Research

12 pages, 867 KiB

Open AccessArticle

The Effect of the Immunization Schedule and Antibody Levels (Anti-S) on the Risk of SARS-CoV-2 Infection in a Large Cohort of Healthcare Workers in Northern Italy

by Emanuele Sansone, Giulia Collatuzzo, Stefano Renzetti, Giorgia Ditano, Carlo Bonfanti, Emma Sala, Luigina Terlenghi, Alberto Matteelli, Mahsa Abedini, Shuffield Seyram Asafo, Paolo Boffetta and Giuseppe De Palma

Vaccines 2023, 11(4), 746; https://doi.org/10.3390/vaccines11040746 - 28 Mar 2023

Cited by 4 | Viewed by 1612

Abstract

Given their occupational risk profile, HCWs were the first to receive anti-SARS-CoV-2 vaccination. However, breakthrough infections remained common, mainly sustained by new SARS-CoV-2 variants of concern (VOCs) that rapidly spread one after another in Italy. Evidence suggests that the measured level of anti-SARS-CoV-2 [...] Read more.

Given their occupational risk profile, HCWs were the first to receive anti-SARS-CoV-2 vaccination. However, breakthrough infections remained common, mainly sustained by new SARS-CoV-2 variants of concern (VOCs) that rapidly spread one after another in Italy. Evidence suggests that the measured level of anti-SARS-CoV-2 antibodies does not clearly predict the level of protection conferred by either natural infection or vaccine-induced immunization, highlighting the need for further study on the diversity in susceptibility to SARS-CoV-2 infection. The present study aimed to characterize different risk profiles for SARS-CoV-2 infection in HCWs who had recently received the booster dose, and who were classified according to their immunization profile. The very small number of workers infected during the 8 months following the primary-cycle administration represents proof of the vaccine’s effectiveness against non-omicron strains. The comparison among different immunization profiles showed that hybrid immunization (vaccine plus natural infection) elicits higher antibody levels. However, hybrid immunization does not always provide better protection against reinfection, thus suggesting that the immunization profile plays a major role as a virus–host interaction modifier. Despite the high resistance to the reinfection, the peri-booster infection had a not-neglectable infection rate (5.6%), this further reinforcing the importance of preventive measures. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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Graphical abstract

6 pages, 585 KiB

Open AccessCommunication

Ex Vivo Immune Responsiveness to SARS-CoV-2 Omicron BA.5.1 Following Vaccination with Unmodified mRNA-Vaccine

by Anna Sabrina Kuechler, Eva Heger, Maike Wirtz, Sandra Weinhold, Markus Uhrberg, Fritz Boege and Karin Schulze-Bosse

Vaccines 2023, 11(3), 598; https://doi.org/10.3390/vaccines11030598 - 06 Mar 2023

Viewed by 1111

Abstract

(1) Background: The high incidence of SARS-CoV-2 infection in vaccinated persons underscores the importance of individualized re-vaccination. PanIg antibodies that act against the S1/-receptor binding domain quantified in serum by a routine diagnostic test (ECLIA, Roche) can be used to gauge the individual [...] Read more.

(1) Background: The high incidence of SARS-CoV-2 infection in vaccinated persons underscores the importance of individualized re-vaccination. PanIg antibodies that act against the S1/-receptor binding domain quantified in serum by a routine diagnostic test (ECLIA, Roche) can be used to gauge the individual ex vivo capacity of SARS-CoV-2 neutralization. However, that test is not adapted to mutations in the S1/-receptor binding domain, having accumulated in SARS-CoV-2 variants. Therefore, it might be unsuited to determine immune-reactivity against SARS-CoV-2 BA.5.1. (2) Method: To address this concern, we re-investigated sera obtained six months after second vaccinations with un-adapted mRNA vaccine Spikevax (Moderna). We related serum levels of panIg against the S1/-receptor binding domain quantified by the un-adapted ECLIA with full virus neutralization capacity against SARS-CoV-2 B.1 or SARS-CoV-2 BA5.1. (3) Results: 92% of the sera exhibited sufficient neutralization capacity against the B.1 strain. Only 20% of the sera sufficiently inhibited the BA5.1 strain. Sera inhibiting BA5.1 could not be distinguished from non-inhibiting sera by serum levels of panIg against the S1/-receptor binding domain quantified by the un-adapted ECLIA. (4) Conclusion: Quantitative serological tests for an antibody against the S1/-receptor binding domain are unsuited as vaccination companion diagnostics, unless they are regularly adapted to mutations that have accumulated in that domain. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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10 pages, 1216 KiB

Open AccessArticle

Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022

by Rachel C. Klosko, Sarah E. Lynch, Danielle L. Cabral, Kanneboyina Nagaraju, Yvonne A. Johnston, Joshua D. Steinberg and Kenneth L. McCall

Vaccines 2023, 11(2), 276; https://doi.org/10.3390/vaccines11020276 - 28 Jan 2023

Viewed by 1645

Abstract

The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the [...] Read more.

