Real-world effectiveness of molnupiravir and nirmatrelvir/ritonavir among COVID-19 community, highly vaccinated patients with high risk for severe disease: Evidence that both antivirals reduce the risk for disease progression and death

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Feb. 10, 2023

Abstract Besides the significant benefits of vaccination against COVID-19, risk severe disease and death from COVID-19 among highly vulnerable populations remains concern. Implementation oral antiviral treatment has shown for outpatients with high disease, however, their effectiveness to be evaluated in real-life settings presence new Omicron subvariants. We aimed investigate molnupiravir nirmatrelvir/ritonavir using a retrospective cohort design outcomes hospital admission Greece. The each drug was estimated through comparison antiviral’s recipients an age-matched control group non-recipients, adjusted age, previous SARS-CoV-2 infection, status, recency. Our analysis showed that significantly reduced hospitalization (OR = 0.40, p < 0.001) 0.31, 0.001), effect being more intense elderly patients (≥75 years old). higher those full adherence. Nirmatrelvir/ritonavir found also reduce 0.28, and, similarly molnupiravir, stronger highest levels Analysis relative versus suggested associated 0.58, compared co-morbidities. real-world study provides evidence about vaccinated These findings highlight although mortality been mainly due emergence variants, antivirals provide additional therefore use is documented strongly indicated.

Language: Английский

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Results of the Stop the Spread Ottawa (SSO) cohort study: a Canadian urban-based prospective evaluation of antibody responses and neutralisation efficiency to SARS-CoV-2 infection and vaccination

BMJ Open, Journal Year: 2023, Volume and Issue: 13(10), P. e077714 - e077714

Published: Oct. 1, 2023

Predictors of COVID-19 vaccine immunogenicity and the influence prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection require elucidation.Stop Spread Ottawa is a prospective cohort individuals at-risk for or who have been infected with SARS-CoV-2, initially enrolled 10 months beginning October 2020. This was enriched public-facing workers. analysis focuses on safety initial two doses vaccine.Post-vaccination data blood specimens were available 930 participants. 22.8% SARS-CoV2 to first dose. Cohort characteristics include: median age 44 (IQR: 22-56), 66.6% women, 89.0% white, 83.2% employed. 38.1% reported more comorbidities 30.8% immune compromising condition(s). Over 95% had detectable IgG levels against spike receptor binding domain (RBD) 3 post second By multivariable analysis, increasing high-level compromise predicted diminishing RBD titres at month higher immediately vaccination in those SARS-CoV-2 6 wider time intervals between dose 1 2. neutralisation generally similar by sex, weight whether receiving homogeneous heterogeneous combinations vaccines. Common symptoms included fatigue (64.7%), injection site pain (47.5%), headache (27.2%), fever/chills (26.2%) body aches (25.3%). These subsequent doses.The are safe, well-tolerated highly immunogenic across broad spectrum recipients including working public facing environments.

Language: Английский

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Employee investigation and contact tracing program in a pediatric cancer hospital to mitigate the spread of COVID-19 among the workforce, patients, and caregivers

Frontiers in Public Health, Journal Year: 2024, Volume and Issue: 11

Published: Jan. 8, 2024

Background Case investigations and contact tracing are essential disease control measures used by health departments. Early in the pandemic, they were seen as a key strategy to stop COVID-19 spread. The CDC urged rapid action scale up train large workforce collaborate across public private agencies halt transmission. Methods We developed program for case investigation that followed local guidelines, compliant with Occupational Safety Health Administration (OSHA) regulations tailored needs resources of our institution. Program staff trained assessed competency before joining program. Results From March 2020 May 2021, we performed 838 investigations, which led 136 contacts. Most employees reported known SARS-CoV-2 exposure from community ( n = 435) or household 343). Only seven (5.1%) determined more likely than not have infection related workplace exposure, when so, lapses following masking recommendations identified. Between June 2021–February 2022, adjusted demand different waves, particularly omicron, significantly reducing amount data collected. No transmission patients caregivers was observed during this period. Conclusion Prompt implementation is possible, it effectively reduces exposures. This approach can be adapted suit specific requirements various healthcare settings, those serving most vulnerable patient populations.

