Previous COVID-19 Infection Research Articles

A booster dose of SARS-COV-2 vaccine improves suboptimal seroconversion rates in patients with inflammatory bowel disease. Results of a prospective multicenter study of GETECCU (VACOVEII study)

BackgroundThe response to SARS-CoV-2 vaccination decreases in inflammatory bowel disease (IBD) patients, specially under anti-TNF treatment. However, data on medium-term effectiveness are limited, specially using new recommended seroconversion rate (>260BAU/mL). Our aim was to evaluate the 6-month>260 BAU-seroconversion rate after full vaccination and after booster-dose. MethodsVACOVEII is a Spanish multicenter, prospective study promoted by GETECCU. IBD patients full vaccinated against SARS-CoV-2 and without previous COVID-19 infection, treated or not with immunosuppressants, were included. The booster dose was administered 6 months after the full vaccination. Seroconversion was set at 260BAU/mL, according to most recent recommendations and was assessed 6 months after the full vaccination and 6 months after booster-dose. ResultsBetween October 2021 and March 2022, 313 patients were included (124 no treatment or mesalazine; 55 immunomodulators; 87 anti-TNF; 19 anti-integrin; and 28 ustekinumab). Most patients received mRNA-vaccines (86%). Six months after full vaccination, overall seroconversion rate was 44.1%, being significantly lower among patients on anti-TNF (19.5%, p<0.001) and ustekinumab (35.7%, p=0.031). The seroconversion rate after booster was 92%. Again, anti-TNF patients had a significantly lower seroconversion rate (67%, p<0.001). mRNA-vaccine improved seroconversion rate (OR 11.720 [95% CI 2.26–60.512]). ConclusionThe full vaccination regimen achieves suboptimal response in IBD patients, specially among those anti-TNF or ustekinumab. The booster dose improves seroconversion rate in all patients, although it remains limited in those treated with anti-TNF. These results reinforce the need to prioritize future booster doses in patients on immunosuppressants therapy, specially under anti-TNF, and using mRNA-vaccines.

Prospective comparative analysis of the ambulatory blood pressure monitoring changes in patients with hypertension after COVID‑19 in the conditions of the Arctic watch

Objective. To conduct a prospective (2-year) comparative analysis of the dynamics of 24-hour ambulatory blood pressure monitoring (ABPM) in patients with arterial hypertension (HTN) and previous COVID-19 infection working in the conditions of the Arctic watch.Design and methods. In the Medical Unit of Gazprom Dobycha Yamburg LLC (GDY) in the polar shift settlement of Yamburg, 347 patients were examined: 222 men (M) and 125 women (W). All of them underwent ABPM according to the standard protocol in 2019 and 2022. Among them, 261 patients had confirmed COVID-19 between 2020 and 2021 and were treated in the Medical Unit of GDY. Among the examined M and W, according to medical history in 2019, 80 % of M (178 from 222 people) and 66 % of W (82 from 125 people) had elevated blood pressure (BP), p = 0,003. Among patients with HTN, 109 M (61,2 %) and 42 W (51,2 %) survived after COVID-19, p = 0,129. They formed observation group (n = 151). Comparison group included HTN patients without COVID-19 (n = 109).Results. In patients with HTN who had COVID-19, ABPM showed an increase in average daily systolic BP (SBP) values after 2 years: from 134,5 (12,3) to 140,5 (11,8) mmHg (p &lt; 0,0001) and diastolic BP (DBP): from 96,6 (14,0) to 105,1 (13,4) mmHg (p &lt; 0,0001), hypertensive load time indices (TI): TI SBP24 (from 49,5 (29,3) to 61,6 (28,1) mmHg (p &lt; 0,0001) and TI DBP24 from 69,3 (30,5) to 83,4 (21,9) mmHg (p &lt; 0,0001), increase in daytime SBP variability (p = 0,048), decrease in daily SBP indices by 1,2 %: from 7,9 (4,6) to 6,7 (4,3) (p = 0,038) and DBP by 2,0 %: from 9,7 (4,8) to 7,7 (4,7) (p = 0,032). Desynchronization of SBP and DBP rhythms were found by chronobiological analysis.Conclusions. A prospective comparative analysis of the dynamics of ABPM in patients with HTN after COVID-19 in the conditions of the Arctic watch showed an increase in the average daily values of SBP and DBP and their daily variability, deterioration in the daily BP profile with an increase in the “night peaker” phenotype. In patients with HTN who did not have COVID-19, a prospective analysis of ABPM showed a significant increase in DBP and average daily hypertensive load of DBP, which may contribute to further cardiovascular remodeling. In patients with HTN who have recovered from COVID-19, desynchronization processes of SBP and DBP rhythms intensify, which requires an in-depth analysis of the chronobiological structure of the rhythm BP.

