Symptomatic COVID-19 Disease Research Articles

Epidemiology and risk factors related to severity of clinical manifestations of COVID-19 in outpatients: A retrospective study in Haiti.

BackgroundHaiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations.MethodsWe conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease.ResultsOf 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%), and myalgia (45.8%). The odds of having moderate-to-severe disease were highest among persons with hypertension (aOR = 1.72, 95% Confidence Interval [CI] (1.34, 2.20), chronic pulmonary disease (aOR = 3.93, 95% CI (1.93, 8.17)) and tuberculosis (aOR = 3.44, 95% CI (1.35, 9.14)) compared to persons without those conditions. The odds of having moderate-to-severe disease increased with age but was also seen among children aged 0–4 years (OR: 1.73, 95% CI (0.93, 3.08)), when using 30–39 years old as the reference group. All of the older age groups, 50–64 years, 65–74 years, 75–84 years, and 85+ years, had significantly higher odds of having moderate-to-severe COVID-19 compared with ages 30–39 years. Diabetes was associated with elevated odds of moderate-to-severe disease in bivariate analysis (OR = 2.17, 95% CI (1.58,2.98) but, this association did not hold in multivariable analyses (aOR = 1.22,95%CI (0.86,1.72)).ConclusionThese findings from a resource-constrained country highlight the importance of surveillance systems to track emerging infections and their risk factors. In addition to co-morbidities described elsewhere, tuberculosis was a risk factor for moderate-to-severe COVID-19 disease.

A comprehensive review of BBV152 vaccine development, effectiveness, safety, challenges, and prospects.

The world has responded to the COVID-19 pandemic with unprecedented speed and vigor in the mass vaccination campaigns, targeted to reduce COVID-19 severity and mortality, reduce the pressure on the healthcare system, re-open society, and reduction in disease mortality and morbidity. Here we review the preclinical and clinical development of BBV152, a whole virus inactivated vaccine and an important tool in the fight to control this pandemic. BBV152, formulated with a TLR7/8 agonist adjuvant generates a Th1-biased immune response that induces high neutralization efficacy against different SARS-CoV-2 variants of concern and robust long-term memory B- and T-cell responses. With seroconversion rates as high as 98.3% in vaccinated individuals, BBV152 shows 77.8% and 93.4% protection from symptomatic COVID-19 disease and severe symptomatic COVID-19 disease respectively. Studies in pediatric populations show superior immunogenicity (geometric mean titer ratio of 1.76 compared to an adult) with a seroconversion rate of >95%. The reactogenicity and safety profiles were comparable across all pediatric age groups between 2-18 yrs. as in adults. Like most approved vaccines, the BBV152 booster given 6 months after full vaccination, reverses a waning immunity, restores the neutralization efficacy, and shows synergy in a heterologous prime-boost study with about 3-fold or 300% increase in neutralization titers against multiple SARS-CoV-2 variants of concern. Based on the interim Phase III data, BBV152 received full authorization for adults and emergency use authorization for children from ages 6 to 18 years in India. It is also licensed for emergency use in 14 countries globally. Over 313 million vaccine doses have already been administered in India alone by April 18th, 2022.

Early Effectiveness of Four SARS-CoV-2 Vaccines in Preventing COVID-19 among Adults Aged ≥60 Years in Vojvodina, Serbia.