The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86–4.54) in a medical provider’s office, 0.85 (95% CI, 0.26–2.43) in a pharmacy and 1.01 (95% CI, 0.15–3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71–1.47) in a medical provider’s office, 1.06 (95% CI, 0.72–1.54) in a pharmacy, and 1.12 (95% CI, 0.61–1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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8 pages, 246 KiB

Open AccessArticle

Remdesivir Alone or in Combination with Monoclonal Antibodies as an Early Treatment to Prevent Severe COVID-19 in Patients with Mild/Moderate Disease at High Risk of Progression: A Single Centre, Real-Life Study

by Riccardo Scotto, Antonio Riccardo Buonomo, Antonio Iuliano, Maria Foggia, Alessia Sardanelli, Riccardo Villari, Biagio Pinchera, Ivan Gentile and Federico II COVID-Team

Vaccines 2023, 11(2), 200; https://doi.org/10.3390/vaccines11020200 - 17 Jan 2023

Cited by 5 | Viewed by 1898

Abstract

Early treatment with antivirals against SARS-CoV-2 infection can prevent the onset of severe COVID-19 in fragile and immunocompromised patients. In this real-life, prospective, observational study, we evaluated efficacy and safety of a 3-day early treatment with remdesivir in adult and fragile patients with [...] Read more.

Early treatment with antivirals against SARS-CoV-2 infection can prevent the onset of severe COVID-19 in fragile and immunocompromised patients. In this real-life, prospective, observational study, we evaluated efficacy and safety of a 3-day early treatment with remdesivir in adult and fragile patients with a diagnosis of SARS-CoV-2 infection who referred to the COVID-19 early treatment service of Infectious Diseases Unit of University of Naples Federico from 10 January 2022 to 31 March 2022. The included patients could be treated with either remdesivir alone or with remdesivir plus a monoclonal antibody with activity against SARS-CoV-2. Among the 62 included patients, we showed low rates of hospitalization (8%), increase in oxygen supplementation (3.2%), ICU admission (1.6%) and death (1.6%). The rate of disease progression was 8% and it was similar in patients treated with remdesivir alone or in combination with monoclonal antibodies (6.7% and 9.4%, respectively; p = 0.531). The rate of adverse drug reaction was low and similar in the two groups (13.3% in patients treated with remdesivir, 15.6% in patients treated with the combination; p = 0.543). Most common adverse events were headache and fever. In conclusion, in our cohort of patients at a high risk of worse COVID-19 outcomes, an early course of remdesivir showed low rates of disease progression and adverse drug reactions. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

16 pages, 2395 KiB

Open AccessArticle

Immune Responses to SARS-CoV-2 Infection and Vaccine in a Big Italian COVID-19 Hospital: An 18-Month Follow-Up

by Emanuele Sansone, Carlo Bonfanti, Emma Sala, Stefano Renzetti, Luigina Terlenghi, Alberto Matteelli, Mara Maria Tiraboschi, Tatiana Pedrazzi, Massimo Lombardo, Camillo Rossi, Anna Maria Indelicato, Arnaldo Caruso and Giuseppe De Palma

Vaccines 2023, 11(1), 8; https://doi.org/10.3390/vaccines11010008 - 20 Dec 2022

Cited by 4 | Viewed by 1433

Abstract

Objectives: This is a longitudinal prospective study which was designed to assess the trend of anti-SARS-CoV-2 antibodies targeting the Spike (anti-S) and Nucleocapside protein (anti-N) viral antigens over a 9-month period after the administration of an anti-SARS-CoV-2 vaccine in a big COVID-19 hospital [...] Read more.