Factors underlying COVID-19 booster vaccine uptake among adults in Belgium

ObjectiveThis study aimed to investigate factors influencing the uptake of first and second COVID-19 booster vaccines among adults in Belgium, particularly age, sex, region of residence and laboratory confirmed COVID-19 infection history.ResultsA binomial regression model was used with having received the first or second booster as outcome and age, sex, region of residence and infection history as fixed variables. Among adults, there was generally a higher uptake to receive the first booster among older age groups compared to younger ones. Females, individuals residing in Flanders and those with no previous COVID-19 infection were more likely to receive the first booster. For the second booster, the same age trend was seen as for the first booster. Males, individuals residing in Flanders and those who tested positive for COVID-19 once after first booster were more likely to receive the second booster. Individuals with multiple positive COVID-19 tests before and after primary course or first booster were less likely to receive the subsequent booster dose compared to COVID-naïve individuals. This information could be used to guide future vaccination campaigns during a pandemic and can provide valuable insights into booster uptake patterns.

Clinical and immunological responses to COVID-19 vaccination in rheumatoid arthritis patients on disease modifying antirheumatic drugs: a cross-sectional study.

This study was conducted to investigate the immunological and clinical response to COVID-19 vaccination in rheumatoid arthritis (RA) patients receiving disease modifying antirheumatic drugs (DMARDs). A cross-sectional study was conducted among RA patients who received two doses of COVID-19 vaccine within 6 months to one year. Demographic information, comorbidities, vaccination details, and past COVID-19 infection details were collected. Hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels were estimated. Disease Activity Score-28 (DAS-28) was calculated for RA patients. Anti-spike antibody (ASA) concentrations were measured, and compared with a healthy control population. Correlations of ASA with age, sex, disease parameters, medication use, and comorbidities were assessed. A total of 103 RA patients and 185 controls were included in the study. RA patients had higher mean age, lower mean Hb, higher ESR, and elevated IL-6 levels. Both groups showed positive results for anti-spike antibodies, with a higher percentage in controls. Among RA patients majority had low DAS-28 score. The number of DMARDs used showed a negative correlation with antibody levels. There was a slight positive correlation between ASA concentration and DAS-28 score. Comorbidities did not significantly influence antibody concentration. No significant differences were found in antibody levels based on the type of COVID-19 vaccine or previous COVID-19 infection or booster dose vaccination among RA patients. The study revealed that RA patients showed a reduced antibody response following COVID-19 vaccination compared to the control group and potentially influenced by immunosuppressive treatments and disease-related factors.

Sexual satisfaction and vaccine application in health professionals in the COVID-19 pandemic.

The negative effects of the COVID-19 pandemic on sexual satisfaction have been emphasized in many studies. However, there is not much information about the effects of the COVID-19 pandemic on the sexual satisfaction of healthcare professionals. In addition, it is not known exactly how vaccination application affects sexual satisfaction. Therefore, in this study, we aimed to evaluate whether the sexual satisfaction of male health personnel would change with vaccination. One hundred and two unvaccinated and 95 vaccinated male healthcare professionals participated in this study. The COVID-19 Phobia Scale (C19P-S) and The New Sexual Satisfaction Scale (NSSS) were administered to the participants. We did not detect any difference in sexual satisfaction according to vaccine administration. However, we found significant relationships between COVID-19 anxiety and sexual satisfaction. On the other hand, age, fear of COVID-19, and previous COVID-19 infection story were predictive factors on sexual satisfaction. The effects of the COVID-19 pandemic on sexual satisfaction are multifaceted. Our findings indicate that fear of COVID-19, rather than vaccination, determines sexual satisfaction.

Reactogenicity of the BNT162b2 mRNA vaccine (Pfizer-BioNTech) against COVID-19 in workers of a tertiary hospital