Real-world evidence of the vaccine effectiveness (VE) of different COVID-19 vaccines is needed in order to better shape vaccine recommendations and policies and increase vaccine acceptance, especially among vulnerable populations such as the elderly. We analyzed the early effectiveness of four COVID-19 vaccines, namely BNT162b2, BBIBP-CorV, Gam-COVID-Vac and ChAdOx1 nCoV-19 in population aged ≥60 years for symptomatic, mild and severe COVID-19, in the period January–April 2021 in Vojvodina, a northern province of Serbia. Incidence rates of SARS-CoV-2 infection were calculated using data from the provincial COVID-19 surveillance registry, and vaccination coverage data were obtained from the nationwide registry of administered COVID-19 vaccines. During the observation period, 134,535 subjects aged ≥60 years were fully vaccinated, of whom 87.7% received BBIBP-CorV, 7.1% BNT162b2 and 5.2% Gam-COVID-Vac vaccines. The estimated VE in fully vaccinated persons was 86.9% (95% CI, 86–87.7) for BBIBP-CorV, 95% (95% CI, 92.4–96.7) for Gam-COVID-Vac and 99% (95% CI, 97.8–99.5) for BNT162b2, while VE after the first dose of ChAdOx1 nCoV-19 was 88.6% (95% CI, 80.5–93.4). Estimates were similar when stratifying the analyses to severe and mild SARS-CoV-2 infections. Our analysis provides evidence of high early effectiveness of BNT162b2, BBIBP-CorV, Gam-COVID-Vac and ChAdOx1 nCoV-19 in elderly people in preventing symptomatic, severe and mild COVID-19 disease, particularly after being fully vaccinated.

Prevalence of Liver Injury in 445 Patients with Corona Virus Disease-19

Background and Aim: Severe acute respiratory syndrome COVID-19 disease patients are susceptible to abnormal liver function and its prevalence varies from 16 to 52%. The present study aimed to assess the incidence of liver injuries in 445 patients with COVID-19 infections. Methodology: This retrospective study was carried out on 445 COVID-19 infected patients in the department of Gastroenterology, Northwest General Hospital & Research Centre Hayatabad Peshawar and Bacha Khan Medical Complex, Swabi for the duration of six-months from February 2021 to July, 2021. The patient’s demographic details, COVID symptoms, laboratory tests, and previous illness history were recorded. COVID-19 was diagnosed through Reverse transcriptase-polymerase chain reaction (RT- PCR) via oropharyngeal and nasopharyngeal swabs. Ethical approval was taken from the institutional ethical committee. SPSS version 21 was used for data analysis. Results: Of the total 445 COVID-19 infected patients, the incidence of elevated, mild elevated, moderately elevated, and severely elevated Aspartate transaminase (AST) was 208 (46.8%), 47 (10.6%), 10 (2.3%), and 4 (0.9%) respectively. The prevalence of symptomatic abnormal liver was 89% compared to asymptomatic 81% at p=0.001). Moderate, mild, and elevated Alanine transaminase (ALT) was 1.2%, 10.9%, and 29.8% respectively. The incidence of respiratory symptoms and loose stool was 44.2% and 12.3% compared to 30.3% and 3.8% respectively. Abnormal liver patients were more susceptible to severe COVID-19 disease 26.7% compared to 14.2%. Conclusion: Our study found that patients with COVID-19 had a high rate of liver test abnormalities. The majority of the patients had transaminase elevations that were borderline or mild. Abnormal liver disease patients are more susceptible to symptomatic disease, mortality, and severe COVID-19 disease. Keywords: Prevalence, COVID-19 disease, Liver Injuries

Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression

SummaryBackgroundKnowing whether COVID-19 vaccine effectiveness wanes is crucial for informing vaccine policy, such as the need for and timing of booster doses. We aimed to systematically review the evidence for the duration of protection of COVID-19 vaccines against various clinical outcomes, and to assess changes in the rates of breakthrough infection caused by the delta variant with increasing time since vaccination.MethodsThis study was designed as a systematic review and meta-regression. We did a systematic review of preprint and peer-reviewed published article databases from June 17, 2021, to Dec 2, 2021. Randomised controlled trials of COVID-19 vaccine efficacy and observational studies of COVID-19 vaccine effectiveness were eligible. Studies with vaccine efficacy or effectiveness estimates at discrete time intervals of people who had received full vaccination and that met predefined screening criteria underwent full-text review. We used random-effects meta-regression to estimate the average change in vaccine efficacy or effectiveness 1–6 months after full vaccination.FindingsOf 13 744 studies screened, 310 underwent full-text review, and 18 studies were included (all studies were carried out before the omicron variant began to circulate widely). Risk of bias, established using the risk of bias 2 tool for randomised controlled trials or the risk of bias in non-randomised studies of interventions tool was low for three studies, moderate for eight studies, and serious for seven studies. We included 78 vaccine-specific vaccine efficacy or effectiveness evaluations (Pfizer–BioNTech-Comirnaty, n=38; Moderna-mRNA-1273, n=23; Janssen-Ad26.COV2.S, n=9; and AstraZeneca-Vaxzevria, n=8). On average, vaccine efficacy or effectiveness against SARS-CoV-2 infection decreased from 1 month to 6 months after full vaccination by 21·0 percentage points (95% CI 13·9–29·8) among people of all ages and 20·7 percentage points (10·2–36·6) among older people (as defined by each study, who were at least 50 years old). For symptomatic COVID-19 disease, vaccine efficacy or effectiveness decreased by 24·9 percentage points (95% CI 13·4–41·6) in people of all ages and 32·0 percentage points (11·0–69·0) in older people. For severe COVID-19 disease, vaccine efficacy or effectiveness decreased by 10·0 percentage points (95% CI 6·1–15·4) in people of all ages and 9·5 percentage points (5·7–14·6) in older people. Most (81%) vaccine efficacy or effectiveness estimates against severe disease remained greater than 70% over time.InterpretationCOVID-19 vaccine efficacy or effectiveness against severe disease remained high, although it did decrease somewhat by 6 months after full vaccination. By contrast, vaccine efficacy or effectiveness against infection and symptomatic disease decreased approximately 20–30 percentage points by 6 months. The decrease in vaccine efficacy or effectiveness is likely caused by, at least in part, waning immunity, although an effect of bias cannot be ruled out. Evaluating vaccine efficacy or effectiveness beyond 6 months will be crucial for updating COVID-19 vaccine policy.FundingCoalition for Epidemic Preparedness Innovations.

Episcleritis and sub-conjunctival haemorrhage in Post- acute COVID-19 patients - A case series

The research on COVID-19 is mainly focused on the respiratory system for survival rate improvement. In recent days, the affect of the disease on other organs including eye has been reported.However, a lot of research and data is needed to understand the pathophysiology and develop effective treatment strategies.In the present study, we report a series of 8 patients who presented themselves in the hospital with complaints of redness in the eye. All these patients had a history of COVID-19 illness during preceding one month. Patients were diagnosed with epislecritis and/or sub-conjunctival haemorrhage using clinical evaluation. They were put on topical steriods and ganciclovir. All the patients improved/recovered within 10 days of presentation. Our study reports the ocular manifestations- episcleritis and sub-conjunctival haemorrhage as Post-acute COVID-19 symptom in cases of lab positive and symptomatic mild COVID-19 disease. These ocular manifestations have been otherwise reported during acute phase or as one of the early signs of infections. Mild cases of COVID-19 presented themselves with episcelritis and/or sub-conjunctival haemorrhage after acute phase (3- 4 weeks after commencement of infections). This highlights that SARS-COV-2 leads to hemorrhagic and inflammatory response in the eyes as a sequelae, well beyond the period when replication-competent SARS-CoV-2 have not been isolated.

SAFETY AND EFFECTIVENESS OF THE BNT162B2 MRNA COVID-19 VACCINE IN A NATIONWIDE COHORT OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE

BACKGROUND & AIMSThe effectiveness of currently available SARS-CoV-2 vaccines in patients with inflammatory bowel disease (IBD) remains unknown. We aimed to determine the effectiveness of the Pfizer-BNT162b2 mRNA vaccine in a nationwide cohort of patients with IBD in Qatar.METHODSUsing a cohort design, we compared 476 IBD patients vaccinated identified between January 1, 2021, and March 31, 2021, with 476 matched unvaccinated controls (matched on age and date of SARS-CoV-2 testing). Study outcomes included documented SARS-CoV-2 infection, symptomatic COVID-19, and COVID-19 related hospitalization. We also studied the side effects of the vaccination, including the effect on IBD exacerbation and hospitalizations related to adverse events.RESULTSTotal follow-up was 23,289 person-days for the vaccinated and 23,653 person-days for the unvaccinated group. Vaccine effectiveness >14 days [AAB1] after the second dose was 85.1% (95% CI: 65.2, 93.6) for confirmed infection, and 87.1% (95% CI: 63.6, 95.4)[AAB2] for symptomatic infection. No patient required hospitalization >14 days after the second vaccine dose. Estimated vaccine effectiveness between 22 to 35 days after the first dose was 14.8% (95% CI: -151.5, 71.2) [AAB3] for any documented infection, and 59.8% (95% CI: -106.1, 92.2) for symptomatic COVID-19 disease. For patients taking biologics with or without immunomodulators, vaccine effectiveness >14 days after the second dose was 94% (95% CI: 53.1, 99.2), and 92.7% (95% CI: 45.1, 99.0) for any documented infection and symptomatic COVID-19 respectively. Vaccine effectiveness was 87.4% (95% CI: 46.0, 97.1) for any documented infection and 91.7% (95% CI: 37.2, 98.9) for symptomatic COVID-19 during the same period for patients taking immunomodulators alone. None of the vaccinated patients required intensive care unit admission or died. No patient had IBD exacerbation or required hospitalization for vaccination-related adverse events.CONCLUSIONIn a nationwide cohort of IBD patients, the BNT162b2 mRNA vaccine was safe and highly effective.

SAFETY AND EFFECTIVENESS OF THE BNT162B2 MRNA COVID-19 VACCINE IN A NATIONWIDE COHORT OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE

The effectiveness of currently available SARS-CoV-2 vaccines in patients with inflammatory bowel disease (IBD) remains unknown. We aimed to determine the effectiveness of the Pfizer-BNT162b2 mRNA vaccine in a nationwide cohort of patients with IBD in Qatar. Using a cohort design, we compared 476 IBD patients vaccinated identified between January 1, 2021, and March 31, 2021, with 476 matched unvaccinated controls (matched on age and date of SARS-CoV-2 testing). Study outcomes included documented SARS-CoV-2 infection, symptomatic COVID-19, and COVID-19 related hospitalization. We also studied the side effects of the vaccination, including the effect on IBD exacerbation and hospitalizations related to adverse events. Total follow-up was 23,289 person-days for the vaccinated and 23,653 person-days for the unvaccinated group. Vaccine effectiveness >14 days [AAB1] after the second dose was 85.1% (95% CI: 65.2, 93.6) for confirmed infection, and 87.1% (95% CI: 63.6, 95.4)[AAB2] for symptomatic infection. No patient required hospitalization >14 days after the second vaccine dose. Estimated vaccine effectiveness between 22 to 35 days after the first dose was 14.8% (95% CI: -151.5, 71.2) [AAB3] for any documented infection, and 59.8% (95% CI: -106.1, 92.2) for symptomatic COVID-19 disease. For patients taking biologics with or without immunomodulators, vaccine effectiveness >14 days after the second dose was 94% (95% CI: 53.1, 99.2), and 92.7% (95% CI: 45.1, 99.0) for any documented infection and symptomatic COVID-19 respectively. Vaccine effectiveness was 87.4% (95% CI: 46.0, 97.1) for any documented infection and 91.7% (95% CI: 37.2, 98.9) for symptomatic COVID-19 during the same period for patients taking immunomodulators alone. None of the vaccinated patients required intensive care unit admission or died. No patient had IBD exacerbation or required hospitalization for vaccination-related adverse events. In a nationwide cohort of IBD patients, the BNT162b2 mRNA vaccine was safe and highly effective.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Promising Effects of 3-Month Period of Quercetin Phytosome® Supplementation in the Prevention of Symptomatic COVID-19 Disease in Healthcare Workers: A Pilot Study.

