Severity Of COVID-19 Symptoms Research Articles

Serological Screening for Severe Acute Respiratory Syndrome Coronavirus-2 in Type 1 Diabetic Children and Adolescents

Abstract Background Diabetes was identified as a risk factor for many infections. In the SARS-CoV-2 pandemic, diabetes is one of the leading comorbidities associated with infection severity. Aim of the Work To determine the severity of COVID-19 symptoms in type 1 diabetic children and adolescents. To Determine the effect of SARS-CoV-2 lockdown on glycemic control. Patients and Methods A cross sectional observational study was carried out in Pediatric and Adolescent Diabetology Unit (PADU), Children's Hospital, Ain Shams University between September 2020 and January 2022. The study included 500 randomly selected diabetic children and adolescents. They were tested for Hemoglobin A1C and SARS-CoV-2 IgM and IgG antibody. Results There is a significant relation between myalgia (p = 0.012 ), diarrhea( p = 0.007) and IgM positivity, and a significant relation between diarrhea and both IgG and IgM positivity (p = 0.005). Other symptoms had a non-significant relation with COVID-19 IgM or IgG. All symptoms suggestive of COVID-19 infection that were detected in our patients were not severe. During COVID-19 pandemic, glycemic control deteriorated in our patients as mean HbA1c reached 9.6% as compared to a mean level of 8.8% before COVID-19 pandemic. Conclusion Diabetes comorbidity did not increase the severity of COVID-19 symptoms to our patients. Glycemic control as indicated by HbA1c level showed deterioration during lockdown due to impaired access to care.

Duration and severity of COVID-19 symptoms among primary healthcare workers: A cross-sectional survey.

This study aims to investigate the epidemiological characteristics of COVID-19 infection among healthcare workers, including the severity, duration of infection, post-infection symptoms and related influencing factors. A self-administered questionnaire was utilized to assess the post-infection status of primary healthcare workers in Jiangsu Province. The questionnaire collected information on demographic characteristics, lifestyle habits, post-infection clinical manifestations, work environment and recovery time of the respondents. Customized outcome events were selected as dependent variables and logistic regression models were employed to analyse the risk factors. Phi-coefficient was used to describe the relationship between post-infection symptoms. The analysis revealed that several factors, such as female, older age, obesity, previous medical history, exposure to high-risk environments and stress, were associated with a higher likelihood of experiencing more severe outcomes. On the other hand, vaccination and regular exercise were found to contribute to an earlier resolution of the infection. Among the post-infection symptoms, cough, malaise and muscle aches were the most frequently reported. Overall, there was a weak association among symptoms persisting beyond 14 days, with only cough and malaise, malaise and dizziness and headache showing a stronger correlation. The study findings indicate that the overall severity of the first wave of infection, following the complete lifting of restrictions in China, was low. The impact on primary healthcare workers was limited, and the post-infection symptoms exhibited similarity to those observed in other countries. It is important to highlight that these conclusions are specifically relevant to the population infected with the Omicron variant. This study helps to grasp the impacts of the first wave of COVID-19 infections on healthcare workers in China after the national lockdown was lifted. Primary healthcare workers in Jiangsu Province, including doctors, nurses, pharmacists and other personnel from primary healthcare units such as community health service centres and health centres.

Predictors of somatic symptoms during the COVID-19 pandemic: a national longitudinal survey in Japan

ObjectivesThe COVID-19 pandemic has highlighted the long-term consequences of SARS-CoV-2 infection, termed long COVID. However, in the absence of comparative groups, the differentiation of disease progression remains difficult, as COVID-19...

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

The effect of COVID-19 on pain control in patients with a neurostimulator in situ- a retrospective study.

