Risk Of COVID-19 Research Articles

Occupational risks of COVID-19: a case-cohort study using health insurance claims data in Germany

BackgroundStudies on occupation and COVID-19 infection that cover a range of occupational groups and adjust for important confounders are lacking. This study aimed to estimate occupational risks of hospitalization with COVID-19 by taking into account sociodemographic factors and previous comorbidities.MethodsWe applied a case-cohort design using workers insured with one of Germany’s largest statutory health insurers as a data source for occupational and demographical information as well as for information on comorbidities. Cox regression models with denominator weights for cases and controls assessed relative risks of hospitalization with COVID-19 in 2020.ResultsThe study consisted of 11,202 COVID-19 cases and 249,707 non-cases. After adjusting for age, sex, number of pre-existing comorbidities, and socioeconomic status, we found at least doubled risks for occupations in theology and church work (HR = 3.05; 95% CI 1.93–4.82), occupations in healthcare (HR = 2.74; 95% CI 2.46–3.05), for bus and tram divers (HR = 2.46; 95% CI 2.04–2.97), occupations in meat processing (HR = 2.16; 95% CI 1.57–2.98), and professional drivers in passenger transport (e.g. taxi drivers) (HR = 2.00; 95% CI 1.59–2.51). In addition, occupations in property marketing and management, social workers, laboratory workers, occupations in personal care (e.g. hairdressers), occupations in housekeeping and occupations in gastronomy all had statistically significantly increased risks compared to the reference population (administrative workers).ConclusionsWe identified occupations with increased risks for hospitalization with COVID-19. For those having a doubled risk it can be assumed that COVID-19 diseases are predominantly occupationally related. By identifying high-risk occupations in non-healthcare professions, effective measures to prevent infections in the workplace can be developed, also in case of a future pandemic.

Affect mediates culture’s effects on COVID-19 risk perceptions, behavioral intentions, and policy support among americans

The Affect Heuristic-Cultural Cognition Theory (AH-CCT) model and the Solution Aversion-based (SA) model both suggest affect, meaning feelings or discrete emotions about a target, mediates associations between ‘culture,’ such as political ideology or cultural biases, and risk responses, such as risk perceptions, protective behaviours, and supportive attitudes towards protective policy. However, the models differ respectively by defining negative affect as directed towards the hazard (‘hazard affect’) or a specific behaviour or policy response (‘solution aversion,’ negative affect about a proposed risk reduction method). We compare these models with longitudinal mediation analysis of U.S. COVID-19 survey data (n = 866 in smallest-sample wave). Solution aversion accounted for more associations of culture with risk perceptions, such as personal risk, collective risk, and risk severity; behaviour and behavioural intentions, regarding mask wearing, avoiding large public gatherings, and vaccination; and support for risk mitigation policies, regarding mask mandates, public gathering bans, and vaccination mandates. Statistically significant direct effects were rare and were mainly for egalitarian cultural bias; indirect effects occurred for egalitarians, political conservatives, and individualists. Implications for further research on risk responses are discussed relative to limited previous work on these affect-mediation models.

Differential risk of healthcare workers versus the general population during outbreak, war and pandemic crises.

Healthcare workers may have different risk for severe outcomes compared with the general population during diverse crises. This paper introduces the concept of healthcare worker versus population hazard (HPH), the risk of an outcome of interest in active healthcare workers compared with the general population they serve. HPH can be expressed with relative risk (HPH(r)) and absolute risk difference (HPH(a)) metrics. Illustrative examples are drawn from infectious outbreaks, war, and the COVID-19 pandemic on death outcomes. HPH can be extreme for lethal outbreaks (HPH(r) = 30 to 143, HPH(a) = 8 to 91 per 1000 for Ebola deaths in 3 Western African countries in 2013-5), and modestly high in relative terms and very high in absolute terms for protracted, major armed conflicts (HPH(r) = 1.38 and HPH(a) = 10.2 for Syria during 2011-2024). Conversely, healthcare workers had 8-12-fold lower risk than the population they served for pandemic excess deaths (physicians in USA) or COVID-19 deaths (physicians in Ontario, healthcare workers in Finland), while healthcare workers in Indonesia did not have this advantage for COVID-19 deaths versus the general population. HPH is susceptible to data inaccuracies in numbers of at-risk populations and of outcomes of interest. Importantly, inferences about healthcare worker risk can be misleading, if deaths of retired healthcare workers contaminate the risk calculations- as in the case of misleading early perceptions of exaggerated COVID-19 risk for healthcare professionals. HPH can offer useful insights for risk assessment to healthcare professionals, the general public, and policy makers and may be useful to monitor for planning and interventions during crises.