Objectives: This is a longitudinal prospective study which was designed to assess the trend of anti-SARS-CoV-2 antibodies targeting the Spike (anti-S) and Nucleocapside protein (anti-N) viral antigens over a 9-month period after the administration of an anti-SARS-CoV-2 vaccine in a big COVID-19 hospital located in Northern Italy. Participants: 7411 vaccinated workers were included in a linear mixed-effect model analysis performed to model the anti-S decay over the 9 months following the vaccination, during serological screening performed approximately 2, 4, and 9 months following the first jab administration. Serological tests performed in the 9 months preceding vaccine administration were retrospectively analysed to identify the burden of infections occurring before vaccination. Results: The serological assays were used for monitoring the antibody titres during the observational period. Vaccination significantly reduced the rate of infection and elicited a specific humoral response, which lasted during the whole observational period (9 months). A decay was observed in all considered subgroups. At 35 weeks, workers with no history of pre-vaccine infection showed a significantly lower anti-S titre (−2522 U/mL on average (−2589.7 to −2445.7)); younger workers showed significantly higher anti-S titres (140.2 U/mL on average (82.4 to 201.3)). Only seven immunocompromised workers did not show significant levels of anti-S antibodies; three of them, all females, showed a specific T-cell response. Conclusions: Comparing the 9-month periods before and after the first vaccine dose, a significant reduction in infection rate was observed (1708 cases vs. 156). Pre-vaccine infection, especially if contracted during the first pandemic wave, greatly enhanced the response to vaccination, which was significantly affected also by age both in extent and duration (inversely related). A gender effect on the T-cell immune response was observed in a small group of workers who did not produce antibodies after vaccine administration. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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11 pages, 2529 KiB

Open AccessArticle

Genomic Tracking of SARS-CoV-2 Variants in Myanmar

by Khine Zaw Oo, Zaw Win Htun, Nay Myo Aung, Ko Ko Win, Kyaw Zawl Linn, Sett Paing Htoo, Phyo Kyaw Aung, Thet Wai Oo, Myo Thiha Zaw, Linn Yuzana Ko, Kyaw Myo Tun, Kyee Myint and Ko Ko Lwin

Vaccines 2023, 11(1), 6; https://doi.org/10.3390/vaccines11010006 - 20 Dec 2022

Viewed by 1513

Abstract

In December 2019, the COVID-19 disease started in Wuhan, China. The WHO declared a pandemic on 12 March 2020, and the disease started in Myanmar on 23 March 2020. In December 2020, different variants were brought worldwide, threatening global health. To counter those [...] Read more.

In December 2019, the COVID-19 disease started in Wuhan, China. The WHO declared a pandemic on 12 March 2020, and the disease started in Myanmar on 23 March 2020. In December 2020, different variants were brought worldwide, threatening global health. To counter those threats, Myanmar started the COVID-19 variant surveillance program in late 2020. Whole genome sequencing was done six times between January 2021 and March 2022. Among them, 83 samples with a PCR threshold cycle of less than 25 were chosen. Then, we used MiSeq FGx for sequencing and Illumina DRAGEN COVIDSeq pipeline, command line interface, GISAID, and MEGA version 7 for data analysis. In January 2021, no variant was detected. The second run, during the rise of cases in June 2021, showed Alpha, Delta, and Kappa variants. The third and the fourth runs in August and December showed only a Delta variant. Omicron and Delta variants were detected during the fifth run in January 2022. The sixth run in March 2022 showed only Omicron BA.2. Amino acid mutation at the receptor binding domain of Spike glycoprotein started since the second run coupling with high transmission, recurrence, and vaccine escape. We also found the mutation at the primer targets used in current RT-PCR platforms, but there was no mutation at the existing antiviral drug targets. The occurrence of multiple variants and mutations claimed vigilance at ports of entry and preparedness for effective control measures. Genomic surveillance with the observation of evolutionary data is required to predict imminent threats of the current disease and diagnose emerging infectious diseases. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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14 pages, 2457 KiB

Open AccessArticle

COVID-19: Impact of Original, Gamma, Delta, and Omicron Variants of SARS-CoV-2 in Vaccinated and Unvaccinated Pregnant and Postpartum Women

by Fabiano Elisei Serra, Elias Ribeiro Rosa Junior, Patricia de Rossi, Rossana Pulcineli Vieira Francisco and Agatha Sacramento Rodrigues

Vaccines 2022, 10(12), 2172; https://doi.org/10.3390/vaccines10122172 - 17 Dec 2022

Cited by 4 | Viewed by 1768

Abstract

This study compares the clinical characteristics and disease progression among vaccinated and unvaccinated pregnant and postpartum women who tested positive for different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using the Brazilian epidemiological data. Data of pregnant or postpartum patients testing [...] Read more.

This study compares the clinical characteristics and disease progression among vaccinated and unvaccinated pregnant and postpartum women who tested positive for different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using the Brazilian epidemiological data. Data of pregnant or postpartum patients testing positive for SARS-CoV-2 and presenting with coronavirus disease 2019 (COVID-19) from February 2020 to July 2022 were extracted from Brazilian national database. The patients were grouped based on vaccination status and viral variant (original, Gamma, Delta, and Omicron variants), and their demographics, clinical characteristics, comorbidities, symptoms, and outcomes were compared retrospectively. Data of 10,003 pregnant and 2361 postpartum women were extracted from the database. For unvaccinated postpartum women, intensive care unit (ICU) admission was more likely; invasive ventilation need was more probable if they tested positive for the original, Gamma, and Omicron variants; and chances of death were higher when infected with the original and Gamma variants than when infected with other variants. Vaccinated patients had reduced adverse outcome probability, including ICU admission, invasive ventilation requirement, and death. Postpartum women showed worse outcomes, particularly when unvaccinated, than pregnant women. Hence, vaccination of pregnant and postpartum women should be given top priority. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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14 pages, 1549 KiB

