29, 2021, 98 CF patients were included in the study. Seventeen patients were diagnosed with COVID-19. For the CF patients, the annual cumulative incidence of COVID-19 was 17.3%, similar to that for the general population, adjusted for age (18.5%). The most common symptoms at diagnosis of COVID-19 were cough (in 59%), dyspnea (in 53%), fatigue (in 53%), and fever (in 47%). Only 6 (35%) of the patients required hospitalization, and 3 (17.6%) required oxygen support. Only 1 patient required mechanical ventilation, having subsequently died. During the first year of the SARS-CoV-2 pandemic in southern Brazil, the cumulative incidence rate of COVID-19 was similar between CF patients and the general population. More than 50% of the CF patients with SARS-CoV-2 infection had a mild clinical presentation, without the need for hospital admission, and almost the entire sample recovered completely from the infection, the exception being 1 patient who had advanced lung disease and who died.