Assessing the impact of vaccines on COVID-19 efficacy in survival rates: a survival analysis approach for clinical decision support.

The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, has presented significant challenges to healthcare systems worldwide. This study, based on an analysis of a cohort from the Public Health System of Andalusia (Spain), aims to evaluate how vaccination affects case-fatality rate in patients hospitalized due to COVID-19 infection in Andalusia. The cohort consists of 37,274 individuals after applying the inclusion criteria. We conducted survival analyses employing the Cox proportional hazards models and generated adjusted survival curves to examine the outcomes. The analyses were performed from three perspectives: vaccinated vs. unvaccinated patients, vaccinated and unvaccinated patients grouped by age, and stratified by vaccination status. Results indicate a substantial correlation between vaccination and a 20% reduction in the risk of case-fatality. Age-specific effects reveal varying degrees of protection across different age groups. These findings emphasize the pivotal role of vaccination status in COVID-19 risk assessment, supporting the development of a clinical decision support system for accurate predictions and optimizing healthcare management at admission.

Humoral response 24 months after the first COVID-19 vaccination in people with HIV with and without diabetes

People with HIV (PWH) and people with diabetes mellitus have increased risk of severe COVID-19, but little is known about humoral response to COVID-19 vaccines in PWH with DM. We investigated SARS-CoV-2 antireceptor-binding domain (anti-RBD) immunoglobulin G (IgG) geometrical concentrations and neutralizing antibody capacity (nAB) in PWH with and without diabetes mellitus. Anti-RBD IgG and nAB in COVID-19-vaccinated PWH were not associated with diabetes mellitus-status or HbA1c 24 months after the initial COVID-19 vaccination.

Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States.

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing. The Global Center for Health Security established an ethics advisory committee to support COVID-19 response efforts. The ethics advisory committee supported the development of guidance on infection prevention and control to promote justice, reciprocity, health, safety, and equity for workers in the meat processing industry. Our experience highlighted the fundamental role of ethical analysis in public health response efforts, but ethical analysis in this case required an interdisciplinary approach, including the need for effective community-relevant solutions. The integration of an ethics committee into public health emergency response efforts can address ethical concerns for workers in industries that must remain operational during public health emergencies.

In-hospital outcomes of healthcare-associated COVID-19 (Omicron) versus healthcare-associated influenza: a retrospective, nationwide cohort study in Switzerland.

As COVID-19 is integrated into existing infectious disease control programs, it is important to understand the comparative clinical impact of COVID-19 and other respiratory diseases. We conducted a retrospective cohort study of patients with symptomatic healthcare-associated COVID-19 or influenza reported to the nationwide, hospital-based surveillance system in Switzerland. Included patients were adults (≥18 years) hospitalized for ≥3 days in tertiary care and large regional hospitals. Patients had COVID-19 symptoms and a RT-PCR-confirmed SARS-CoV-2 infection ≥3 days after hospital admission between 1 February 2022 and 30 April 2023, or influenza symptoms and a RT-PCR-confirmed influenza A or B infection ≥3 days after hospital admission between 1 November 2018 and 30 April 2023. Primary and secondary outcomes were 30-day in-hospital mortality and admission to intensive care unit (ICU), respectively. Cox regression (Fine-Gray model) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounding. We included 2901 patients with symptomatic healthcare-associated COVID-19 (Omicron) and 868 patients with symptomatic healthcare-associated influenza from nine hospitals. We found a similar case fatality ratio between healthcare-associated COVID-19 (Omicron) (6.2%) and healthcare-associated influenza (6.1%) patients; after adjustment, patients had a comparable subdistribution hazard ratio for 30-day in-hospital mortality (0.91, 95%CI 0.67-1.24). A similar proportion of patients were admitted to ICU (2.4% COVID-19; 2.6% influenza). COVID-19 and influenza continue to cause severe disease among hospitalized patients. Our results suggest that in-hospital mortality risk of healthcare-associated COVID-19 (Omicron) and healthcare-associated influenza are comparable.

