Nirmatrelvir Use and Severe Covid-19 Outcomes during the Omicron Surge

New England Journal of Medicine, Год журнала: 2022, Номер 387(9), С. 790 - 798

Опубликована: Авг. 24, 2022

The oral protease inhibitor nirmatrelvir has shown substantial efficacy in high-risk, unvaccinated patients infected with the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data regarding effectiveness preventing disease 2019 (Covid-19) outcomes from B.1.1.529 (omicron) are limited.We obtained data for all members Clalit Health Services who were 40 years age or older at start study period and assessed as being eligible to receive therapy during omicron surge. A Cox proportional-hazards regression model time-dependent covariates was used estimate association treatment hospitalization death due Covid-19, adjustment sociodemographic factors, coexisting conditions, previous SARS-CoV-2 immunity status.A total 109,254 met eligibility criteria, whom 3902 (4%) received period. Among 65 older, rate Covid-19 14.7 cases per 100,000 person-days among treated compared 58.9 untreated (adjusted hazard ratio, 0.27; 95% confidence interval [CI], 0.15 0.49). adjusted ratio 0.21 (95% CI, 0.05 0.82). 64 age, 15.2 15.8 0.74; 0.35 1.58). 1.32 0.16 10.75).Among rates significantly lower those than did not. No evidence benefit found younger adults.

Язык: Английский

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COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection

Journal of Biomedical Science, Год журнала: 2022, Номер 29(1)

Опубликована: Окт. 15, 2022

Abstract Coronavirus Disease 2019 (COVID-19) has been the most severe public health challenge in this century. Two years after its emergence, rapid development and deployment of effective COVID-19 vaccines have successfully controlled pandemic greatly reduced risk illness death associated with COVID-19. However, due to ability rapidly evolve, SARS-CoV-2 virus may never be eradicated, there are many important new topics work on if we need live for a long time. To end, hope provide essential knowledge researchers who improvement future vaccines. In review, provided an up-to-date summary current vaccines, discussed biological basis clinical impact variants subvariants, analyzed effectiveness various vaccine booster regimens against different strains. Additionally, reviewed potential mechanisms vaccine-induced adverse events, summarized studies regarding immune correlates protection, finally, next-generation

Язык: Английский

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Effectiveness of a bivalent mRNA vaccine booster dose to prevent severe COVID-19 outcomes: a retrospective cohort study

The Lancet Infectious Diseases, Год журнала: 2023, Номер 23(8), С. 914 - 921

Опубликована: Апрель 14, 2023

Язык: Английский

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Mutations in SARS-CoV-2: Insights on structure, variants, vaccines, and biomedical interventions

Biomedicine & Pharmacotherapy, Год журнала: 2022, Номер 157, С. 113977 - 113977

Опубликована: Ноя. 7, 2022

COVID-19 is a worldwide pandemic caused by SARS-coronavirus-2 (SARS-CoV-2). Less than year after the emergence of Covid-19 pandemic, many vaccines have arrived on market with innovative technologies in field vaccinology. Based use messenger RNA (mRNA) encoding Spike SARS-Cov-2 protein or recombinant adenovirus vectors enabling gene to be introduced into our cells, these strategies make it possible envisage vaccination new light tools that are more scalable vaccine used so far. Faced appearance variants, which will gradually take precedence over strain at origin allow much faster update fight against some may escape neutralization antibodies. However, only policy based rapid and massive population but requiring supply sufficient doses could combat variants. Indeed, greater number infected individuals, virus multiplies, an increased risk variants viruses. This review discuss SARS-CoV-2 pathophysiology evolution approaches altered transmission platforms emphasize different mutations how they influence characteristics. Also, this article summarizes common implication genetic variety biomedical arbitrations.