Open AccessArticle

Side Effects of COVID-19 Vaccines Primer Doses: Experience of Saudi Healthcare Workers Participating in CoVaST-SA

by Abanoub Riad, Safa S. Alsaad, Ali A. Almurikhi, Fayez A. Alzahrani, Ali M. Alghamdi, Esra H. Alzaid and Miloslav Klugar

Vaccines 2022, 10(12), 2137; https://doi.org/10.3390/vaccines10122137 - 13 Dec 2022

Cited by 2 | Viewed by 1426

Abstract

Background: Side effects emerging after COVID-19 vaccines may adversely impact public confidence in vaccines. Therefore, this study was designed to explore the short-term side effects of COVID-19 vaccines as a part of the COVID-19 Vaccines Safety Tracking (CoVaST) study. Methods: A cross-sectional survey-based [...] Read more.

Background: Side effects emerging after COVID-19 vaccines may adversely impact public confidence in vaccines. Therefore, this study was designed to explore the short-term side effects of COVID-19 vaccines as a part of the COVID-19 Vaccines Safety Tracking (CoVaST) study. Methods: A cross-sectional survey-based study was carried out to collect data from healthcare workers (HCWs) in Saudi Arabia. The study was initiated between June and December 2021. A validated questionnaire was used in this study consisting of four categories, including demographic characteristics and medical anamnesis of the participants, COVID-19-associated anamnesis, and side effects of vaccine uptake. Results: The study included 1039 participants, of which 70.2% were females, and their median age was 34. About 82.9% and 52.3% of the participants reported a minimum of both one local and systemic side effect, respectively. Females, young participants (≤34 years old), and non-obese participants had more potential to disclose post-vaccination side effects than their counterparts. Heterologous schedules and viral vector-based vaccines were linked with a greater rate of systemic side effects, whereas homologous vaccination schedules and mRNA-based vaccines were linked with a greater rate of local side effects. Conclusion: Future studies on COVID-19 vaccines should focus on the role of BMI, previous infection, and vaccination schedule in terms of vaccine safety and reactogenicity. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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11 pages, 1714 KiB

Open AccessArticle

The Inhibition of SARS-CoV-2 and the Modulation of Inflammatory Responses by the Extract of Lactobacillus sakei Probio65

by Irfan A. Rather, Lee-Ching Lew, Majid Rasool Kamli, Khalid Rehman Hakeem, Jamal S. M. Sabir, Yong-Ha Park and Yan-Yan Hor

Vaccines 2022, 10(12), 2106; https://doi.org/10.3390/vaccines10122106 - 09 Dec 2022

Cited by 4 | Viewed by 1674

Abstract

In the three years since the first outbreak of COVID-19 in 2019, the SARS-CoV-2 virus has continued to be prevalent in our community. It is believed that the virus will remain present, and be transmitted at a predictable rate, turning endemic. A major [...] Read more.

In the three years since the first outbreak of COVID-19 in 2019, the SARS-CoV-2 virus has continued to be prevalent in our community. It is believed that the virus will remain present, and be transmitted at a predictable rate, turning endemic. A major challenge that leads to this is the constant yet rapid mutation of the virus, which has rendered vaccination and current treatments less effective. In this study, the Lactobacillus sakei Probio65 extract (P65-CFS) was tested for its safety and efficacy in inhibiting SARS-CoV-2 replication. Viral load quantification by RT-PCR showed that the P65-CFS inhibited SARS-CoV-2 replication in human embryonic kidney (HEK) 293 cells in a dose-dependent manner, with 150 mg/mL being the most effective concentration (60.16% replication inhibition) (p < 0.05). No cytotoxicity was inflicted on the HEK 293 cells, human corneal epithelial (HCE) cells, or human cervical (HeLa) cells, as confirmed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The P65-CFS (150 mg/mL) also reduced 83.40% of reactive oxidizing species (ROS) and extracellular signal-regulated kinases (ERK) phosphorylation in virus-infected cells, both of which function as important biomarkers for the pathogenesis of SARS-CoV-2. Furthermore, inflammatory markers, including interferon-α (IFN-α), IFN-ß, and interleukin-6 (IL-6), were all downregulated by P65-CFS in virus-infected cells as compared to the untreated control (p < 0.05). It was conclusively found that L. sakei Probio65 showed notable therapeutic efficacy in vitro by controlling not only viral multiplication but also pathogenicity; this finding suggests its potential to prevent severe COVID-19 and shorten the duration of infectiousness, thus proving useful as an adjuvant along with the currently available treatments. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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13 pages, 278 KiB