COVID-19 and pregnancy: a comprehensive study of comorbidities and outcomes

ObjectivesThis study aimed to investigate the impact of pregnancy and pre-existing comorbidities on COVID-19 infections and associated complications of hospitalisation and mortality in women of reproductive age (WRA). The study also compared the risk of severe COVID-19 complications between pregnant women (PW) and non-pregnant women (NPW) with and without pre-existing comorbidities. Special focus was placed on some understudied comorbidities of immunosuppression, chronic renal disease and chronic obstructive pulmonary disease (COPD).MethodsThe study utilized anonymized patient-related information for a population of 7,342,869 WRA from the Mexican Ministry of Health data repository on COVID-19. Descriptive variables were characterized using frequencies, percentages, means, and standard deviations. Adjusted odds ratios (aORs) were used to assess the associations between risk factors and outcomes of hospitalisation and mortality. The study covered the entire COVID-19 pandemic period from January 30, 2020, to May 5, 2023.ResultsThe findings revealed that PW were not more likely to get COVID-19 infections than NPW. PW with COVID-19 infections were more likely to require hospital admission, intubation treatments, and ICU admission compared to NPW with COVID-19. PW with immunosuppression had an increased odds ratio (aOR) of getting COVID-19 infections compared to NPW (PW: aOR = 1.0396; NPW: aOR = 0.8373). NPW with immunosuppression had higher risk of mortality (all-cause death: aOR = 1.7084; COVID-19-associated death: aOR = 1.4079) and hospitalisation (all-cause hospitalisation: aOR = 4.1328; COVID-19-associated hospitalisation: aOR = 3.0451) than NPW without immunosuppression. Renal disease was identified as a concerning pre-existing condition that increased the risks of COVID-19 associated mortality/hospitalizations and all-cause mortality/hospitalizations for both PW and NPW. NPW with renal disease had much higher odds ratio (aOR) of either COVID-19-associated-hospitalisations (NPW: aOR = 8.639; PW: aOR = 1.7603) or all-cause hospitalisations (NPW: aOR = 8.8594; PW: aOR = 1.786) than PW with renal disease.ConclusionsThis study provides valuable insights into the impact of pregnancy and pre-existing comorbidities on COVID-19 outcomes in WRA. The findings underscore the importance of considering demographic factors and pre-existing comorbidities in the management of PW with COVID-19. The study also highlights the need for further research to understand the unique impacts of different comorbidities, particularly immunosuppression and renal disease, on COVID-19 outcomes in WRA.

Antimicrobial prescribing practices and factors associated with antimicrobial prescribing in hospitalized COVID-19 patients in Oyo state: A retrospective study.

Proportion of hospitalized COVID-19 patients receiving antimicrobial drug is significantly high despite evidence of low level of actual bacterial co-infection, potentially contributing to poor health outcome and global antimicrobial resistance. A retrospective study was performed on antimicrobial agents prescribed to adult patients with confirmed COVID-19 admitted across three isolation facilities between 1 March 2020 and 30 April 2021 in Ibadan, Oyo state, Nigeria. From individual records, we evaluated patient demographics, COVID-19 risk factors, diagnostic testing, disease severity and antimicrobial utilization. The primary aim was to determine the prevalence of antimicrobial prescription as well as factors associated with antimicrobial prescribing in hospitalized patients with COVID-19 in Oyo state. In total, 271 patients were included in this study. The median age of the population was 51 years (IQR; 32-62 years). The mean duration of hospital admission was 13 days (IQR: 10-14 days). Majority of participants were symptomatic (81.5%). All participants had a COVID-19 PCR test performed and none had bacterial culture performed. All patients received antimicrobial therapy across the entire cohort. The mean DOT per LOT across cohorts was 1.2 for mild cases, 1.4 for moderate cases and 1.3 for severe cases. Factors associated with the number of antimicrobials per prescription were being single (P = 0.02), being below 60 years of age (P = 0.04), mild COVID-19 symptoms (P < 0.001) and diabetes comorbidity (P = 0.03). Given the high rate of antimicrobial prescription and absence of bacteriological culture analysis in these patients, there is risk of development and spread of antimicrobial resistant. Continuous review of antimicrobial prescription is critical in the management of hospitalized COVID-19 patients.