ObjectiveTo analyze the local and systemic reactions that appeared after the first and second dose of the BNT162b2 vaccine against COVID-19 (Pfizer-BioNTech) in a sample of workers from a tertiary hospital, and to identify the factors related to greater vaccine reactogenicity. MethodA self-administered questionnaire was used to interview 291 workers from a tertiary hospital who received the BNT162b2 vaccine against COVID-19 between January and March 2021. The questionnaire included questions about the sociodemographic variables of the participants, previous COVID-19 infection, and local and systemic reactions after the first and second dose of the vaccine. ResultsThe most common adverse reaction was soreness at the injection site, which was reported more frequently after the first dose of the vaccine. The systemic reactions evaluated were reported more frequently after the second dose of the vaccine. Women, younger adults, and subjects with a prior COVID-19 infection reported increased reactogenicity. Furthermore, high reactogenicity after the first dose was found to be related to a higher number of adverse reactions after the second dose of the vaccine. ConclusionsThe distribution of reactogenicity in the present study is consistent with the data reported in previous studies on the BNT162b2 vaccine, especially in terms of its association with the participants’ characteristics. These findings could facilitate the identification of people at a higher risk of developing high reactogenicity to the vaccine, thereby making it possible to anticipate the appearance of adverse reactions and plan for their treatment.

Self-reported adverse events within the seven days following the Spikevax® (Moderna) vaccination

ObjectiveContinuous monitoring of COVID-19 vaccines safety may provide additional information to health care professionals and the general population. The aim of the present study was to analyze the local and systemic adverse events following the administration of the Spikevax® (Moderna) vaccine, and to identify the factors related to greater reactogenicity. MethodUsing a telephone survey, we interviewed 331 recipient of the Spikevax® vaccine (50.2% men; Meanage = 46.4). Participants characteristics, prior COVID-19 infection and Local and systemic adverse events within seven days following the first and second vaccine doses were asked. ResultsInjection site pain, fatigue and headache were the most common adverse events. The prevalence and intensity of local events was higher after the first dose, while systemic events were higher in the second one. Most adverse events were mild/moderate; 1.2% of participants needed hospitalization or emergency room visit. Women and participants aged 18-55 years were more likely to experience greater reactogenicity, participants with prior COVID-19 infection had more systemic events after the first dose, and participants with chronic diseases other than hypertension reported fewer systemic adverse events following the second dose. ConclusionsOur results are consistent with previous studies, identifying women, people aged 18-55 years and those with previous COVID-19 infection as those who experienced the greatest reactogenicity to the vaccine. A relationship was also found between reactogenicity and suffering from a chronic disease other than hypertension.

Side effects of COVID-19 vaccines in the middle eastern population.

The COVID-19 pandemic has caused severe worldwide health concerns since its first description as the SARS-COV-2 virus in December 2019. The wide dissemination of this virus, together with the lack of treatment, prompted vaccine development within a short period of time to elicit a protective immunity against COVID-19. Due to their rapid development, potential subsequent side effects of COVID-19 vaccines were overlooked, which might lead to many health concerns. This is especially true for patients at a greater risk of harm from COVID-19, such as pregnant women, children, and patients with pre-existing chronic diseases. In this review, we provide a summary of common to rare side effects of administrated COVID-19 vaccines in a Middle Eastern population. We have found that the distinction between side effects from COVID-19 vaccines in terms of frequency and severity is attributed to the differences in study populations, gender, and age. Pain at the injection site, fever, headache, fatigue, and muscle pain were the most common reported side effects. Vaccinated subjects with previous COVID-19 infection exhibited an equivalent neutralizing response after just one dose compared to two doses of vaccine. Consequently, individuals who experienced more side effects had significantly higher antibody levels. This indicates that having better immunity correlates with higher antibody levels, leading to a higher frequency of vaccine side effects. Individuals with underlying comorbidities, particularly having known allergies and with illnesses such as diabetes and cancer, might be more prone to post-vaccination side effects. Studies of a high-risk population in Middle Eastern countries are limited. Future studies should be considered to determine long-term side effects, side effects after booster doses, and side effect differences in cases of heterologous and homologous vaccination for better understanding and proper handling of high-risk populations and patients who experience these side effects.

Pre-Graft Vaccination or Infection Do Not Provide More Protection Against COVID-19 Infections in Post-Graft Vaccinated Recipients of Allogeneic Stem Cell Transplantation