Open AccessArticle

Assessment of Perceived Health Status and Access to Health Service during the COVID-19 Pandemic: Cross-Sectional Survey in Italy

by Concetta Paola Pelullo, Pamela Tortoriello, Silvia Angelillo, Francesca Licata, Francesco Napolitano and Gabriella Di Giuseppe

Vaccines 2022, 10(12), 2051; https://doi.org/10.3390/vaccines10122051 - 30 Nov 2022

Cited by 2 | Viewed by 1212

Abstract

(1) Background: The aims of this survey were to assess the perceived health status and to evaluate the use of healthcare services during the pandemic period. (2) Methods: This cross-sectional survey was conducted from May to October 2021 in the Campania and Calabria [...] Read more.

(1) Background: The aims of this survey were to assess the perceived health status and to evaluate the use of healthcare services during the pandemic period. (2) Methods: This cross-sectional survey was conducted from May to October 2021 in the Campania and Calabria regions, Southern Italy. The sample was selected among 655 subjects attending vaccination or primary care physician clinics. (3) Results: More than half (57.2%) of the respondents were female, the mean age was 49 years (range 19–97), and 61.3% had at least one chronic disease. Among the respondents, 56.3% declared that they had accessed healthcare at least once during the pandemic and, among all respondents who did not access healthcare, 23.2% gave reasons related to the COVID-19 pandemic. The two scores obtained from the Short-Form-12 Health Survey (SF-12), physical health summary (PCS) and mental health summary (MCS), had a means of 48.4 and 45.9, respectively. Among the respondents, 2.3% of respondents considered their health poor, 43.1% good and 6.4% excellent. (4) Conclusions: Our results suggest the need to ensure, in similar health emergency situations, a quick response from the National Health System so that ordinary medical assistance activities can be guaranteed in full safety, avoiding the risk of missed access or lack of assistance. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

14 pages, 2983 KiB

Open AccessArticle

A Simple Non-Invasive Score Based on Baseline Parameters Can Predict Outcome in Patients with COVID-19

by Riccardo Scotto, Amedeo Lanzardo, Antonio Riccardo Buonomo, Biagio Pinchera, Letizia Cattaneo, Alessia Sardanelli, Simona Mercinelli, Giulio Viceconte, Alessandro Perrella, Vincenzo Esposito, Alessio Vinicio Codella, Paolo Maggi, Emanuela Zappulo, Riccardo Villari, Maria Foggia, Ivan Gentile and Federico II COVID-Team

Vaccines 2022, 10(12), 2043; https://doi.org/10.3390/vaccines10122043 - 29 Nov 2022

Cited by 1 | Viewed by 1334

Abstract

We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission, and fatal outcome among patients with COVID-19. Consecutive adult inpatients with SARS-CoV-2 infection and respiratory symptoms treated in three different COVID centres [...] Read more.

We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission, and fatal outcome among patients with COVID-19. Consecutive adult inpatients with SARS-CoV-2 infection and respiratory symptoms treated in three different COVID centres were enrolled, and they were tested for laboratory parameters within 48 h from admission. Three-hundred ninety patients were enrolled. Age, baseline CRP, and LDH were associated with a P/F ratio < 200 during hospitalization. Male gender and CRP > 60 mg/L were shown to be independently associated with ICU admission. Lymphocytes < 1000 cell/μL were associated with the worst P/F ratio. CRP > 60 mg/L predicted exitus. We subsequently devised an 11-points numeric ordinary scoring system based on age, sex, CRP, and LDH at admission (ASCL score). Patients with an ASCL score of 0 or 2 were shown to be protected against a P/F ratio < 200, while patients with an ASCL score of 6 to 8 were shown to be at risk for P/F ratio < 200. Patients with an ASCL score ≥ 7 had a significantly increased probability of death during hospitalization. In conclusion, patients with elevated CRP and LDH and an ASCL score > 6 at admission should be prioritized for careful respiratory function monitoring and early treatment to prevent a progression of the disease. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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12 pages, 1178 KiB

Open AccessArticle

A Questionnaire-Based Cross-Sectional Survey of Knowledge, Attitudes, and Practices toward COVID-19 among Students and Staff in Asir, Saudi Arabia during the Second Wave of the Pandemic

by Norhan Saif Sheraba, Khalid Orayj, Ali Alqahtani, Rehab H. El-sokkary and Mohammad Khalid

Vaccines 2022, 10(12), 2014; https://doi.org/10.3390/vaccines10122014 - 25 Nov 2022

Cited by 2 | Viewed by 1780

Abstract

Being in a rapidly changing and dynamic environment during the COVID-19 pandemic, individuals’ perceptions change on a daily basis, and this starts to inform the status of knowledge, attitude, and practices (KAP) during the second wave of the pandemic. Aim: To assess the [...] Read more.