Identifying influencing factors and constructing a prediction model for long COVID-19 in hemodialysis patients.

This study aimed to identify the potential influencing factors and construct a prediction model for long COVID in hemodialysis patients. We retrospectively reviewed 115 patients undergoing hemodialysis in a tertiary hospital between December 2022 and January 2023. Both univariate and multivariate logistic regression models were applied to identify potential influencing factors, and the prediction model was constructed using an ROC curve. Of the 115 included patients, 60 experienced long COVID, with a prevalence of 52.2%. The univariate analysis found that a three-dose COVID-19 vaccination was associated with a reduced risk of long COVID (OR: 0.10; 95%CI: 0.01-0.86; P = 0.036). However, severe COVID (OR: 9.49; 95%CI: 1.14-78.90; P = 0.037), undergoing CT examination (OR: 3.01; 95%CI: 1.34-6.78; P = 0.008), and abnormal neutrophil (OR: 5.95; 95%CI: 1.26-28.19; P = 0.025), and platelet (OR: 2.39; 95%CI: 1.11-5.13; P = 0.025) counts were associated with a higher risk of long COVID. After adjusting for potential confounding factors, undergoing CT examination (OR: 2.60; 95%CI: 1.02-6.64; P = 0.046) and having abnormal neutrophil (OR: 8.16; 95%CI: 1.57-42.38; P = 0.013) and monocyte (OR: 17.77; 95%CI: 1.30-242.29; P = 0.031) counts were associated with a higher risk of long COVID. The prediction model constructed based on these factors showed a relatively better predictive value (AUC: 0.738; 95%CI: 0.648-0.828; P < 0.001). The risk of long COVID-19 in hemodialysis patients was significantly related to undergoing CT examination and having abnormal neutrophil and monocyte counts, and the prediction model constructed using these factors showed a moderate predictive value.

Assessing COVID-19 Vaccine Effectiveness and Risk Factors for Severe Outcomes through Machine Learning Techniques: A Real-World Data Study in Andalusia, Spain.

COVID-19 vaccination has become a pivotal global strategy in managing the pandemic. Despite COVID-19 no longer being classified as a Public Health Emergency of International Concern, the virus continues affecting people worldwide. This study aimed to evaluate risk factors and vaccine effectiveness on COVID-19-related hospital admissions, intensive care unit (ICU) admission and mortality within the Andalusian population throughout the pandemic. From March 2020 to April 2022, 671,229 individuals, out of 9,283,485 with electronic health records in Andalusia, experienced SARS-CoV-2 infection and were included in the analysis. Data on demographics, medical history, vaccine administration, and hospitalization records were collected. Associations between medical history, COVID-19 vaccines, and COVID-19 outcomes were assessed. Our study identified 48,196 hospital admissions, 5,057 ICU admissions, and 11,289 deaths linked to COVID-19. Age, male sex, and chronic diseases were identified as risk factors, while the COVID-19 vaccine demonstrated protective effects, although with reduced effectiveness during the omicron variant period. However, the risk for these outcomes increased over time after receiving the last vaccine dose, particularly after six months, especially among those aged 60 or older. The global health challenge of COVID-19 persists, marked by emerging variants with higher virulence and severity, particularly among the unvaccinated and those beyond six months post-vaccination, especially those aged 60 and above. These findings highlight the need for robust surveillance systems targeting new variants and administering booster doses, particularly for individuals aged 60 or older with underlying health conditions, to mitigate the global burden of COVID-19.