Quercetin, for its crucial properties, fulfills the need for a multifactor action that is useful for the potential counterbalance of a COVID-19 infection. Given this background, the aim of the study was to evaluate the potential effect of 3 months’ supplementation with Quercetin Phytosome® (250 mg twice a day) as prevention against symptomatic COVID-19. In total, 120 subjects were enrolled (males, 63; females, 57; age 49 ± 12), with 60 in the supplementation group and 60 in the placebo group. No significant differences were detected between groups in terms of gender, smoking, and chronic disease. Subjects underwent rapid COVID-19 diagnostic tests every 3 weeks. During our study, 5 subjects had COVID-19, 1 out of 60 subjects in the quercetin group and 4 out of 60 in the control group. Complete clinical remission was recorded at 7 and 15 days in the quercetin and placebo groups, respectively. Analysis showed that, at 5 months, the COVID free survival function (risk of infection) was 99.8% in subjects under quercetin supplementation and 96.5% in control group. As shown by the value of EXP(B), those who had taken the supplement had a protection factor of 14% more to not contract the COVID-19 infection than that of those who had taken a placebo. Obtained results are encouraging, but further studies are required to add quercetin as regular prophylaxis.

Life Sciences Discovery and Technology Highlights

Life Sciences Discovery and Technology Highlights

Efficacy, safety, and lot-to-lot immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152): interim results of a randomised, double-blind, controlled, phase 3 trial

BackgroundWe report the clinical efficacy against COVID-19 infection of BBV152, a whole virion inactivated SARS-CoV-2 vaccine formulated with a toll-like receptor 7/8 agonist molecule adsorbed to alum (Algel-IMDG) in Indian adults.MethodsWe did a randomised, double-blind, placebo-controlled, multicentre, phase 3 clinical trial in 25 Indian hospitals or medical clinics to evaluate the efficacy, safety, and immunological lot consistency of BBV152. Adults (age ≥18 years) who were healthy or had stable chronic medical conditions (not an immunocompromising condition or requiring treatment with immunosuppressive therapy) were randomised 1:1 with a computer-generated randomisation scheme (stratified for the presence or absence of chronic conditions) to receive two intramuscular doses of vaccine or placebo administered 4 weeks apart. Participants, investigators, study coordinators, study-related personnel, the sponsor, and nurses who administered the vaccines were masked to treatment group allocation; an unmasked contract research organisation and a masked expert adjudication panel assessed outcomes. The primary outcome was the efficacy of the BBV152 vaccine in preventing a first occurrence of laboratory-confirmed (RT-PCR-positive) symptomatic COVID-19 (any severity), occurring at least 14 days after the second dose in the per-protocol population. We also assessed safety and reactogenicity throughout the duration of the study in all participants who had received at least one dose of vaccine or placebo. This report contains interim results (data cutoff May 17, 2021) regarding immunogenicity and safety outcomes (captured on days 0 to 56) and efficacy results with a median of 99 days for the study population. The trial was registered on the Indian Clinical Trials Registry India, CTRI/2020/11/028976, and ClinicalTrials.gov, NCT04641481 (active, not recruiting).FindingsBetween Nov 16, 2020, and Jan 7, 2021, we recruited 25 798 participants who were randomly assigned to receive BBV152 or placebo; 24 419 received two doses of BBV152 (n=12 221) or placebo (n=12 198). Efficacy analysis was dependent on having 130 cases of symptomatic COVID-19, which occurred when 16 973 initially seronegative participants had at least 14 days follow-up after the second dose. 24 (0·3%) cases occurred among 8471 vaccine recipients and 106 (1·2%) among 8502 placebo recipients, giving an overall estimated vaccine efficacy of 77·8% (95% CI 65·2–86·4). In the safety population (n=25 753), 5959 adverse events occurred in 3194 participants. BBV152 was well tolerated; the same proportion of participants reported adverse events in the vaccine group (1597 [12·4%] of 12 879) and placebo group (1597 [12·4%] of 12 874), with no clinically significant differences in the distributions of solicited, unsolicited, or serious adverse events between the groups, and no cases of anaphylaxis or vaccine-related deaths.InterpretationBBV152 was highly efficacious against laboratory-confirmed symptomatic COVID-19 disease in adults. Vaccination was well tolerated with no safety concerns raised in this interim analysis.FundingBharat Biotech International and Indian Council of Medical Research.