Being in a rapidly changing and dynamic environment during the COVID-19 pandemic, individuals’ perceptions change on a daily basis, and this starts to inform the status of knowledge, attitude, and practices (KAP) during the second wave of the pandemic. Aim: To assess the KAP on COVID-19 among students, teaching staff, and administrative staff in the Asir region for the first time. Methods: A questionnaire-based survey cross-sectional study was conducted from 10 February to 10 March 2021 using an online questionnaire. Results: In the survey of students and staff in educational institutes in the Asir region, the target population were well informed about COVID-19; in 10 out of 13 questions, more than 80% of the respondents answered correctly. The attitude of the target populations was quite positive. They were worried about the increase in the number of COVID-19 cases. The target populations were concerned (94.8%) for their kith and kin not to get infected. The target populations agree with the precautionary measures that were taken by Saudi authorities. A positive association was found between knowledge and practices as well as knowledge and attitudes of the target population. A significantly positive association was observed between attitudes and practices of the educational institutes’ respondents in Asir, Saudi Arabia. Conclusion: The students and staff in educational institutes in the Asir region have a high level of knowledge about COVID-19, have a positive attitude toward it, take proper precautions against it, and are enthusiastic about the COVID-19 vaccine. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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11 pages, 467 KiB

Open AccessCommunication

Cellular and Humoral SARS-CoV-2 Vaccination Responses in 192 Adult Recipients of Allogeneic Hematopoietic Cell Transplantation

by Thomas Meyer, Gabriele Ihorst, Ingrid Bartsch, Robert Zeiser, Ralph Wäsch, Hartmut Bertz, Jürgen Finke, Daniela Huzly and Claudia Wehr

Vaccines 2022, 10(11), 1782; https://doi.org/10.3390/vaccines10111782 - 23 Oct 2022

Cited by 4 | Viewed by 1466

Abstract

To determine factors influencing the vaccination response against SARS-CoV-2 is of importance in recipients of allogeneic hematopoietic cell transplantation (allo-HCT) as they display an increased mortality after SARS-CoV-2 infection, an increased risk of extended viral persistence and reduced vaccination response. Real-life data on [...] Read more.

To determine factors influencing the vaccination response against SARS-CoV-2 is of importance in recipients of allogeneic hematopoietic cell transplantation (allo-HCT) as they display an increased mortality after SARS-CoV-2 infection, an increased risk of extended viral persistence and reduced vaccination response. Real-life data on anti-SARS-CoV-2-S1-IgG titers (n = 192) and IFN-γ release (n = 110) of allo-HCT recipients were obtained using commercially available, validated assays after vaccination with either mRNA (Comirnaty™, Pfizer-BioNTech™, NY, US and Mainz, Germany or Spikevax™, Moderna™, Cambridge, Massachusetts, US) or vector-based vaccines (Vaxzevria™,AstraZeneca™, Cambridge, UK or Janssen COVID-19 vaccine™Johnson/Johnson, New Brunswick, New Jersey, US), or after a heterologous protocol (vector/mRNA). Humoral response (78% response rate) was influenced by age, time after transplantation, the usage of antithymocyte globulin (ATG) and ongoing immunosuppression, specifically corticosteroids. High counts of B cells during the vaccination period correlated with a humoral response. Only half (55%) of participants showed a cellular vaccination response. It depended on age, time after transplantation, ongoing immunosuppression with ciclosporin A, chronic graft-versus-host disease (cGvHD) and vaccination type, with vector-based protocols favoring a response. Cellular response failure correlated with a higher CD8+ count and activated/HLA-DR+ T cells one year after transplantation. Our data provide the basis to assess both humoral and cellular responses after SARS-CoV2 vaccination in daily practice, thereby opening up the possibility to identify patients at risk. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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9 pages, 251 KiB

Open AccessArticle

Nirmatrelvir/Ritonavir and Molnupiravir in the Treatment of Mild/Moderate COVID-19: Results of a Real-Life Study

by Ivan Gentile, Riccardo Scotto, Nicola Schiano Moriello, Biagio Pinchera, Riccardo Villari, Emilia Trucillo, Luigi Ametrano, Ludovica Fusco, Giuseppe Castaldo, Antonio Riccardo Buonomo and Federico II COVID Team

Vaccines 2022, 10(10), 1731; https://doi.org/10.3390/vaccines10101731 - 17 Oct 2022

Cited by 41 | Viewed by 3433

Abstract

Molnupiravir and nirmatrelvir were the first available oral antivirals (OAs) active against SARS-CoV-2. Trials evaluating the efficacy of OAs involved patients unvaccinated and infected with variants different from those currently circulating. We conducted a retrospective study on patients with confirmed SARS-CoV-2 infection treated [...] Read more.