COMPONENTS OF METABOLIC SYNDROME AS A RISK FACTOR FOR COVID-19 IN INDIA

Objective: Several patients with components of metabolic syndrome (MetS) like obesity, hypertension, diabetes mellitus and dyslipidemia is a risk factor for COVID-19 in India. Aims of our review to bring together current data about components of metabolic syndrome &amp; COVID 19 infection. It specially looks the relation between components of MetS (Obesity, Diabetes mellitus, Hypertension and dyslipidemia) and COVID 19. At the time of writing the review is updated till time. Methods: Search of literature was done by using google search &amp; PubMed engines for prepare review related to my article. Results: Patients with components of metabolic syndrome like obesity, diabetes, hypertension and dyslipidemia have increased evidence of incidence and severity of COVID-19. COVID-19 has effect on the pathophysiology of all these components of metabolic syndrome. The control of all these components of metabolic syndrome is important not only for patients who are infected with COVID-19, but also for those without the disease. Conclusions: It is commonly known that the existence of comorbidities such as increase in BMI, dyslipidemia, diabetes mellitus and hypertension is associated with additional severe course of COVID-19. So measurement of components of metabolic syndrome parameters is essential to better estimate the risk of COVID-19 and management and control of these components (BMI, blood glucose, blood pressure, lipid profile) of metabolic syndrome parameters will cause less possibility to occur COVID-19.

Scale-specific effects of urban landscape pattern on the COVID-19 epidemic in Hangzhou, China

ContextUnderstanding the scale-specific effects of different landscape variables on the COVID-19 epidemics is critical for developing the precise and effective prevention and control strategies within urban areas.ObjectiveBased on the landscape epidemiology framework, we analyzed the scale-specific effects of urban landscape pattern on COVID-19 epidemics in Hangzhou, China.MethodsWe collected COVID-19 cases in Hangzhou from 2020‒2022 and combined the datasets of land use and land cover (LULC) and social gathering point (SGP) to quantify the urban landscape pattern. Optimal general linear model with stepwise regression was applied to explore the dominant landscape factors driving the COVID-19 transmission in the city. Furthermore, multi-scale geographically weighted regression illustrated the spatial heterogeneity and scale specificity of these landscape variables’ effects to COVID-19 epidemic.ResultsEight landscape variables of LULC and SGP patterns were identified which explained 68.5% of the variance in spatial risk of COVID-19. Different optimal bandwidths across these variables in MGWR indicated their scale-specific effects. LSI of green space enhanced the spatial risk across the entire region. The effects of landscape contagion, the number of water bodies, LSI of cropland and built-up areas, and the density of commercial houses were detected to vary between urban and suburban areas. The effects of LSI of water bodies and the density of shopping malls were found to vary among different districts.ConclusionsIn this study, we firstly discriminated the scale-specific effects of different landscape variables on the COVID-19 epidemic in the urban region. These findings can help to optimize the differentiated zoning prevention and control strategies for COVID-19 in cities and guide policy-making and urban planning at a multi-scale hierarchical perspective to improve public health and urban sustainability.

The impact of COVID-19 risk perception on college students’ subjective well-being as moderated by parenting style

Questionnaires completed by 589 college students were used to investigate the impact of the risk perception of the COVID-19 pandemic on college students’ subjective well-being. The goal was to explore the relationship between college students’ risk perception and subjective well-being during the COVID-19 pandemic as well as to analyze the mediating role of emotional regulation and the moderating effect of parenting style. The results showed the following: First, significant negative correlations were found between risk perception and subjective well-being, as well as between the risk perception of the COVID-19 pandemic and emotional regulation. Emotional regulation was significantly positively correlated with subjective well-being. Second, emotional regulation played a mediating role between risk perception and subjective well-being. Third, a positive parenting style played a positive moderating role between risk perception and subjective well-being. We thus concluded that COVID-19 risk perception directly reduces subjective well-being and indirectly affects subjective well-being through emotional regulation. A positive parenting style reduces the negative impact of the risk perception of the COVID-19 pandemic on subjective well-being. This study provides guidance on how to improve college students’ well-being during major public health events.

Long COVID and recovery from Long COVID: quality of life impairments and subjective cognitive decline at a median of 2 years after initial infection