Covid-19 vaccines and variants of concern: A review.

Since the outbreak of coronavirus disease 2019 (Covid‐19) in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the number of confirmed infections has risen to more than 242 million worldwide, with nearly 5 million deaths. Currently, nine Covid‐19 vaccine candidates based on the original Wuhan‐Hu‐1 strain are at the forefront of vaccine research. All nine had an efficacy over 50% against symptomatic Covid‐19 disease: NVX‐CoV2373 (∼96%), BNT162b2 (∼95%), mRNA‐1273 (∼94%), Sputnik V (∼92%), AZD1222 (∼81%), BBIBP‐CorV (∼79%), Covaxin (∼78%), Ad26.CoV.S (∼66%) and CoronaVac (∼51%). However, vaccine efficacy (VE) can be jeopardised by the rapid emergence and spread of SARS‐CoV‐2 variants of concern (VOCs) that could escape from neutralising antibodies and/or cell‐mediated immunity. Rare adverse events have also been reported soon after administration of viral vector and mRNA vaccines. Although many Covid‐19 vaccines have been developed, additional effective vaccines are still needed to meet the global demand. Promising Covid‐19 vaccines such as WIBP‐CorV, AD5‐nCOV, ZyCoV‐D, CVnCoV, EpiVacCorona and ZF2001 have advanced to clinical studies. This review describes the most relevant mutations in the SARS‐CoV‐2 spike protein, discusses VE against VOCs, presents rare adverse events after Covid‐19 vaccination and introduces some promising Covid‐19 vaccine candidates.

Variant SARS-CoV-2 mRNA vaccines confer broad neutralization as primary or booster series in mice

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of a global pandemic. Safe and effective COVID-19 vaccines are now available, including mRNA-1273, which has shown 94% efficacy in prevention of symptomatic COVID-19 disease. However, the emergence of SARS-CoV-2 variants has led to concerns of viral escape from vaccine-induced immunity. Several variants have shown decreased susceptibility to neutralization by vaccine-induced immunity, most notably B.1.351 (Beta), although the overall impact on vaccine efficacy remains to be determined. Here, we present the initial evaluation in mice of 2 updated mRNA vaccines designed to target SARS-CoV-2 variants: (1) monovalent mRNA-1273.351 encodes for the spike protein found in B.1.351 and (2) mRNA-1273.211 comprising a 1:1 mix of mRNA-1273 and mRNA-1273.351. Both vaccines were evaluated as a 2-dose primary series in mice; mRNA-1273.351 was also evaluated as a booster dose in animals previously vaccinated with mRNA-1273. The results demonstrated that a primary vaccination series of mRNA-1273.351 was effective at increasing neutralizing antibody titers against B.1.351, while mRNA-1273.211 was effective at providing broad cross-variant neutralization. A third (booster) dose of mRNA-1273.351 significantly increased both wild-type and B.1.351-specific neutralization titers. Both mRNA-1273.351 and mRNA-1273.211 are being evaluated in pre-clinical challenge and clinical studies.

Change in cigarette dependence among a cohort of smokers following COVID-19 diagnosis in Kashmir valley: An observational follow-up study

Background: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate the change in cigarette dependence among newly diagnosed COVID-19 cases. Aims and Objectives: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate change in cigarette dependence among newly diagnosed COVID-19 cases. Materials and Methods: Study was conducted between October and December 2020 and newly diagnosed male COVID-19 patients who were current smokers at diagnosis were recruited from two hospitals involved in testing and treatment of COVID-19. Baseline socioclinical information was recorded at diagnosis in addition to the estimation of cigarette dependence using Fagerstrom Test for Nicotine Dependence (FTND) and health status using Post-COVID-19 Functional Scale (PCFS). Follow-up was done at 2 weeks after recovery using both FTND and PCFS scales. Wilcoxon signed-rank test, paired t-test, and ANOVA were used for univariate analysis and multivariate regression was done. Results: A total of 171 subjects with mean age of 43.79 years were included in the study. FTND scores decreased significantly from the day of diagnosis to follow-up visit with 79% of subjects reporting a decrease. On univariate analysis, decrease in FTND had a significant association with presence of comorbidity, any symptoms, presence of respiratory symptoms, and if supplemental oxygen was administered. On multivariate analysis, symptomatic COVID-19 disease, higher age, PCFS at baseline, and PCFS at follow-up had a significant association with decreased PCFS values at follow-up. Conclusion: COVID-19 diagnosis was followed by significant decrease in FTND score, particularly for symptomatic and older subjects. Post-COVID follow-up visits should be used asan opportunity by health providers to ensure its sustainability and for achieving cessation.