Background : Available just one year after the beginning of the pandemic, in December 2020, vaccination has been a revolution allowing to avoid severe forms of the deadly COVID-19 infectious disease in the healthy population as well as in immunocompromised hosts, including recipients of allogeneic stem cell transplantation (Allo-SCT). These patients (pts) were first vaccinated after transplant but rapidly both pts and donors could receive vaccine before Allo-SCT. The impact of vaccination pre- or post- Allo-SCT or both has not been clearly evaluated yet. Moreover, the role of a previous COVID-19 infection before Allo-SCT remains to be specified. Methods : The impact of pre- and post-Allo-SCT COVID-19 vaccination and previous COVID-19 infection in adults allografted in our Hematology Department between October 2020 and March 2023 and with a follow-up of at least 3 months post-transplant was investigated. Data were collected up to July 2023 and pts or donors were joined by phone if needed to ensure updated information. Three groups were defined : 1) pts or donors with no vaccine and no previous COVID-19 infection before Allo-SCT and vaccination after transplant, 2) pts and/or donors vaccinated and without COVID-19 infection before transplant (with or without vaccine after transplant), and 3) pts and/or donors with a previous COVID-19 infection (with or without vaccine pre and post-transplant). The rates of overall and severe forms of COVID-19 infections after Allo-SCT were collected overall and in each group. Severe forms were defined by COVID-19-related hospitalizations (including those in intensive care unit) and/or death. Some pts also received tixagevimab and cilgavimab (Tix/cil) as preventive treatment after Allo-HSCT during the Delta wave. Results : A total of 157 pts was considered (Table 1.median age : 59 yo, range : 20-74 ; male n=91; myeloid disease n=122 ; lymphoid disease n=31; other disease n= 4; conditioning regimen : myeloablative n=17 ; reduced-intensity n=133 ; sequential n=7 ; donor type : sibling n=39, matched unrelated n=56, haploidentical n=59, one mismatch unrelated n=2, cord blood n=1). Post-Allo-HSCT vaccination rates were 100% in group 1 (n=58/58), 50% in group 2 (n=31/62) and 32% (n=12/37) in group 3. Most pts were considered during the delta/omicron waves. The first vaccination post-graft was performed at a median of 168 days (range: 27-482) while COVID-19 infection occurred at a median of 312 days (range: 0-1027) post-graft. Results are summarized in Table 2. Overall and severe COVID-19 infection rates were 35% and 9.5%, respectively while there were 3% of COVID-related deaths for the whole cohort. Post-Allo-HSCT vaccination was clearly associated with protection against COVID-19 infection (incidence of 20% in vaccinated pts vs 62.5% in non-vaccinated, p&amp;lt;0.001). However, rates of severe forms or deaths related to COVID-19 were similar between vaccinated and non-vaccinated pts. COVID-19 infection rates were 24%, 31% and 32% in groups 1, 2 and 3, respectively. Severe COVID-19 infection and death rates were also similar between the three groups at 12%, 11% and 3%, and 3%, 3% and 3%, respectively. Considering only pts vaccinated after transplant, all rates were again similar between each group, suggesting that pre-graft vaccination or infection before Allo-HSCT do not provide more protection. Interestingly, pts in the first year post-transplant had no superior risk of COVID-19 infection or severe forms of the disease. Tix/cil was used mainly in non-vaccinated post-transplant patients and was associated with the same rate of COVID-19 infections compared to patients not receiving Tix/cil. As these latter patients were almost all vaccinated after transplant (90%), this confirms that Tix/cil was as efficient as vaccine use during the Delta wave to protect patients who did not receive vaccine after transplant. Deaths and relapse rates were also comparable between the three groups suggesting no impact of pre-Allo-SCT vaccine or infection on outcomes. Conclusion : In this study, post-Allo-SCT vaccination appears to be of crucial importance to protect recipients against COVID-19 infections. Pre-graft vaccine or infection are not associated with less COVID-19 infections nor severe forms of the disease in pts vaccinated after transplant, suggesting that post-graft vaccination is sufficient to ensure good protection in these pts.