De-novo chronic neuropathic pain following COVID-19 is widely recognised. However, there are currently no published studies investigating the effect of SARS-CoV-2 infection on patients with pre-existing neuropathic pain who have required spinal cord stimulator (SCS) implantation. Here, the authors aimed to analyse outcomes in their institution's patients who had spinal cord stimulator (SCS) implantation or revision procedures to the system over a 5-year period. Specifically, the short-term and long-term outcomes of patients who contracted COVID-19 during the follow-up period were compared to the control group of patients who did not. Patients included in this study had spinal cord stimulator implantation (de-novo and revision procedures) between 1 January 2017 and 31 January 2022, for neuropathic pain of any aetiology. Patients deemed eligible for the study were invited to participate in a telephone survey through which clinical outcome data were collected. Pain scores were assessed with a modified form of the Brief Pain Inventory (BPI). Of 91 patients, 48 (52.7%) had contracted COVID-19 by the time of the survey. Patients who contracted COVID-19 had significantly worse BPI scores in the 'Least pain' domain following their infection and at time of the survey, when compared to their score 6 months after the operation. 22.9% (n = 11) of the patients who contracted COVID-19 experienced a change in their symptoms following their infection. Within this sub-group, there was a statistically significant deterioration in BPI scores in 10/11 domains following their infection and in 2/11 domains at time of the survey. Worsening severity of COVID-19 symptoms was not associated with worse BPI scores. Infection with SARS-CoV-2, in a significant proportion of patients with an SCS in situ, causes at least a transient deterioration in pain control. Further prospective multicentre studies are indicated to establish the prevalence of this phenomenon.

Factors Associated with Long COVID Recovery among US Adults

BackgroundWhile factors associated with long COVID (LC) continue to be illuminated, little is known about recovery. This study used national survey data to assess factors associated with recovery from LC. MethodsWe used data from the 2022 National Health Interview Survey, a cross-sectional sample of noninstitutionalized US adults. Survey analysis was used to account for oversampling and nonresponse bias and to obtain nationally representative estimates. A multivariable logistic regression model was used to identify potential predictors of LC recovery. ResultsAmong those reporting ever having COVID-19, 17.7% or an estimated 17.5 million American adults reported ever having LC, and among those with LC, 48.5% or an estimated 8.5 million reported having recovered. Multivariable logistic regression analysis showed that Hispanic adults were significantly more likely than White adults to report recovery from LC. At the same time, those with severe COVID-19 symptoms and those who had more than a high school degree, were aged 40 years or older, or were female were less likely to report recovery. ConclusionSignificant variations in LC recovery were noted across age, sex, race and ethnicity, education, and severity of COVID-19 symptoms. Further work is needed to elucidate the causes of these differences and identify strategies to increase recovery rates.

Associations between Tobacco Smoking and Self-Reported SARS-CoV-2/COVID-19 Infections, Disease Severity, and Duration in the German Population

Abstract: Background: Our aim was to assess, in the general German population, the association between tobacco smoking status and self-reported SARS-CoV-2 infection, COVID-19 symptom severity, and symptom duration. Methods: Cross-sectional household survey with face-to-face interviews of representative samples of the German population conducted between 02/2021-04/2022. Associations between smoking status (current, long-term ex-, never) and three self-reported outcomes (corona infection status, symptom severity, and symptom duration) were analysed with regression models, adjusted for a range of potential confounding factors, including vaccination status in a sub-sample. We also ran sensitivity analyses. Results: 872 people reported an infection (5.4 % of 16,028). There was no relevant and statistically significant association between current smoking and long-term ex-smoking compared with never smoking regarding ever being infected with corona (aOR=1.02, 95 %CI=0.86–1.20 and aOR=1.03, 95 %CI=0.83–1.28, respectively), symptom severity (aOR=0.84, 95 %CI=0.59–1.20 and aOR=0.88, 95 %CI=0.55–1.38, respectively), and symptom duration (aβ)=-0.09 months, 95 %CI=-0.45–0.28 and aβ=0.002 months, 95 %CI=-0.48–0.48). Sensitivity analyses examining the interaction between survey wave and smoking status showed that the risk of an infection increased over time, and this increase was higher in current smokers compared with never smokers. Conclusions: In the general German population smokers appear to be as likely to acquire a corona infection as long-term ex- and never smokers.

A Narrative Review on the Management of Severe COVID-19 Infection Using Stem Cell-based therapies with a Focus on the Registered Clinical Trials

The emergence of SARS-CoV-2 has led to a concerning global pandemic. The severity of COVID-19 symptoms may be enhanced due to underlying medical conditions. Several studies demonstrated severe COVID-19 infection can lead to innate and adaptive immune dysregulation, hypercytokinemia as well and the formation of fibro myxoid exudate in the respiratory alveolar, ultimately resulting in pulmonary fibrosis and ARDS as the leading cause of mortality and morbidity. Currently, there is a widespread global endeavor in finding efficient drugs or vaccines to manage COVID-19. Although some FDA-approved treatments have been introduced for COVID-19, alternative therapies might decrease the mortality rates. Various sources of stem cell-derived exosomes, pluripotent stem cells, and mesenchymal stem cells as cell-based therapies have been applied to moderate to severe COVID-19 patients with ARDS, leading to positive results. Cell-based therapies can probably inhibit tissue remodeling and subsequent end-organ damage by modulating the cytokine cascades and cellular apoptosis. The present review aims to discuss the advantages of stem cell-based therapies in the treatment of COVID-19 patients and the possible challenges associated with their application.