BackgroundRecovery from SARS CoV-2 infection is expected within 3 months. Long COVID occurs after SARS-CoV-2 when symptoms are present for more than 3 months that are continuous, relapsing and remitting, or progressive. Better understanding of Long COVID illness trajectories could strengthen patient care and support.MethodsWe characterized functional impairments, quality of life (QoL), and cognition among patients who recovered from SARS-CoV-2 infection within 3 months (without Long COVID), after 3 months (Recovered Long COVID), or remained symptomatic (Long COVID). Among 7305 patients identified with previous SARS-CoV-2 infection between March 2020 and December 2021, confirmed in the medical record with laboratory test or physician diagnosis, 435 (6%) completed a single self-administered survey between March 2022 and September 2022. Multi-domain QoL and cognitive concerns were evaluated using PROMIS-29 and the Cognitive Change Index-12.ResultsNearly half the participants (47.7%) were surveyed more than 2 years from initial infection (median = 23.3 months; IQR = 18.6, 26.7) and 86.7% were surveyed more than 1 year from infection. A significantly greater proportion of the Long COVID (n = 215) group, (Current and Recovered combined), had moderate-to-severe impairment in all health domains assessed compared to those Without Long COVID (n = 220; all p < 0.05). The Recovered Long COVID group (n = 34) had significantly lower prevalence of fatigue, pain, depression, and physical and social function impairment compared to those with Current Long COVID (n = 181; all p < 0.05). However, compared to patients Without Long COVID, the Recovered Long COVID group had greater prevalences of fatigue, pain (p ≤ 0.06) and subjective cognitive decline (61.8% vs 29.1%; p < 0.01). Multivariate relative risk (RR) regression indicated Long COVID risk was greater for older age groups (RR range 1.46–1.52; all p ≤ 0.05), those without a bachelor’s degree (RR = 1.33; 95% CI = 1.03–1.71; p = 0.03), and those with 3 or more comorbidities prior to SARS-CoV-2 infection (RR = 1.45; 95% CI = 1.11–1.90; p < 0.01).ConclusionsLong COVID is associated with long-term subjective cognitive decline and diminished quality of life. Clinically significant cognitive complaints, fatigue, and pain were present even in those who reported they had recovered from Long COVID. These findings have implications for the sustainability of participation in work, education, and social activities.

Factors Influencing Moroccans' Intention to Get the COVID-19 Vaccine: Results From a Cross-Sectional Study.

Background During the COVID-19 pandemic, the introduction of the vaccine represented a light of hope. With the vaccine now accessible globally, the focus shifts to encouraging community vaccination to attain herd immunity. This study describes the factors that affect individuals' willingness to get vaccinated in Morocco. Methods From April 9, 2022, to April 27, 2023, a cross-sectional survey was conducted among Moroccan individuals aged 18 and older at primary healthcare centers. The survey was administered through anonymous questionnaires and explored various factors that influence people's intentions regarding COVID-19 vaccination. These factors included sociodemographic and clinical characteristics, perceptions of COVID-19 risk, knowledge about vaccines, and concerns about vaccine safety and efficacy. Chi-square tests or Student's t-tests were used to describe these variables, and significant determinants of vaccine intention were identified using a logistic regression model. Results Among the 453 participants, 77.5% were women. The mean age was 41.4±16.6 years. Amongthe surveyed group, 51.2% indicated that they did not intend to get vaccinated against COVID-19. Several factors were significantly associated with the willingness to be vaccinated (p<0.05), including having no income (adjusted OR (AOR): 2.7, 95% confidence interval (CI): 1.9-5.1, p=0.003), believing that COVID-19 is a serious infection (AOR: 13.1, 95% CI: 7.6-22.3, p<0.001), not having had a COVID-19 infection (AOR: 3.3, 95% CI: 1.7-6.4, p=0.001), having concerns about vaccine side effects (AOR: 8.6, 95% CI: 4.4-16.9, p<0.001), and believing in the benefit of booster doses (AOR: 5.5, 95% CI: 2.4-12.6, p<0.001). Conclusion The low vaccination intent observed in this study presents a major challenge for controlling COVID-19 and potentially other infectious diseases because the determinants of vaccine intent are likely similar. This finding underscores the urgent need for reliable, authoritative information on the risks of disease, the efficacy of the vaccine, and the benefits of vaccination. Additionally, assessing the commitment to completing full vaccination schedules is crucial to enhancing population-wide vaccine uptake.