Язык: Английский

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Comparative effectiveness of bivalent BA.4-5 and BA.1 mRNA booster vaccines among adults aged ≥50 years in Nordic countries: nationwide cohort study

BMJ, Год журнала: 2023, Номер unknown, С. e075286 - e075286

Опубликована: Июль 25, 2023

Abstract Objective To estimate the effectiveness of bivalent mRNA booster vaccines containing original SARS-CoV-2 and omicron BA.4-5 or BA.1 subvariants as fourth dose against severe covid-19. Design Nationwide cohort analyses, using target trial emulation. Setting Denmark, Finland, Norway, Sweden, from 1 July 2022 to 10 April 2023. Participants People aged ≥50 years who had received at least three doses covid-19 vaccine (that is, a primary course first booster). Main outcome measures The Kaplan-Meier estimator was used compare risk hospital admission death related in people Comirnaty (Pfizer-BioNTech) Spikevax (Moderna) (second booster) with (first vaccinated between four people. Results A total 634 199 receiving 042 124 across Nordic countries were included. Receipt associated comparative 67.8% (95% confidence interval 63.1% 72.5%) difference –91.9 –152.4 –31.4) per 100 000 months follow-up compared having (289 v 893 events). corresponding for boosters (332 977 events) 65.8% (59.1% 72.4%) –112.9 (–179.6 –46.2) 000, respectively. Comparative 69.8% (52.8% 86.8%) –34.1 (–40.1 –28.2) (93 325 70.0% (50.3% 89.7%) –38.7 (–65.4 –12.0) (86 286) dose. Comparing directly resulted month –14.9% (–62.3% 32.4%) 10.0 (–14.4 34.4) (802 932 unweighted –40.7% (–123.4% 42.1%) 8.1 (–3.3 19.4) (229 243 did not differ sex age (</≥70 years) seemed be sustained up six day vaccination modest waning. Conclusion Vaccination reduced rates among adults years. protection afforded by significantly when compared, any potential would most likely very small absolute numbers.

Язык: Английский

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Insights for COVID-19 in 2023

Revista Española de Quimioterapia, Год журнала: 2022, Номер 36(2), С. 114 - 124

Опубликована: Дек. 12, 2022

Predictions for a near end of the pandemic by World Health Organization should be interpreted with caution. Current evidence indicates that efficacy fourth dose classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection its predominant variant (Omicron). However, high against severe symptomatic infection, hospitalization death. The new being introduced are bivalent active Omicron variants. Potential to coming year include vaccine based on recombinant protein emulates receptor binding domain Spike under development Spanish company Hipra, as well nasal oral administration. Available information suggests COVID-19 can administered association influenza vaccination without particular complications. New drugs COVID-19, both antiviral anti-inflammatory, investigation, but this does not seem case monoclonal antibodies. indication use masks some circumstances will maintained next view accumulation scientific data their efficacy. Finally, long COVID Post-COVID syndrome may continue affect very proportion patients who have had disease, requiring combined diagnostic therapeutic resources.

Язык: Английский

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Neutralizing antibody activity against 21 SARS-CoV-2 variants in older adults vaccinated with BNT162b2

Nature Microbiology, Год журнала: 2022, Номер 7(8), С. 1180 - 1188

Опубликована: Июль 14, 2022

SARS-CoV-2 variants may threaten the effectiveness of vaccines and antivirals to mitigate serious COVID-19 disease. This is most concern in clinically vulnerable groups such as older adults. We analysed 72 sera samples from 37 individuals, aged 70-89 years, vaccinated with two doses BNT162b2 (Pfizer-BioNTech) 3 weeks apart, for neutralizing antibody responses wildtype SARS-CoV-2. Between 20 after second vaccine dose, titres fell 4.9-fold a median titre 21.3 (neutralization dose 80%), 21.6% individuals having no detectable antibodies at later time point. Next, we examined neutralization 21 distinct variant spike proteins these sera, confirmed substantial antigenic escape, especially Omicron (B.1.1.529, BA.1/BA.2), Beta (B.1.351), Delta (B.1.617.2), Theta (P.3), C.1.2 B.1.638 variants. By combining pseudotype specific receptor-binding domain (RBD) enzyme-linked immunosorbent assays, showed that changes position 484 RBD were mainly responsible escape. Nineteen same boosted third contained higher titres, providing cross-protection against BA.1 BA.2. Despite immunity waning over adults, booster can elicit broad large number this cohort.