Long-term persistence of SARS-CoV-2 neutralizing antibody responses after infection and estimates of the duration of protection.

BackgroundThe duration of immunity in SARS-CoV-2 infected people remains unclear. Neutralizing antibody responses are the best available correlate of protection against re-infection. Recent studies estimated that the correlate of 50% protection from re-infection was 20% of the mean convalescent neutralizing antibody titre.MethodsWe collected sera from a cohort of 124 individuals with RT-PCR confirmed SARS-CoV-2 infections from Prince of Wales Hospital, Princess Margaret Hospital, Queen Elizabeth Hospital and Queen Mary Hospitals of the Hospital Authority of Hong Kong, for periods up to 386 days after symptom onset and tested these for antibody to SARS-CoV-2 using 50% virus plaque reduction neutralization tests (PRNT50), surrogate neutralization tests and spike receptor binding domain (RBD) binding antibody. Patients were recruited from 21 January 2020 to 16 February 2021 and follow-up samples were collected until 9th March 2021.FindingsBecause the rate of antibody waning slows with time, we fitted lines of decay to 115 sera from 62 patients collected beyond 90 days after symptom onset and estimate that PRNT50 antibody will remain detectable for around 1,717 days after symptom onset and that levels conferring 50% protection will be maintained for around 990 days post-symptom onset, in symptomatic patients. This would potentially be affected by emerging virus variants. PRNT titres wane faster in children. There was a high level of correlation between PRNT50 antibody titers and the % of inhibition in surrogate virus neutralization tests.InterpretationThe data suggest that symptomatic COVID-19 disease is followed by relatively long-lived protection from re-infection by antigenically similar viruses.FundingHealth and Medical Research Fund, Commissioned research on Novel Coronavirus Disease (COVID-19) (Reference Nos. COVID190126 and COVID1903003) from the Food and Health Bureau and the Theme-based Research Scheme project no. T11–712/19-N, the University Grants Committee of the Hong Kong SAR Government.

Chest CT-Scan Findings of an Iraqi Patient with Symptomatic Covid-19 Disease

Background: On the first of June, 2021, 1,201,352 cases of covid-19 were reported by the Iraqi Ministry of Health, and 16375 patients died because of the disease. The aim of this paper is to describe chest CT-scan findings of an Iraqi patient who was observed early during June, 2021, and had symptomatic covid-19, but he didn’t need hospitalization. Patients and methods: A forty-year old school teacher developed covid-19 disease with fever, fatigue, anorexia, and cough. The patient recovered after about two weeks. Results: Chest CT-scan performed during first week of illness showed: (1) Multiple bilateral ground glass opacities. (2) Atelectatic bands. (3) Thickening of the interlobular septa. (4) Vascular thickening. Conclusion: The chest CT-scan findings in this Iraqi patient was rather typical of covid-19 disease and included the most commonly reported abnormality of ground-glass shadows.

