Efficacy of SARS-CoV-2 vaccines and the dose–response relationship with three major antibodies: a systematic review and meta-analysis of randomised controlled trials

The Lancet Microbe, Journal Year: 2023, Volume and Issue: 4(4), P. e236 - e246

Published: Feb. 28, 2023

Summary

Background

The efficacy of SARS-CoV-2 vaccines in preventing severe COVID-19 illness and death is uncertain due to the rarity data individual trials. How well antibody concentrations can predict also uncertain. We aimed assess these infections different severities dose–response relationship between efficacy.

Methods

did a systematic review meta-analysis randomised controlled trials (RCTs). searched PubMed, Embase, Scopus, Web Science, Cochrane Library, WHO, bioRxiv, medRxiv for papers published Jan 1, 2020 Sep 12, 2022. RCTs on were eligible. Risk bias was assessed using tool. A frequentist, random-effects model used combine common outcomes (ie, symptomatic asymptomatic infections) Bayesian rare hospital admission, infection, death). Potential sources heterogeneity investigated. relationships neutralising, spike-specific IgG receptor binding domain-specific titres with examined by meta-regression. This registered PROSPERO, CRD42021287238.

Findings

28 (n=286 915 vaccination groups n=233 236 placebo groups; median follow-up 1–6 months after last vaccination) across 32 publications included this review. combined full 44·5% (95% CI 27·8–57·4) infections, 76·5% (69·8–81·7) 95·4% credible interval 88·0–98·7) hospitalisation, 90·8% (85·5–95·1) 85·8% (68·7–94·6) death. There against but insufficient evidence suggest whether could differ according type vaccine, age vaccinated individual, between-dose (p>0·05 all). Vaccine infection waned over time vaccination, an average decrease 13·6% 5·5–22·3; p=0·0007) per month be enhanced booster. found significant non-linear each (p<0·0001 all), there remained considerable efficacy, which cannot explained concentrations. risk low most studies.

Interpretation

higher than milder infection. wanes Higher are associated estimates precise predictions difficult large unexplained heterogeneity. These findings provide important knowledge base interpretation application future studies issues.

Funding

Shenzhen Science Technology Programs.

Language: Английский

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Effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines against SARS-CoV-2 Omicron BA. 2 variant infection, severe illness, and death

BMC Medicine, Journal Year: 2022, Volume and Issue: 20(1)

Published: Oct. 20, 2022

Abstract Background Limited data are available on the effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines in real-world use—especially against Omicron variants SARS-CoV-2 infection-naïve population. Methods A matched case-control study was conducted among people aged ≥ 3 years between 2 December 2021 13 May 2022. Cases were SARS-CoV-2-infected individuals, individuals with severe/critical COVID-19, or COVID-19-related deaths. Controls selected from consecutively test-negative at same time as cases diagnosed exact-matched year-of-age, gender, birthplace, illness onset date, residential district ratios 1:1 infected 4:1 death. Additionally, two subsets constructed to analyze separate vaccine (VE) (subset 1) Ad5-vectored 2) each three outcomes. Results Our included 612,597 documented infections, which 1485 progressed severe critical 568 died. Administering provided limited protection infection across all age groups (overall VE: 16.0%, 95% CI: 15.1–17.0%) but high (88.6%, 85.8–90.8%) death (91.6%, 86.8–94.6%). In subset 1, showed 16.3% (15.4–17.2%) effective infection, 88.6% (85.8–90.9%) COVIID-19, 91.7% (86.9–94.7%) Booster vaccination enhanced (92.7%, 90.1–94.6%) (95.9%, 91.4–98.1%). Inactivated VE began wane 12 weeks after last dose, doses sustained levels (> 80%) death, while 13.2% (10.9–15.5%) 77.9% (15.6–94.2%) COVIID-19. Conclusions found durable two- three-dose Omicron-associated groups, lower reinforces importance full-series timely booster dose administration for eligible individuals.