52 Depressive Symptoms and Subjective Cognitive Decline in Individuals with COVID-19

Objective:Many individuals with COVID-19 develop mild to moderate physical symptoms that can last days to months. In addition to physical symptoms, individuals with COVID-19 have reported depressive symptoms and cognitive decline, posing a long-term threat to mental health and functional outcomes. Few studies have examined the presence of co-occurring depression and subjective cognitive decline in individuals who tested positive for COVID-19. The current study examined whether having COVID-19 is subsequently associated with greater depressive symptoms and subjective cognitive decline when compared to healthy individuals. Our study also examined differential associations between symptoms of depression and subjective cognitive decline between individuals who have and have never had COVID-19.Participants and Methods:Adults (N = 104; mean age = 37 years, 69% female) were recruited online from Ontario and British Columbia, Canada. Participants were categorized into two groups: (1) persons who tested positive for COVID-19 at least three months prior, had been symptomatic, and had not been ventilated (N = 50); and (2) persons who have never been suspected of having COVID-19 (N = 54). The Center for Epidemiological Studies Depression Scale (CES-D) and the Subjective Cognitive Decline Questionnaire (SCD-Q) were administered to both groups as part of a larger clinical neuropsychological evaluation. Two separate linear regression analyses were conducted to examine the association of COVID-19 with depressive symptoms and subjective cognitive decline. A moderation analysis was performed to examine whether depressive symptoms were associated with subjective cognitive decline and the extent to which this differed by group (COVID-19 and controls). Participants’ age, self-reported sex, and history of depression were included as covariates.Results:The first regression model explained 17.2% of the variance in CES-D scores. It was found that the COVID-19 group had significantly higher CES-D scores (ß = .20, p = .03). The second regression model explained 35.9% of the variance in SCD-Q scores. Similar to the previous model, it was found that the COVID-19 group had significantly higher SCD-Q scores compared to healthy controls (ß = .22 p = .01). Lastly, the moderation model indicated that higher CES-D scores were associated with higher SCD-Q scores (ß = .43, p &lt; .01), but there was no statistically significant group X CES-D score interaction.Conclusions:These findings suggest that individuals who previously experienced a mild to moderate symptomatic COVID-19 infection report greater depressive symptom severity as well as greater subjective cognitive decline. Additionally, while more severe depressive symptoms predicted greater subjective cognitive decline in our sample, the magnitude of this association did not vary between those with and without a previous COVID-19 infection. While the underlying neurobiological and social mechanisms of cognitive difficulties and depressive symptoms in persons who have had COVID-19 have yet to be fully elucidated, our findings highlight treatment for depression and cognitive rehabilitation as potentially useful intervention targets for the post COVID-19 condition.

Loneliness and depression in older adults with multimorbidity: the role of self-efficacy and social support.

As relatively little is known about self-efficacy and social support in individuals aged 65 years and older and whether they are facing a decline in life due to multimorbidity and previous COVID-19 infection, this study investigated hypotheses based on Social Cognitive Theory. It was tested whether depressive symptoms in multimorbid patients who were hospitalized for COVID-19 infection, and recover post infection during their hospital stay, do not differ from those of multimorbid patients hospitalized for other conditions. Furthermore, we tested whether depressive symptoms are associated with increased loneliness scores, low self-efficacy beliefs, and poorly perceived social support. Additionally, it was investigated whether self-efficacy is a mediator variable, and social support is a moderator variable between loneliness and depression. N = 135 patients with or without previous COVID-19 infection (mean age 64.76) were recruited. Paper questionnaires were collected at the time of inpatient hospital admission in the year 2021 and in a cross-sectional study design. The study compared n = 45 multimorbid patients who survived COVID-19 infection with those n = 90 who were not infected before. No significant difference in depressive symptomology between these two groups revealed [t(133) = 130, p = 0.90, d = 0.024); F(3, 122) = 0.255, p = 0.86]. The study found a positive correlation between loneliness and anxiety and depression in both groups (rdepression = 0.419 and ranxiety = 0.496). Self-efficacy mediated the relation between loneliness and depression. The completely standardized indirect effect was β = 0.111, percentile Bootstrap 95% CI 0.027-0.201. The research findings suggest the importance of self-efficacy, and loneliness in the development of depressive symptoms, and have several practical implications for improving the mental health of multimorbid patients: Prospectively, treatment should not only focus on physical and cognitive health, but also on promoting self-efficacy and perceived social support, as well as address loneliness with psychoeducational interventions. Replication of the findings and conducting interventional research also employing lifestyle components should follow up, as this study tested associations but no causal relationships.

Determinants of COVID-19 vaccine intention in a University population: a serial mediation approach

Abstract Background While many studies have used the Health Belief Model (HBM) to understand vaccination intention, few have explored the relationships between the HBM constructs. The aim of this study is to develop a serial mediation model dealing with latent variables to assess direct and indirect effects of the six HBM constructs (perceived susceptibility, severity, benefits, barriers, self-efficacy and cue to action) on COVID-19 vaccine intention. Methods From April to June 2021, a questionnaire on vaccine intention against COVID-19 was administered to staff and students at the University of Liège (Belgium). To evaluate direct and indirect effects of the HBM constructs on vaccine intention (score 0-100), serial mediation models for each latent variable permutation were assessed with Partial Least Squares Path Modeling (PLS-PM). Bayesian information criterion (BIC) was used to compare models. Internal consistency reliability and discriminant validity were evaluated. Sociodemographic variables, health literacy, psychological profile, body mass index, chronic disease and previous COVID-19 infection were included in the models as covariates. Results The sample consisted of 1256 participants. After running all permutation chains, the final causal chain, with the lowest BIC value, was barriers (-0.09 (-0.15 - -0.03))* - severity (-0.13 (-0.20 - -0.07))* - low self-efficacy (0.20 (0.15 - 0.25))* - low susceptibility (-0.55 (-0.60 - -0.51))* - vaccine intention (outcome). This highlighted a significant indirect and direct effect (-0.20 (-0.25 - -0.15))* between barriers and vaccine intention. Constructs benefits and cue to action were removed due to no significant path and weak reliability. Non-significant confounding factors were also removed. *estimate Conclusions The results showed that perceived barriers are a key determinant of COVID-19 vaccine resistance. Public health actors should communicate messages to remove barriers that reduce vaccine intention primarily. Key messages • Serial mediations allow a better understanding of how a vaccination intention works. • Public health communications should primarily focus on messages to remove barriers to get vaccinated.