Persistent immune abnormalities discriminate post-COVID syndrome from convalescence

BackgroundInnate lymphoid cells (ILCs) are key organizers of tissue immune responses and regulate tissue development, repair, and pathology. Persistent clinical sequelae beyond 12 weeks following acute COVID-19 disease, named post-COVID syndrome (PCS), are increasingly recognized in convalescent individuals. ILCs have been associated with the severity of COVID-19 symptoms but their role in the development of PCS remains poorly defined.Methods and resultsHere, we used multiparametric immune phenotyping, finding expanded circulating ILC precursors (ILCPs) and concurrent decreased group 2 innate lymphoid cells (ILC2s) in PCS patients compared to well-matched convalescent control groups at > 3 months after infection or healthy controls. Patients with PCS showed elevated expression of chemokines and cytokines associated with trafficking of immune cells (CCL19/MIP-3b, FLT3-ligand), endothelial inflammation and repair (CXCL1, EGF, RANTES, IL-1RA, PDGF-AA).ConclusionThese results define immunological parameters associated with PCS and might help find biomarkers and disease-relevant therapeutic strategies.

A Narrative Review on the Management of Severe COVID-19 Infection Using Stem Cell-based therapies with a Focus on the Registered Clinical Trials

The emergence of SARS-CoV-2 has led to a concerning global pandemic. The severity of COVID-19 symptoms may be enhanced due to underlying medical conditions. Several studies demonstrated severe COVID-19 infection can lead to innate and adaptive immune dysregulation, cytokine storms as well and the formation of fibromyxoid exudate in the respiratory alveolar, ultimately resulting in pulmonary fibrosis and ARDS as the leading cause of mortality and morbidity. Currently, there is a widespread global endeavor in finding efficient drugs or vaccines to manage COVID-19. Although some FDA-approved treatments have been introduced for COVID-19, alternative therapies might decrease the mortality rates. Various sources of pluripotent and mesenchymal stem cells as cell-based therapies have been applied on moderate to severe COVID-19 patients with acute respiratory distress syndrome, leading to positive results. Cell-based therapies by modulating the cytokine cascades and cellular apoptosis can probably inhibit tissue remodeling and subsequent end-organ damage. The present review aims to discuss the advantages of stem cell-based therapies in the treatment of COVID-19 patients and the possible challenges associated with their application.

Prevalence and Obstetric Management Changes During the COVID-19 Pandemic in Peripartum SARS-CoV-2-Positive Women - an Analysis of the CRONOS Registry Data.

The analysis of CRONOS data for this article presents the infection prevalence among parturients and subsequent changes in obstetric management over time in Germany. 2,184 women with peripartum SARS-CoV-2 infection (<14d before birth) were included. Monthly period prevalence was calculated using the number of affected women on the CRONOS registry relative to total monthly births in each hospital from March 2020 to May 2022 and compared to RKI data. Trends related to changes in obstetric management were calculated based on severity of illness. By June 2021, the obstetric population shows a discretely higher infection prevalence compared to the general population, falling below the RKI reported prevalence by October 2021. The overall rate of iatrogenic deliveries remains unchanged over time (p-value for trend=0.779). During wave 1 to 4, deliveries due to SARS-CoV-2 infection rose among moderately to severely ill women (p-value for trend 0.0000) and was increased compared to moderately ill women (p=0.001). We showed that comprehensive screening provides timely information on infection prevalence. Recruitment fatigue caused by higher clinician workload due to increased admissions and more cases with severe illness probably caused reduced prevalence reporting. Changes in obstetric management were related to COVID-19 symptom severity. A comprehensive national perinatal registry is needed to examine other areas of perinatal care in Germany.