Language: Английский

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Estimates of COVID‐19 deaths in Mainland China after abandoning zero COVID policy

European Journal of Clinical Investigation, Journal Year: 2023, Volume and Issue: 53(4)

Published: Jan. 24, 2023

Abstract Background China witnessed a surge of Omicron infections after abandoning ‘zero COVID’ strategies on 7 December 2022. The authorities report very sparse deaths based restricted criteria, but massive are speculated. Methods We aimed to estimate the COVID‐19 fatalities in Mainland until summer 2023 using experiences Hong Kong and South Korea 2022 as prototypes. Both these locations experienced waves having had few SARS‐CoV‐2 during 2020–2021. estimated age‐stratified infection fatality rates (IFRs) extrapolated population age structure China. also accounted separately for residents long‐term care facilities both Korea. Results Infection rate estimates non‐elderly strata were modestly higher than projected 987,455 619,549 maximal respectively, if entire infected. Expected ranged from 49,962 691,219 assuming 25–70% being infected variable protection elderly (from none three‐quarter reduction fatalities). main analysis (45% impact among reduced by half) 152,886–249,094 2023. Large uncertainties exist regarding potential changes dominant variant, health system strain non‐COVID‐19 deaths. Conclusions most critical factor that can affect total is extent which be protected.

Language: Английский

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Immunological imprinting shapes the specificity of human antibody responses against SARS-CoV-2 variants

Immunity, Journal Year: 2024, Volume and Issue: 57(4), P. 912 - 925.e4

Published: March 14, 2024

Language: Английский

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A comparative characterization of SARS-CoV-2-specific T cells induced by mRNA or inactive virus COVID-19 vaccines

Cell Reports Medicine, Journal Year: 2022, Volume and Issue: 3(11), P. 100793 - 100793

Published: Oct. 6, 2022

Unlike mRNA vaccines based only on the spike protein, inactivated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) should induce a diversified T cell response recognizing distinct structural proteins. Here, we perform comparative analysis of SARS-CoV-2-specific cells in healthy individuals following vaccination with SARS-CoV-2 or vaccines. Relative to vaccination, elicit lower magnitude spike-specific cells, but combination membrane, nucleoprotein, and is quantitatively comparable sole induced by vaccine, they efficiently tolerate mutations characterizing Omicron lineage. However, this multi-protein-specific not mediated coordinated CD4 CD8 expansion selective priming cells. These findings can help understanding role efficacy different control COVID-19 after infection.

Language: Английский

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Effectiveness of BNT162b2 and CoronaVac vaccinations against mortality and severe complications after SARS-CoV-2 Omicron BA.2 infection: a case–control study

Emerging Microbes & Infections, Journal Year: 2022, Volume and Issue: 11(1), P. 2304 - 2314

Published: Aug. 18, 2022

Data regarding protection against mortality and severe complications after Omicron BA.2 infection with CoronaVac BNT162b2 vaccines remains limited. We conducted a case-control study to evaluate the risk of following 1-3 doses using electronic health records database. Cases were adults their first COVID-19-related or between 1 January 31 March 2022, matched up-to 10 controls by age, sex, index date, Charlson Comorbidity Index. Vaccine effectiveness type number was estimated conditional logistic regression adjusted for comorbidities medications. (95% CI) two 90.7% (88.6-92.3) 74.8% (72.5-76.9) in those aged ≥65, 87.6% (81.4-91.8) 80.7% (72.8-86.3) 50-64, 86.6% (71.0-93.8) 82.7% (56.5-93.1) 18-50. 82.1% (74.6-87.3) 58.9% (50.3-66.1) 83.0% (69.6-90.5) 67.1% (47.1-79.6) 78.3% (60.8-88.0) 77.8% (49.6-90.2) Further reduction third dose observed especially ≥65 years, vaccine 98.0% (96.5-98.9) 95.5% (93.7-96.8) mortality, 90.8% (83.4-94.9) 88.0% (80.8-92.5) complications. Both vaccination effective amidst pandemic, risks decreased further dose.

Language: Английский

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Immunogenicity of COVID-19 vaccines in solid organ transplant recipients: a systematic review and meta-analysis

Clinical Microbiology and Infection, Journal Year: 2022, Volume and Issue: 29(4), P. 441 - 456