Language: Английский

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Predicting COVID-19 Re-Positive Cases in Malnourished Older Adults: A Clinical Model Development and Validation

Clinical Interventions in Aging, Journal Year: 2024, Volume and Issue: Volume 19, P. 421 - 437

Published: March 1, 2024

Purpose: Building and validating a clinical prediction model for novel coronavirus (COVID-19) re-positive cases in malnourished older adults.Patients Methods: Malnourished adults from January to May 2023 were retrospectively collected the Department of Geriatrics Affiliated Hospital Chengdu University Traditional Chinese Medicine.They divided into "non-repositive" group "re-positive" based on number COVID-19 infections, training set validation at 7:3 ratio.The least absolute shrinkage selection operator (LASSO) regression analysis was used identify predictive factors re-positivity adults, nomogram constructed.Independent influencing screened by multivariate logistic regression.The model's goodness-of-fit, discrimination, calibration, impact assessed Hosmer-Lemeshow test, area under curve (AUC), calibration curve, decision (DCA), (CIC), respectively.Results: We included 347 cases, 243 set, 104 set.We 10 variables as outcome.By analysis, preliminary identified protective factors, risk independent that affect outcome.We constructed adults.The test yielded χ 2 =5.916,P =0.657; AUC 0.881; when threshold probability >8%, using this predict whether more beneficial than implementing intervention programs all patients; >80%, positive estimated value closer actual cases.Conclusion: This can help early, facilitate early decision-making intervention, have important implications improving patient outcomes.We also expect large-scale, multicenter studies further validate, refine, update model.

Language: Английский

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Assessing the real-world effectiveness of five SARS-CoV-2 vaccines in a cohort of Mexican pensioners: a nationwide nested test-negative design study

The Lancet Regional Health - Americas, Journal Year: 2023, Volume and Issue: 27, P. 100612 - 100612

Published: Oct. 19, 2023

Despite the extensive distribution of COVID-19 vaccines across Latin America, research on their real-world performance remains limited. We aimed to evaluate effectiveness five (BNT162b2, AZD1222, CoronaVac, Gam-COVID-Vac, and Ad5-nCoV) in a cohort 2,559,792 pensioners covered by Mexican Institute Social Security.

Language: Английский

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Real-world effectiveness of mRNA COVID-19 vaccines in the elderly during the Delta and Omicron variants: Systematic review

World Journal of Meta-Analysis, Journal Year: 2023, Volume and Issue: 11(5), P. 167 - 180

Published: June 15, 2023

As of 31 December 2022, there were over 6.6 million coronavirus disease 2019 (COVID-19) deaths and 651 cases across 200 countries worldwide. Despite the increase in vaccinations booster shots, COVID-19 continue to remain high. While effectiveness these vaccines has already been established by different manufacturers, fact remains that created quickly for global emergency use, tested under controlled clinical conditions from voluntary subjects age groups whose general characteristics may differ actual population.To conduct a systematic review determine real-world mRNA elderly during predominance Delta Omicron variants preventing related infection, hospital, intensive care unit (ICU) admission intubation, death.A combination Medical Subject Headings non-Medical was carried out identify all relevant research articles meets inclusion exclusion criteria PubMed, Cochrane, CINAHL, Scopus, ProQuest, Embase, Web Science, Google Scholar databases, as well qualified studies pre-print servers using medRxiv Research Square, published January 1, 2021 - 31, 2022.As per criteria, Pfizer-BioNTech Moderna evaluated an estimated total study population 26,535,692 ICU death outcome measures between conducted New York, Finland, Canada, Costa Rica, Qatar, Greece, Brazil. The risk bias nonrandomized interventions (ROBINS-I) tool cohort, case-control, cross-sectional studies. trial data on demonstrated 94% vaccine elderly, results this showed settings is marginally lower against infection (40%-89%), hospitalization (92%), intubation (98%-85%), (77%-87%) with indication diminished time. Furthermore, 2 doses are inadequate only provides interim protection.Because natural diminishing vaccine, need dose restore its efficacy vital. From perspective, use highly heterogeneous inhibits comparison, contrast, integration which makes pooling problematic. pharmaceutical intervention like vaccination important fight epidemic, utilizing common measurements or carrying minimal heterogeneity measurements, equally crucial better understand respond international health crisis.