Patterns of corticosteroid use among remdesivir and matched patients and associated clinical outcomes in hospitalized COVID-19 patients

ABSTRACT Introduction We aimed to investigate patterns of corticosteroid use and their relationship with remdesivir use and clinical outcomes in a large real-life cohort of COVID-19 patients treated in a tertiary-level institution. Methods We retrospectively analyzed a total of 1558 severe and critical COVID-19 patients, including 779 patients treated with remdesivir and 779 matched control patients. Results A total of 167 (10.7%) patients received none, 710 (45.6%) low, 539 (34.6%) high, and 142 (9.1%) very high corticosteroid doses. Patients treated with remdesivir had significantly longer exposure to corticosteroids, received higher average and maximal daily doses, and cumulative corticosteroid doses. In the multivariate analysis remdesivir use, lower cumulative comorbidity burden, higher severity of COVID-19 symptoms, and mechanical ventilation were recognized as mutually independent predictors of the use of higher corticosteroid doses. Higher corticosteroid doses were associated with significantly increased mortality. Among non-remdesivir treated patients, there was a U-shaped relationship between maximal daily corticosteroid dose and mortality. Among remdesivir treated patients gradual increase in mortality with increasing corticosteroid doses was observed. Conclusion Patterns of corticosteroid use differ regarding the use of remdesivir and may moderate its association with survival among severe and critical COVID-19 patients.

The rs11385942 and rs657152 variants are not associated with COVID-19 severity and outcomes in patients treated with favipiravir and remdesivir

Background. There is a mounting evidence in the scientific literature that susceptibility to SARS-CoV-2 infection could vary. The severity of COVID-19 symptoms can range from asymptomatic to severe respiratory failure, requiring prolonged artificial ventilation. The underlying causes of this range of clinical manifestations remain unclear. Identification of the risk factors that may cause this variation in clinical symptoms is important for identifying the most susceptible populations at highest risk. This should help improve prevention measures, reduce hospitalizations, and decrease the mortality rate of the disease. Previously, an association has been found between the severity of COVID-19 and the genetic markers rs11385942 G&gt;GA and rs657152 A&gt;C.The aim. To assess the impact of carrying polymorphic markers rs11385942 G&gt;GA and rs657152 A&gt;C on the severity of COVID-19 in patients undergoing specific therapy. Materials and methods. A total of 240 patients hospitalized with a coronavirus infection were included in the study. All patients received therapy with favipiravir or remdesivir. The presence of the rs11385942 G&gt;GA and rs657152 A&gt;C variants was determined in all patients. The study compared the length of hospital stays, frequency of patient transfers to the intensive care unit (ICU), and frequency of clinical outcomes (recovery or death) among carriers of allelic variants of the markers under investigation.Results. There were no significant associations between the carriage of variants rs11385942 G&gt;GA and rs657152 A&gt;C and the duration of patients’ hospitalization, frequency of patient transfers to the ICU, and patient outcomes.Conclusion. The carriage of rs11385942 G&gt;GA and rs657152 A&gt;C variants did not affect the severity or type of clinical outcomes in patients with COVID-19.

Moderación por el género de los efectos del encuadre visual de mensajes COVID-19 sobre emociones negativas

Un reciente meta-análisis reveló que mensajes persuasivos enmarcados en ganancias inducen emociones positivas en la audiencia mientras que mensajes encuadrados en pérdidas inducen emociones negativas; más aún, la experiencia de emociones positivas potencia la influencia de los encuadramientos de ganancia mientras que las emociones negativas aumentan los efectos de los enmarques de pérdida. Esto sugiere que los efectos de los encuadres de ganancia versus pérdida en la adherencia del público al mensaje son mediados por emociones. Como se sabe que las mujeres experimentan más emociones negativas que los hombres, en el presente estudio exploratorio nosotros evaluamos sesgos de género en las emociones negativas inducidas por imágenes que acompañaban a textos con recomendaciones nutricionales para prevenir la severidad de los síntomas de COVID-19. Los textos estuvieron encuadrados en no-pérdidas. Usando fotos de un ataúd versus una familia, encontramos una robusta interacción imagen x género entre trabajadores de un hospital en Lima, Perú: mientras que el ataúd tendía a aumentar las emociones negativas de las mujeres, aquellas de los hombres presentaban una tendencia opuesta. Así, concluimos que la intervención de emociones en un mismo proceso de persuasión puede terminar en adherencias diferentes de hombres y mujeres al mensaje y esto debe estudiarse. Los investigadores que ignoren la variable género en el encuadramiento visual de mensajes pueden arribar a conclusiones distorsionadas.