A-170 Investigation of High Rate of Low Positive Quantiferon-TB Gold Plus Results

Abstract Background Tuberculosis (TB) is a communicable disease, transmitted almost exclusively by cough aerosols carrying pathogens of the M. tuberculosis complex. TB continues to be a major public health threat, causing an estimated 10.4 million new cases and 1.3 million deaths from TB globally in 2016. Many more people may have latent tuberculosis infection (LTBI), which may go undetected without further laboratory investigation. The Quantiferon-TB Gold Plus (QFT-Plus) is an Interferon Gamma Release Assay (IGRA) for the identification of LTBI. It detects the cellular immune response to antigens of M. tuberculosis and represents an indirect marker of M. tuberculosis exposure. In January of 2021, the NorthShore University HealthSystem Core Laboratory transitioned from a reference laboratory ELISA-based QFT-Plus test to an in-house DiaSorin LIAISON® QuantiFERON®-TB Gold Plus test. After implementation, we noticed a higher rate of low positive QFT-Plus results (1.3%–5.4%) in our patient population that we regard as a mixed risk population. The expected percent of low positive results in a mixed risk population is 2%–3%. Objective To determine the potential causes of a higher rate of low positive Quantiferon-TB Gold Plus Results. Methods Forty specimens with Antigen-Nil results between 0.35–1.00 IU/mL using LIAISON® QuantiFERON®-TB Gold Plus reagent from 8/2022–10/2022 were collected for this study. All forty specimens were re-tested using ELISA-based methodology. Patient demographics and medical history were reviewed for any factor that may be responsible for the low positive results. Results Results from the two different methodologies were compared: 28/40 (70%) specimens showed positive results on the DiaSorin LIAISON®-XL platform, but negative results on the ELISA platform. Review of medical history showed that 92% of the sample population had received more than 2 doses of COVID-19 vaccine and 12.5 % had previous COVID-19 infection. 30% had an underlying autoimmune disease, with psoriasis and rheumatoid arthritis being the most common. However, no correlation was found between medical or vaccination history and the QFT-Plus results. Conclusion LIAISON® QuantiFERON®-TB Gold Plus is a Chemiluminescence immunoassay which is more sensitive than ELISA, resulting in an increased number of low positive QFT-Plus results. Physicians need to correlate clinical findings and TB exposure history to the QFT-Plus results when making clinical decisions.

Attitudes and practices toward COVID-19 precautionary measures: A comparative study of health professionals and public.

Containment of the COVID-19 pandemic has been impaired by the denial and defiance of preventive recommendations. We aimed to study the attitudes toward COVID-19 social measures among laypersons and healthcare professionals. We conducted a cross-sectional study in the United Arab Emirates using a self-administered online questionnaire. Both healthcare workers and laypersons were actively recruited. In addition to sociodemographic variables, the questionnaire included questions on anxiety, knowledge, and defiance related to COVID-19. A total of 615 individuals with a mean age of 32 years (SD, 12) participated. Females comprised 69% and healthcare workers constituted 60% of the study sample. Among laypersons, over 42% reported having social gatherings at home, and 44% admitted to visiting crowded places. More than half of the respondents felt increased anxiety. Previous COVID-19 infection did not affect attitudes or anxiety levels. Knowledge about COVID-19 was higher among those who were more educated (r=.21). Healthcare workers had lower anxiety than laypersons (p=.002). COVID-19 anxiety was higher among older persons and did not decrease with more knowledge. COVID-19 defiance was higher among younger male respondents from larger households and did not correlate with knowledge. Multivariate analysis showed more defiant attitudes at younger ages. Anxiety-related to the COVID-19 pandemic is more common in older individuals, whereas younger persons were more likely to deny and defy prevention recommendations despite having knowledge of viral transmission. Voluntary compliance by young individuals requires an engaging communication strategy to generate more compassionate attitudes.