Chest CT-scan findings of an Iraqi patient with symptomatic covid-19 disease

Background: On the first of June, 2021, the total number of the registered cases of covid-19 by the Iraqi Ministry of Health was 1,201,352 , and the total number of deaths was 16375 patients. The aim of this paper is to describe chest CT-scan findings of an Iraqi patient who was observed early during June, 2021, and had symptomatic covid-19, but he didn’t need hospitalization. Patients and methods: A forty-year old school teacher developed covid-19 disease with fever, fatigue, anorexia, and cough. The patient recovered after about two weeks. Results: Chest CT-scan performed during first week of illness showed: (1) Multiple bilateral ground glass opacities. (2) Atelectatic bands. (3) Thickening of the interlobular septa. (4) Vascular thickening. Conclusion: The chest CT-scan findings in this Iraqi patient was rather typical of covid-19 disease and included the most commonly reported abnormality of ground-glass shadows

Serological Response to the BNT162b2 COVID-19 mRNA Vaccine in Adolescent and Young Adult Kidney Transplant Recipients.

Background.Initial reports in adult kidney transplant recipients (KTR) indicate low immunogenicity after 2 doses of the BNT162b2 COVID-19 mRNA vaccine. We describe the immunogenicity of this vaccine compared to the serologic response in naturally infected COVID-19 positive adolescent and young adult KTR.Methods.For this prospective observational study, the study group included 38 KTR who received 2 doses of the tested vaccine, and the control group included 14 KTR who had a previous polymerase chain reaction–confirmed COVID-19 infection.Results.The mean age was 18 ± 3 y. Positive serologic responses were observed in 63% and 100% of the study and control groups, respectively (P = 0.01). Antibody titers were almost 30-fold higher in the control than the study group (median [interquartile range (IQR)]: 2782 [1908–11 000] versus 100.3 [4.7–1744] AU/mL, P < 0.001), despite the longer time from the COVID-19 infection to serologic testing compared to time from vaccination (median [IQR]: 157.5 [60–216] versus 37 [20.5–53] d, P = 0.011). Among vaccinated patients, higher proportions of those seronegative than seropositive were previously treated with rituximab (50% versus 8%, P = 0.01). Time from the second vaccine dose to serologic testing was longer in seropositive than seronegative patients (median [IQR]: 24.5 [15–40] versus 46 [27–56] d, P = 0.05). No patient developed symptomatic COVID-19 disease postvaccination.Conclusions.The BNT162b2 COVID-19 mRNA vaccine yielded higher positive antibody response in adolescent and young adult KTR than previously reported for adult KTR. Antibody titers after vaccination were significantly lower than following COVID-19 infection. Longer time may be required to mount appropriate humoral immunity to vaccination in KTR.

Factors associated with development of symptomatic disease in Ethiopian COVID-19 patients: a case-control study

BackgroundStudies show that having some symptoms seems to be associated with more severe disease and poor prognosis. Therefore, knowing who is more susceptible to symptomatic COVID-19 disease is important to provide targeted preventive and management practice. The aim of the study was to assess factors associated with the development of symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.MethodsA case-control study was conducted from August to September 2020 among a randomly selected 730 COVID-19 patients (337 Asymptomatic and 393 Symptomatic patients). Chi-square test and independent t-test were used to detect the presence of a statistically significant difference in the characteristics of the cases (symptomatic) and controls (asymptomatic), where p-value of < 0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the independent variables and developing symptomatic COVID-19 where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results.ResultsThe result of the multivariable binary logistic regression shows that age group (AOR = 1.89, 95% CI = 1.25, 2.87, p-value = 0.002 for 30–39 years; AOR = 1.69, 95% CI = 1.06, 2.73, p-value = 0.028 for 40–49 years and AOR = 4.42, 95% CI = 2.75, 7.12, p-value = 0.0001 for ≥50 years), sex (AOR = 1.76, 95% CI = 1.26, 2.45, p-value = 0.001) and history of diabetes mellitus (AOR = 3.90, 95% CI = 1.92, 7.94, p-value = 0.0001) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients.ConclusionsDeveloping a symptomatic COVID-19 disease was found to be associated with exposures of old age, male sex, and being diabetic. Therefore, patients with the above factors should be given enough attention in the prevention and management process, including inpatient management, to pick symptoms earlier and to manage accordingly so that these patients can have a favorable treatment outcome.

Chest CT-scan findings of an Iraqi patient with symptomatic covid-19 disease

Chest CT-scan findings of an Iraqi patient with symptomatic covid-19 disease