Investigating the effects of SARS-CoV-2 genetic mutations: Transmissibility, clinical severity, diagnostic implications and case study vaccine designs

SARS-CoV-2 comprises a diverse group of viruses responsible for illnesses ranging from the common cold to more serious respiratory diseases. Among coronaviruses, the four primary subgroups of note are Alphacoronavirus, Beta, Gamma, and Delta coronavirus. This paper examines genetic mutations on the transmissibility of variants in comparison to the original strains, emphasizing the potential consequences for pathogenicity and transmissibility. It underscores the significance of identifying genomic variants and their correlation with viral infectivity and COVID-19 severity to facilitate pandemic control and evolution investigation. Furthermore, the review paper explores the intricate relationship between specific mutations and the severity of COVID-19 symptoms, drawing on global data from clinical studies and surveillance to aid healthcare professionals in resource allocation and tailored treatment strategies. The review encompasses analyses of symptom severity, variations in clinical outcomes among different SARS-CoV-2 variants, and innovative approaches such as reverse vaccinology and adapted vaccines targeting Omicron subvariants. These findings collectively contribute to our understanding of the evolving pandemic and offer potential solutions for its mitigation and control.

Frequency, Characteristics, and Correlates of Cognitive Complaints in a Cohort of Individuals with Post-Acute Sequelae of COVID-19.

Cognitive complaints are among the most frequent symptoms of post-acute sequelae of COVID-19 (PASC). This study aimed to investigate the frequency, characteristics, and clinical correlates of cognitive complaints (CC) in PASC, particularly in relation to objective neuropsychological (NP) performance. Seventy-four participants underwent psychiatric, medical, and NP testing approximately 7 months after acute COVID-19. The Patient Assessment of Own Functioning Inventory (PAOFI) was used to characterize the frequency and severity of CC in domains of memory, language, and cognitive/executive function. The associations of CC with sociodemographic, medical, psychiatric, and NP variables were assessed utilizing correlational analysis, logistic regression, and pairwise comparisons of those categorized as having CC vs. not having CC. Taken together, approximately one-third of the study participants had clinically significant CC. Memory difficulty was the most frequent CC, although all categories were frequently endorsed. Memory and cognitive/executive complaints correlated with NP tests in these and multiple other NP domains. CC were more likely to be under-reported in those with diminished NP performance than over-reported in those without diminished performance. Acute COVID-19 symptom severity, elevated depressive symptoms, and NP tests of diminished attention and psychomotor processing speed were independent predictors of CC in logistic regression. Cognitive complaints after acute COVID-19 should be taken seriously, as they are likely to reflect diminished NP performance, as well as medical, psychiatric, and functional burdens. However, patients with PASC may not accurately identify or characterize objective cognitive difficulties, so programs offering comprehensive care for patients with PASC should offer formal neuropsychological testing.

Clinical signs, symptoms, and severity of COVID-19 in patients with rheumatic diseases during the COVID-19 epidemic

Introduction: Recent studies have shown that patients with rheumatic diseases are more likely to experience severe cases of COVID-19. Additionally, certain anti-inflammatory medications have been linked to a reduction in the severity of COVID-19 symptoms. Objectives: This cross-sectional study aimed to determine the frequency of clinical signs, symptoms, and severity of COVID-19 in outpatients with rheumatic diseases. Patients and Methods: A total of 77 patients with rheumatic disorders who were diagnosed with COVID-19 and referred to Isfahan rheumatology clinics in 2020 were selected for this study. The study investigated their clinical signs, symptoms, severity of COVID-19, type of rheumatic disease, and the medications they were using. Furthermore, the study examined the relationship between the severity of COVID-19 and the type of rheumatic disease. Results: Among the 77 patients, 79.2% had rheumatoid arthritis (RA), 9.1% had systemic lupus erythematosus (SLE), 9.1% had Sjogren’s syndrome, and 2.6% had other rheumatic disorders. The severity of COVID-19 was classified as mild in 40.3% of cases, moderate in 44.2%, and severe in 15.6%. There was no statistically significant relationship between the type of rheumatic disease and the severity of COVID-19 (P=0.093). Conclusion: The findings suggest that patients with rheumatic diseases are more likely to experience severe cases of COVID-19. Conversely, the combination of hydroxychloroquine, sulfasalazine, and prednisolone has been associated with a lower prevalence of severe cases of COVID-19. In contrast, the administration of methotrexate and prednisolone has been linked to a higher prevalence of severe cases of COVID-19.