Published: Dec. 9, 2022

BackgroundSolid organ transplant (SOT) recipients are at increased risks of morbidity and mortality associated with COVID-19.ObjectivesThis study aimed to evaluate the immunogenicity COVID-19 vaccines in SOT recipients.Data sourcesElectronic databases were searched for eligible reports published from 1 December 2019 31 May 2022.Study eligibility criteriaWe included evaluating humoral immune response (HIR) or cellular rate after administration vaccines.ParticipantsSOT who received vaccines.Assessment risk biasWe used Newcastle-Ottawa scale assess bias case-control cohort studies. For randomised-controlled trials, Jadad Scale was used.MethodsWe a random-effects model calculate pooled rates 95% CI. We ratio (RR) CI comparison responses between healthy controls.ResultsA total 91 involving 11 886 (lung: 655; heart: 539; liver: 1946; kidney: 8746) 2125 controls revealed HIR 1st, 2nd, 3rd vaccine doses 9.5% (95% CI, 7–11.9%), 43.6% 39.3–47.8%) 55.1% 44.7–65.6%), respectively. specific organs, still low 1st dose 4.4%; 9.4%; 13.2%; 29.5%) 2nd 28.4%; 37.6%; 50.3%; 64.5%).ConclusionsA booster vaccination enhances SOT; however, significant share has not built detectable receiving dose. This finding calls alternative approaches, including use monoclonal antibodies. In addition, lung need urgent improve response.

Language: Английский

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Innate Immunity in Protection and Pathogenesis During Coronavirus Infections and COVID-19

Annual Review of Immunology, Journal Year: 2024, Volume and Issue: 42(1), P. 615 - 645

Published: June 28, 2024

The COVID-19 pandemic was caused by the recently emerged β-coronavirus SARS-CoV-2. SARS-CoV-2 has had a catastrophic impact, resulting in nearly 7 million fatalities worldwide to date. innate immune system is first line of defense against infections, including detection and response Here, we discuss mechanisms that sense coronaviruses, with focus on infection how these protective responses can become detrimental severe cases COVID-19, contributing cytokine storm, inflammation, long-COVID, other complications. We also highlight complex cross talk among cytokines cellular components system, which aid viral clearance but contribute inflammatory cell death, organ damage pathogenesis. Furthermore, evades key enhance its virulence pathogenicity, as well immunity be therapeutically targeted part vaccination treatment strategy. Overall, comprehensive understanding been crucial fight infections development novel host-directed immunotherapeutic strategies for various diseases.

Language: Английский

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The life and death of RNA across temperatures

Computational and Structural Biotechnology Journal, Journal Year: 2022, Volume and Issue: 20, P. 4325 - 4336

Published: Jan. 1, 2022

Temperature is an environmental condition that has a pervasive effect on cells along with all the molecules and reactions in them. The mechanisms by which prototypical RNA sense withstand heat have been identified mostly bacteria archaea. relevance of these phenomena is, however, broader, similar recently found throughout tree life, from sex determination reptiles to adaptation viral polymerases, genetic disorders humans. We illustrate temperature dependence metabolism examples synthesis degradation mRNAs, review emerged questions. Are exposed greater variations gradients than previously surmised? How do reconcile conflicting thermal stability requirements primary tertiary structures RNAs? To what extent enzymes contribute compensation reaction rates mRNA turnover lowering energy barrier catalyzed reactions? conclude ecological, forensic applications temperature-dependence biotechnological aspects vaccine production.

Language: Английский

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Genesis, evolution and effectiveness of Singapore's national sorting logic and home recovery policies in handling the COVID-19 Delta and Omicron waves

The Lancet Regional Health - Western Pacific, Journal Year: 2023, Volume and Issue: 35, P. 100719 - 100719

Published: March 2, 2023

Singapore developed several novel strategies to transition towards "living with COVID-19", while protecting hospital capacity. The Home Recovery Programme (HRP) was a national, centrally-administered programme that leveraged technology and telemedicine allow low-risk individuals safely recover at home. HRP subsequently expanded by partnering primary care doctors in caring for more cases the community. A key enabler National Sorting Logic (NSL), multi-step triage algorithm allowing risk-stratification of large numbers COVID-19 patients national-level. At core NSL risk assessment criterion, comprising Comorbidities-of-concern, Age, Vaccination status, Examination/clinical findings Symptoms (CAVES). sorted all into various levels - Primary Care, HRP, Treatment Facility Hospital. By adopting national approach managing healthcare capacities triaging patients, able prioritize resources high-risk prevent from being overwhelmed. As part response strategy tackle COVID-19, set up integrated databases enable responsive data analysis support evidence-based policy decisions. Using collected between 30 August 2021 8 June 2022, we conducted retrospective cohort study evaluate outcomes effectiveness vaccination policies, home-based recovery. total 1,240,183 were diagnosed during this period, spanning both Delta Omicron waves, Overall, experienced very low severity (0.51%) mortality (0.11%) rates. Vaccinations significantly lowered risks across age groups. effective predicting severe right-site >93% leveraging high rates, telemedicine, navigate through two waves without impacting severity/mortality rates nor overwhelming capacities.

Language: Английский

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