Genetic variations in Interferon-Induced with Helicase C Domain 1: Impact on COVID-19 risk and severity in the Moroccan population

BackgroundThe clinical spectrum of COVID-19 varies considerably, ranging from asymptomatic cases to severe disease and even death. This variability can partly be attributed to genetic differences in genes associated with inflammation and immune responses. Among these genes, Interferon Induced with Helicase C Domain 1 (IFIH1), which codes for a cytoplasmic sensor, plays a crucial role in detecting SARS-CoV-2 viral RNA and initiating the antiviral interferon (IFN) response, thereby constituting a key element of innate immune defense. AimThis study aims to examine the association between genetic variants in the IFIH1 gene and susceptibility to, as well as the severity of, COVID-19 in the Moroccan population. Materials and MethodsWe conducted a case-control study involving 299 COVID-19 positive patients (149 severe, 150 benign) and 145 uninfected-SARS-CoV-2 controls. We determined the genotypes of two functional variants, rs1990760 (Ala946Thr) and rs3747517 (His843Arg), in the IFIH1 gene using predesigned TaqMan real-time allelic discrimination assay. ResultsOur results indicated that the TT genotype of rs1990760 was associated with increased susceptibility to SARS-CoV-2 under a recessive model (odds ratio [OR] = 2.22, 95 % confidence interval [CI] 1.28–3.84, P=0.003). Conversely, the CT genotype appeared to confer protection against SARS-CoV-2 infection (OR=0.58, 95 % CI 0.38–0.91, P=0.016) and COVID-19 severity (OR=0.56, 95 % CI 0.34–0.91, P=0.019). No significant association was found between rs3747517 and the risk of hospitalization or infection susceptibility. ConclusionThese findings underscore the significance of genetic variability in the IFIH1 gene in shaping individual responses to SARS-CoV-2 in the Moroccan population.

Assessing the influence of nursing home size and care models on COVID-19 case and mortality rates

IntroductionThis study examines the impact of COVID-19 on older adults in traditional nursing homes, Green Houses (GHs), and Continuing Care Retirement Communities-Nursing Homes (CCRCNHs). MethodsCOVID-19 cases and deaths from CMS and LTCFocus data across 11 states from 6/2020 to 9/2022 were used, and Poisson regressions to compare care settings while adjusting for covariates. ResultsCCRCNH and GH residents were older (84.4 and 83.1 years) than those in traditional NHs (77.5 and 77.6 years, p < 0.0001), with more female and White individuals. COVID-19 risk was higher in CCRCNHs (RR 1.51, 95 % CI 1.10–2.07), large NHs (RR 1.57, 95 % CI 1.14–2.15), and highest in small NHs (RR 1.80, 95 % CI 1.32–2.47). Mortality rates across NH types showed no significant difference. ConclusionThe study shows that smaller, person-centered GHs are more effective in controlling COVID-19 infection, suggesting a need to rethink care models to incorporating GH features for better outcomes.GEORGE2 07-AUG-2024 11:31.

Memory B Cells Provide Long-Term Protection to Vaccinated Kidney Transplant Recipients Against SARS-CoV-2 Variants.

Kidney transplant recipients (KTRs) are highly vulnerable to COVID-19. An intensified scheme of vaccination offers short-term protection to the 50%-75% of KTRs able to develop a germinal center reaction, required for the generation of neutralizing titers of antibodies (NAbs). However, the duration of this vaccinal protection is unknown. In-depth longitudinal analysis of the immune response to vaccination of 33 KTRs demonstrates that the low peak of IgGs, the progressive decline in antibody titers, and the emergence of a variant of concerns (VOC) of SARS-CoV2, synergize to let 2/3 of responders to vaccine without NAbs after only a few months. Yet, a retrospective study of an independent cohort of 274 KTRs, revealed that the risk of severe COVID-19 in the latter was low, similar to that of patients with serum neutralizing capacity against VOC. Our work links this late vaccine protection with the presence of memory B cells, which are generated during the initial vaccine-induced germinal center reaction, have a wide repertoire directed against conserved spike epitopes, and rapidly differentiate into IgG-producing plasma cells upon antigenic rechallenge. We conclude that in contrast with a serological layer that goes fading rapidly, the cellular layer of humoral memory provides an efficient long-term protection against VOC to KTRs. This illustration of the complementary roles of the two layers of the humoral memory has implications in immunopathology beyond the COVID-19 in KTRs.

Patients surviving COVID-19 had lower risk for long COVID in the Omicron vs. earlier eras.

Xie Y, Choi T, Al-Aly Z. Postacute sequelae of SARS-CoV-2 infection in the pre-Delta, Delta, and Omicron eras. N Engl J Med. 2024;391:515-525. 39018527.