COVID-19 effects on mental health of children and adolescents with intellectual disabilities in North Kosovo

Background. People with intellectual disabilities (ID) are susceptible to physical, mental and social implications of the COVID-19 pandemic. Aim. Learning the way young individuals with disabilities dealt with the COVID-19 pandemic and how it affected their lives. Materials and Methods. An epidemiological questionnaire including information on the person’s health, mental state, behavior, educational capabilities, and epidemiological and clinical features of the COVID-19 infection was completed by 41 children/young adults and their family members. Results. During the two-year period of the pandemic, we monitored the frequency of COVID-19 infection in children and adolescents with intellectual disorders, children’s mental condition, and the occurrence of post-COVID symptoms. We also discussed the role of society regarding economic stability and support for families with a disabled member. Conclusions. The severity of COVID-19 symptoms was the independent predictor of mental status deterioration. Children and adolescents with ID experienced a greater prevalence of COVID-19 infection as well as post-COVID sequelae.

Sex differences in COVID-19 symptom severity and trajectories among ambulatory adults.

The ongoing COVID-19 pandemic has led to hundreds of millions of infections worldwide. Although differences in COVID-19 hospitalization rates between males and females have been described, many infections in the general population have been mild, and the severity of symptoms during the course of COVID-19 in non-hospitalized males and females is not well understood. We conducted a case-ascertained study to examine household transmission of SARS-CoV-2 infections in Nashville, Tennessee, between April 2020 and April 2021. Among enrolled ambulatory adult participants with laboratory-confirmed SARS-CoV-2 infections, we assessed the presence and severity of symptoms (total, systemic, and respiratory) daily using a symptoms severity questionnaire, from illness onset and throughout the 2-week follow-up period. We compared the mean daily symptom severity scores (0-3: none, mild, moderate, and severe) and change in symptoms between males and females using a multivariable linear mixed effects regression model. The analysis included 223 enrolled adults with SARS-CoV-2 infection (58% females, mostly white, non-Hispanic) from 146 households with 2917 total daily symptom reports. The overall mean severity of total symptoms reported over the illness period was 1.04 and 0.90 for females and males, respectively. Mean systemic and respiratory scores were higher for females than for males (p< 0.001). In multivariable analyses, females reported more severe total and systemic symptoms during the illness period compared with males. However, no significant differences in reported respiratory symptoms were observed. Our findings indicate that among ambulatory adults with SARS-CoV-2 infections, females reported slightly higher symptom severity during their illness compared with males.

Development of an Oral IgA Response against SARS-CoV-2 Following Immunization with Different COVID-19 Vaccines.

The mucosal immune response is recognized to be important in the early control of infection sustained by viruses with mucosal tissues as the primary site of entry and replication, such as SARS-CoV-2. Mucosal IgA has been consistently reported in the mouth and eye of SARS-CoV-2 infected subjects, where it correlated inversely with COVID-19 symptom severity. Yet, there is still scarce information on the comparative ability of the diverse SARS-CoV-2 vaccines to induce local IgA responses at the virus entry site. Thus, the aim of this study was to assess the presence of anti-SARS-CoV-2 IgA in the saliva of 95 subjects vaccinated with a booster dose and different combinations of vaccines, including mRNA-1273 (Moderna), BNT162b2 (Pfizer-BioNTech), and Vaxzevria (AstraZeneca). The results showed the presence of a mucosal response in 93.7% of vaccinated subjects, with a mean IgA titer of 351.5 ± 31.77 U/mL, strongly correlating with the serum anti-SARS-CoV-2 IgG titer (p < 0.0001). No statistically significant differences emerged between the vaccine types, although the salivary IgA titer appeared slightly higher after receiving a booster dose of the mRNA-1273 vaccine (Moderna) following two doses of BNT162b2 (Pfizer-BioNTech), compared to the other vaccine combinations. These data confirm what was previously reported at the eye level and suggest that monitoring salivary IgA may be a useful tool for driving forward vaccine design and surveillance strategies, potentially leading to novel routes of vaccine administration and boosting.