Analysis of the prevalence of anti-SARS-CoV-2 antibodies in groups of medical and non-medical professions.

The assessment of the prevalence of anti-SARS-CoV-2 antibodies in various professional groups is very important. Hence, the purpose of the following study was to analyze the seroprevalence of anti-SARS-CoV-2 antibodies among employees performing both medical and nonmedical professions before the launch of SARS-CoV-2 vaccination. The study was conducted among employers of 1 of the institutions: The Provincial Specialist Hospital of Władysław Biegański in Łódź, Poland, Radio Łódź and the Border Guards of Łódź Airport. Blood samples were collected in December 2020-February 2021. Patients were screened for the presence of SARS-CoV-2 antibodies. Simultaneously respondents were asked to complete a self-designed questionnaire including demographic data, detailed profession, history of SARS-CoV-2 infection and willingness to be vaccinated against COVID-19. Seroprevalence was significantly higher in the group of rural residents (p < 0.012), participants who declared previous COVID-19 infection (p < 0.001) and healthcare workers (HCWs) (p = 0.002), especially nurses (35.5%, p = 0.003) and medics worked in areas dedicated to COVID-19 than in other specialties (38.7% vs. 26.8%, respectively, p = 0.017). There was no association between the presence of antibodies and the gender (p = 0.118), age (p = 0.559) or BMI (p = 0.998). Healthcare workers, in particular nurses, are at high risk of contracting COVID-19 in the workplace. Occupational infections can occur during occur not only during contact with the patient, but also with members of the medical team who do not show typical symptoms of the disease. Shortages in medical staff may also increase the number of infections among HCWs. Medical and hospital staff providing health services during the COVID-19 epidemic in Poland, may seek compensation in the event of consequences related to SARS-CoV-2 infection. The effectiveness of education and self-discipline in complying to safety rules among HCWs should also be constantly monitored. Int J Occup Med Environ Health. 2023;36(5):643-55.

Immune and cytokine alterations and RNA-sequencing analysis in gestational tissues from pregnant women after recovery from COVID-19

BackgroundCOVID-19 is a global pandemic. Understanding the immune responses in pregnant women recovering from COVID-19 may suggest new therapeutic approaches.MethodsWe performed a cross-sectional study between March 1, 2020, and September 1, 2020. Participants were assigned into the convalescent COVID-19 group if they had a previous COVID-19 infection during pregnancy or the healthy control group. RNA-Seq was performed on human umbilical cord mesenchymal stem cells (hUMSCs) and human amniotic mesenchymal stem cells (hAMSCs). Immunohistochemical staining, cytokine testing, lymphocyte subset analysis, RNA-Seq, and functional analyses were performed on the placental and umbilical cord blood (UCB) and compared between the two groups.ResultsA total of 40 pregnant women were enrolled, with 13 in the convalescent group and 27 in the control group. There were 1024, 46, and 32 differentially expressed genes (DEGs) identified in the placental tissue, hUMSCs, and hAMSCs between the convalescent and control groups, respectively. Enrichment analysis showed those DEGs were associated with immune homeostasis, antiviral activity, cell proliferation, and tissue repair. Levels of IL-6, TNF-α, total lymphocyte counts, B lymphocytes, Tregs percentages, and IFN-γ expressing CD4+ and CD8+ T cells were statistically different between two groups (p ≤ 0.05). ACE2 and TMPRSS2 expressed on the placenta were not different between the two groups (p > 0.05).ConclusionMultiple changes in immune responses occurred in the placental tissue, hUMSCs, and hAMSCs after maternal recovery from COVID-19, which might imply their protective roles against COVID-19 infection.

Paediatric COVID-19 vaccination coverage and associated factors among migrant and non-migrant children aged 5-11 years in Aotearoa New Zealand: A population-level retrospective cohort study