Язык: Английский

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Effectiveness of a fourth dose of mRNA COVID-19 vaccine against all-cause mortality in long-term care facility residents and in the oldest old: A nationwide, retrospective cohort study in Sweden

The Lancet Regional Health - Europe, Год журнала: 2022, Номер 21, С. 100466 - 100466

Опубликована: Июль 13, 2022

The effect of a fourth dose COVID-19 vaccine on the risk death in oldest and frailest individuals is unknown.Two matched cohorts were formed using Swedish nationwide registers. In first, residents long-term care facilities (LTCFs) given an mRNA from 1 January 2022 onwards 1:1 birth year county residence to at least third (N = 24,524). second, all aged ≥80 years 394,104). Cox regression models used estimate hazard ratios for all-cause mortality fourth-dose recipients as compared with third-dose recipients, relative effectiveness (VE) estimated minus ratio.From 7 days after baseline onwards, there 1119 deaths LTCF cohort during median follow-up 77 maximum 126 days. During 60, VE was 39% (95% CI, 29-48), which declined 27% -2-48) 61 126. years, 5753 73 143 71% 69-72), 54% 48-60) 143. seemed stronger when it where four months had passed since vaccination (P < 0·001 interaction).As dose, vaccine, administered Omicron era, associated reduced causes LTCFs old first two months, protection became slightly lower. These findings suggest that may prevent premature even emergence variant, although timing seems be important respect slight waning observed months.There no funding source this study.

Язык: Английский

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Association of Receiving a Fourth Dose of the BNT162b Vaccine With SARS-CoV-2 Infection Among Health Care Workers in Israel

JAMA Network Open, Год журнала: 2022, Номер 5(8), С. e2224657 - e2224657

Опубликована: Авг. 2, 2022

Importance

Despite the high 3-dose vaccination rate among health care workers (HCWs) in Israel, a of SARS-CoV-2 breakthrough infections this group was observed during Omicron wave. As result, Israeli Ministry Health decided to recommend fourth vaccine dose medical staff.

Objective

To evaluate benefit BNT162b2 on infection HCWs.

Design, Setting, and Participants

This multicenter cohort study performed January 2022, first month 4-dose campaign, surge variant All at 11 general hospitals Israel who had been vaccinated with 3 doses up September 30, 2021, not contracted COVID-19 before campaign were included.

Exposures

Vaccination 2022.

Main Outcomes Measures

Breakthrough recipients vs measured by polymerase chain reaction test result positive for SARS-CoV-2. tested based symptoms or exposure.

Results

A total 29 611 HCWs (19 381 [65%] female; mean [SD] age, 44 [12] years) received between August 2021; these, 5331 (18%) 2022 infected week after vaccination. Overall rates 368 (7%) 4802 24280 (20%) (relative risk, 0.35; 95% CI, 0.32-0.39). Similar reductions found matched analysis exact day receiving third 0.61; 0.54-0.71) time-dependent Cox proportional hazards regression model (adjusted hazard ratio, 0.56; 0.50-0.63). In both groups, no severe disease death occurred.

Conclusions Relevance

study, resulted reduced hospital reduction lower than that dose; nevertheless, considering infectivity variant, which led critical staff shortages, should be considered mitigate

Язык: Английский

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Expert review of global real-world data on COVID-19 vaccine booster effectiveness and safety during the omicron-dominant phase of the pandemic

Expert Review of Vaccines, Год журнала: 2022, Номер 22(1), С. 1 - 16

Опубликована: Ноя. 4, 2022

COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, emergence of Omicron variant subvariants as globally dominant strains raised doubts about effectiveness currently available prompted debate potential future vaccination strategies.Using publicly IVAC VIEW-hub platform, we reviewed 52 studies on vaccine (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease death stratified by schedule age. In addition, a non-systematic literature review safety was performed to identify single or multi-country investigating adverse event rates at least two vaccines.Booster shots current provide consistently high protection against Omicron-related death. Additionally, this appears be conserved 3 months, with small but significant waning that. The positive risk-benefit ratio these is well established, giving us confidence administer additional doses required. Future strategies will likely include combination schedules based risk profile, overly frequent boosting may neither beneficial nor sustainable general population.

Язык: Английский

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