Language: Английский

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Temporary impact on medical system and effectiveness of mitigation strategies after COVID-19 policy adjustment in China: a modeling study

Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11

Published: Dec. 1, 2023

Background As China amends its “zero COVID” strategy, a sudden increase in the number of infections may overwhelm medical resources and impact has not been quantified. Specific mitigation strategies are needed to minimize disruption healthcare system prepare for next possible epidemic advance. Method We develop stochastic compartmental model project burden on (that is, fever clinic visits admission beds) after adjustment COVID-19 policy, which considers epidemiological characteristics Omicron variant, age composition population, vaccine effectiveness against infection severe COVD-19. also estimate effect four-dose vaccinations (heterologous homologous), antipyretic drug supply, non-pharmacological interventions (NPIs), triage treatment mitigating domestic peak. Result system, this is projected result 398.02 million 16.58 hospitalizations, period 18 30 days, respectively. Antipyretic supply booster vaccination could reduce emergency hospitalization, respectively, while neither them current capacity. The synergy several different suggests that increasing heterologous rate older adult over 90% key measure alleviate bed respiratory diseases basis expanded resource allocation. Conclusion followed policy overloading many local health systems across country at end 2022. combined vaccination, treatment, PHSMs prevent overwhelming resources.

Language: Английский

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mRNA COVID-19 vaccine safety among older adults from the Canadian National Vaccine Safety Network

Vaccine, Journal Year: 2024, Volume and Issue: 42(18), P. 3819 - 3829

Published: May 6, 2024

This study examined short-to-medium term safety of COVID-19 vaccines among adults aged ≥65 years using the Canadian National Vaccine Safety Network active surveillance data. Both vaccinated and unvaccinated older adult participants recruited from seven provinces territories were included in analysis. was assessed at 7 days after vaccination (dose 1, 2 3), months dose 1. Multivariable logistic regression used to examine association between BNT162b2/mRNA-1273 two short-term health events: 1) event preventing daily activities and/or required medical consultation, 2) serious events resulting an emergency department visit hospitalization within following each dose. We also rates for period 1 2, 7-months Between December 2020 February 2022, a total 173,038, 104,452, 13,970 completed 3 surveys, respectively. The control survey by 2,955 adults. Health occurred more frequently recipients homologous mRNA-1273 (adjusted odds ratio [95 % confidence interval]: 2.91 [2.24–3.79]) heterologous (BNT162b2 followed mRNA-1273): 1.50 [1.12–2.02] compared counterparts. There no difference any BNT162b2 participants. very low (≤0.3 %) across all vaccine products doses, not higher controls, associated with or vaccination. Reported symptoms self-limited rarely assessment. Our findings further strengthen current evidence that mRNA are safe can be inform about expected adverse

Language: Английский

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Mortality risk of Severe Acute Respiratory Syndrome cases classified as COVID-19: A longitudinal study

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(8), P. e0309413 - e0309413

Published: Aug. 30, 2024

The COVID-19 pandemic has significantly impacted global health, with diverse factors influencing the risk of death among reported cases. This study mainly analyzes main characteristics that have contributed to increase or decrease in Severe Acute Respiratory Syndrome (SARS) cases classified as southeast Brazil from 2020 2023.

Language: Английский

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Enhanced immunity against SARS-CoV-2 in returning Chinese individuals

Human Vaccines & Immunotherapeutics, Journal Year: 2024, Volume and Issue: 20(1)

Published: Jan. 8, 2024

Global COVID-19 vaccination programs effectively contained the fast spread of SARS-CoV-2. Characterizing immunity status returned populations will favor understanding achievement herd and long-term management in China. Individuals were recruited from 7 quarantine stations Guangzhou, Blood throat swab specimens collected participants, their was determined through competitive ELISA, microneutralization assay enzyme-linked FluoroSpot assay. A total 272 subjects involved questionnaire survey, whom 235 (86.4%) returning Chinese individuals 37 (13.6%) foreigners. 108 individuals. Neutralizing antibodies against SARS-CoV-2 detected ~90% individuals, either primary or homologous heterologous booster group. The serum NAb titers significantly decreased Omicron BA.5, BF.7, BQ.1 XBB.1 compared with prototype virus. However, memory T-cell responses, including specific IFN-γ IL-2 not different Smoking, alcohol consumption, infection, vaccination, time interval between last sampling independent influencing factors for variants concern. vaccine dose unique common factor subvariants. Enhanced established who exposed to reinfection vaccination. Domestic residents benefit after reopening China, which is also useful breakthrough infection.

Language: Английский

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