ObjectiveChildren with migrant and refugee backgrounds may experience immunisation inequities due to barriers to accessing and accepting vaccines. In Aotearoa New Zealand (NZ), national reporting can mask inequities in coverage by migration background. This study explored paediatric COVID-19 vaccine uptake among children with migrant and refugee backgrounds. MethodsThis population-level retrospective cohort study compared rates and determinants of paediatric COVID-19 vaccine uptake as of July 2022 amongst migrant and non-migrant children who were aged between 5 and 11 years as of January 2022. Linked de-identified administrative and health data available in Statistics NZ’s Integrated Data Infrastructure were used, and univariate and multivariable logistic regression were conducted to determine associations. ResultsOf the total study population (N = 451,323), 3.5% were overseas-born migrant children, 31.3% were NZ-born migrant children, and 65.3% were NZ-born non-migrant children. Only 50.8% (229,164 out of 451,323) of children had received at least one dose. Migrant children were significantly more likely to have received a COVID-19 vaccination than non-migrant children. Logistic modelling revealed that all factors, including ethnicity, gender, age, family type, household income, deprivation, region, parent COVID-19 vaccination status, and child’s previous COVID-19 infection, significantly influenced COVID-19 vaccine uptake. The largest contributing factor was parents’ COVID-19 vaccination status. ConclusionsThe findings suggest that NZ’s paediatric COVID-19 vaccination programme was able to address logistical and motivational barriers commonly identified amongst migrants and refugees. Implications for public healthAs parents’ vaccination status is an important factor in vaccinating their own children, continuous efforts are needed to support confident parental COVID-19 vaccine decision-making. To address social inequities, engagement with marginalised communities to co-design tailored and localised approaches is recommended.

COVID-19 Vaccination and Serological Profile of a Brazilian University Population.

COVID-19 led to the suspension academic activities worldwide, affecting millions of students and staff. In this study, we evaluated the presence of IgM and IgG anti-SARS-CoV-2 antibodies in an academic population during the return to classes after a one-year suspension. The study took place over five months at a Brazilian university and included 942 participants. We found that most participants had reactive IgG and non-reactive IgM. All received at least one dose, and 940 received two or more doses, of different COVID-19 vaccines. We obtained a higher average of memory antibodies (IgG) in participants who received the CoronaVac/ChAdOx1 combination. IgG was consistently distributed for each vaccine group, but individuals who completed the vaccination schedule had higher levels. There were no differences between antibodies and gender, presence of symptoms, and previous COVID-19 infection, but older participants (>53 years) and contacts of infected individuals had higher IgM levels. This study makes significant contributions to the assessment of antibodies in the academic environment, allowing us to infer that most participants had memory immunity and low indications of recent infection when returning to face-to-face classes, as well as demonstrating the need to monitor immunity and update vaccinations.

RApid Throughput Screening for Asymptomatic COVID-19 Infection With an Electrocardiogram: A Prospective Observational Study

ObjectiveTo evaluate the ability of a neural network to identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using point-of-care electrocardiography obtained with a portable device. Patient and MethodsWe enrolled 2827 patients in a prospective observational study, from December 10, 2020, through June 4, 2021, to determine the accuracy of a point-of-care, handheld, smartphone-compatible, artificial intelligence–enabled electrocardiography (ECG) (POC AI-ECG) in detecting asymptomatic SARS-CoV-2 infection using a modified version of an existing deep learning model framework trained on 12-lead ECG data. ResultsStudy participants were 48% (n=1067) female, 79% (n=1749) White, and 7% (n=153) endorsed previous COVID-19 infection. We found the POC AI-ECG algorithm was ineffective for detecting asymptomatic SARS-CoV-2 infection (area under curve, 0.56; 95% CI, 0.46-0.66), failing to adequately discriminate between ECGs performed among participants who tested positive compared to those who tested negative. ConclusionContrary to the prior 12-lead ECG study, a POC AI-ECG failed to reliably identify asymptomatic SARS-CoV-2 infection among adults. This study underscores the importance of prospective testing, assuring similar populations, and using similar signals or data when developing AI-ECG tools. Trial registrationclinicaltrials.gov Identifier: NCT04725097

Factors associated with IgG titers against SARS-CoV-2 spike protein after second vaccination in people living with HIV controlled with anti-retroviral therapy

ObjectiveThis study aimed to identify factors associated with the response to the SARS-CoV-2 vaccine in people living with HIV (PLWH). MethodsThis study was conducted at the Jikei University School of Medicine, Tokyo, Japan. IgG antibodies against spike and nucleocapsid proteins were detected using Abbott SARS-CoV-2 IgG II Quant assays. ResultsDuring the investigation period, 371 PLWH were enrolled in this study. PLWH with previous COVID-19 infection, untreated or poorly controlled HIV infection, and those whose blood samples were obtained within less than seven days after the second vaccination were excluded. A total of 310 PLWH controlled with anti-retroviral therapy were included in the final analysis. Multivariate analysis demonstrated that chronic kidney disease (CKD) (β = −0.353, p = 0.049) and the duration between the second vaccination and blood sampling (β = −0.005, p < 0.001) were associated with low spike protein IgG titers. ConclusionEven without hemodialysis or kidney transplant, CKD was associated with vaccine response in PLWH.