Molnupiravir and nirmatrelvir were the first available oral antivirals (OAs) active against SARS-CoV-2. Trials evaluating the efficacy of OAs involved patients unvaccinated and infected with variants different from those currently circulating. We conducted a retrospective study on patients with confirmed SARS-CoV-2 infection treated with OAs during the omicron surge in Italy in order to provide real-life data on the efficacy and safety of OAs during the omicron surge of the COVID-19 pandemic. Among 257 patients, 56.8% received molnupiravir, while 43.2% received nirmatrelvir/ritonavir. Patients in the molnupiravir group were older, had a lower body mass index, and had a higher rate of chronic heart disease than those treated with nirmatrelvir/ritonavir. Three hospitalizations were recorded in the molnupiravir (2.1%) group and one in the nirmatrelvir/ritonavir (0.9%) group. One patient treated with molnupiravir died. The median time to negativity was 8 days in the nirmatrelvir/ritonavir group vs. 10 days in the molnupiravir group, p < 0.01. We recorded 37 ADRs (mainly dysgeusia, diarrhea, and nausea) in 31 individuals (12.1%). Only two patients (0.8%) treated with molnupiravir terminated treatment due to ADRs. In conclusion, in a population of mostly vaccinated patients treated with OAs, we observed a low rate of hospitalization, death, and adverse drug reactions. These rates were lower than those reported in pivotal trials. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

17 pages, 3313 KiB

Open AccessArticle

Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China

by Jiasheng Shao, Rong Fan, Jianrong Hu, Tiejun Zhang, Catherine Lee, Xuyuan Huang, Fei Wang, Haiying Liang, Ye Jin, Ying Jiang, Yanhua Gu and Gang Huang

Vaccines 2022, 10(9), 1409; https://doi.org/10.3390/vaccines10091409 - 28 Aug 2022

Cited by 11 | Viewed by 2892

Abstract

Background: Studies on the Omicron variant infection have generally been restricted to descriptions of its initial clinical and epidemiological characteristics. We investigated the timeline-related progression and clinical outcome in hospitalized individuals with the Omicron variant. Methods: We conducted a retrospective, single-centered study including [...] Read more.

Background: Studies on the Omicron variant infection have generally been restricted to descriptions of its initial clinical and epidemiological characteristics. We investigated the timeline-related progression and clinical outcome in hospitalized individuals with the Omicron variant. Methods: We conducted a retrospective, single-centered study including 226 laboratory-confirmed cases with the Omicron variant between 6 April and 11 May 2022 in Shanghai, China. The final date of follow-up was 30 May 2022. Results: Among 226 enrolled patients, the median age was 52 years, and 118 (52.2%) were female. The duration from onset of symptoms to hospitalization was 3 days (interquartile range (IQR): 2–4 days) for symptomatic patients. Cough occurred in 168 patients (74.3%). The median interval to negative reverse-transcriptase PCR tests of nasopharynx swab was 10 days ((IQR): 8–13 days). No radiographic progressions were found in 196 patients on the 7th day after onset of symptoms. The median duration of fever in all participants was 5 days (IQR: 4–6 days). The median PCR conversion time of Paxlovid-treated patients was 8 days (IQR: 7–10 days) compared with that of a traditional Chinese herb medicine lianhuaqingwen (10 days, IQR: 8–13 days) (p = 0.00056). Booster vaccination can significantly decrease the severity of Omicron infection when compared with unvaccinated patients (p = 0.009). In multivariate logistic analysis, erythrocyte sedimentation rate (ESR) (OR = 1.05) was independently related to the severity of the infection. Conclusions: The majority of clinical symptoms of Omicron infection were not severe. Early and aggressive administration of Paxlovid can significantly reduce the PCR conversion time. Booster vaccination should also be highly recommended in the population over 14 years old. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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13 pages, 1336 KiB

Open AccessArticle

Improved SARS-CoV-2 Neutralization of Delta and Omicron BA.1 Variants of Concern after Fourth Vaccination in Hemodialysis Patients

by Cho-Chin Cheng, Louise Platen, Catharina Christa, Myriam Tellenbach, Verena Kappler, Romina Bester, Bo-Hung Liao, Christopher Holzmann-Littig, Maia Werz, Emely Schönhals, Eva Platen, Peter Eggerer, Laëtitia Tréguer, Claudius Küchle, Christoph Schmaderer, Uwe Heemann, Lutz Renders, Ulrike Protzer and Matthias Christoph Braunisch

Vaccines 2022, 10(8), 1328; https://doi.org/10.3390/vaccines10081328 - 16 Aug 2022

Cited by 11 | Viewed by 1896

Abstract

Hemodialysis patients are exposed to a markedly increased risk when infected with SARS-CoV-2. To date, it is unclear if hemodialysis patients benefit from four vaccinations. A total of 142 hemodialysis patients received four COVID-19 vaccinations until March 2022. RDB binding antibody titers were [...] Read more.

Hemodialysis patients are exposed to a markedly increased risk when infected with SARS-CoV-2. To date, it is unclear if hemodialysis patients benefit from four vaccinations. A total of 142 hemodialysis patients received four COVID-19 vaccinations until March 2022. RDB binding antibody titers were determined in a competitive surrogate neutralization assay. Vero-E6 cells were infected with SARS-CoV-2 variants of concern (VoC), Delta (B.1.617.2), or Omicron (B.1.1.529, sub-lineage BA.1) to determine serum infection neutralization capacity. Four weeks after the fourth vaccination, serum infection neutralization capacity significantly increased from a 50% inhibitory concentration (IC50, serum dilution factor 1:x) of 247.0 (46.3–1560.8) to 2560.0 (1174.0–2560.0) for the Delta VoC, and from 37.5 (20.0–198.8) to 668.5 (182.2–2560.0) for the Omicron VoC (each p < 0.001) compared to four months after the third vaccination. A significant increase in the neutralization capacity was even observed for patients with high antibody titers after three vaccinations (p < 0.001). Ten patients with SARS-CoV-2 breakthrough infection after the first blood sampling had by trend lower prior neutralization capacity for Omicron (p = 0.051). Our findings suggest that hemodialysis patients benefit from a fourth vaccination in particular in the light of the highly infectious SARS-CoV-2 Omicron-variants. A routinely applied four-time vaccination seems to broaden immunity against variants and would be recommended in hemodialysis patients. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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22 pages, 2815 KiB

Open AccessArticle

SARS-CoV-2 Antibody Response against Mild-to-Moderate Breakthrough COVID-19 in Home Isolation Setting in Thailand

by Pichanun Mongkolsucharitkul, Apinya Surawit, Sureeporn Pumeiam, Nitat Sookrung, Anchalee Tungtrongchitr, Pochamana Phisalprapa, Naruemit Sayabovorn, Weerachai Srivanichakorn, Chaiwat Washirasaksiri, Chonticha Auesomwang, Tullaya Sitasuwan, Thanet Chaisathaphol, Rungsima Tinmanee, Methee Chayakulkeeree, Pakpoom Phoompoung, Watip Tangjittipokin, Sansnee Senawong, Gornmigar Sanpawitayakul, Saipin Muangman, Korapat Mayurasakorn and on behalf of the Siriraj Population Health and Nutrition Research (SPHERE) Group Show full author list Hide full author list

Vaccines 2022, 10(7), 1131; https://doi.org/10.3390/vaccines10071131 - 15 Jul 2022

Cited by 2 | Viewed by 2537

Abstract

Background: In December 2021, Omicron replaced Delta as the dominant coronavirus disease 2019 (COVID-19) variant in Thailand. Both variants embody diverse epidemiological trends and immunogenicity. We investigated whether Delta and Omicron patients’ biological and clinical characteristics and immunogenicity differed post-COVID-19 infection. Methods: This [...] Read more.

Background: In December 2021, Omicron replaced Delta as the dominant coronavirus disease 2019 (COVID-19) variant in Thailand. Both variants embody diverse epidemiological trends and immunogenicity. We investigated whether Delta and Omicron patients’ biological and clinical characteristics and immunogenicity differed post-COVID-19 infection. Methods: This retrospective cohort study investigated the clinical outcomes and laboratory data of 5181 patients with mild-to-moderate COVID-19 (Delta, 2704; Omicron, 2477) under home isolation. We evaluated anti-receptor-binding domain immunoglobulin G (anti-RBD IgG) and surrogate viral neutralizing (sVNT) activity in 495 individuals post-COVID-19 infection during the Delta pandemic. Results: Approximately 84% of all patients received favipiravir. The median cycle threshold (Ct) values were lower for Omicron patients than Delta patients (19 vs. 21; p < 0.001), regardless of vaccination status. Upper respiratory tract symptoms were more frequent with Omicron patients than Delta patients. There were no significant associations between Ct and Omicron symptoms (95% confidence interval 0.98–1.02). A two-dose vaccine regimen reduced hospital readmission by 10% to 30% and death by under 1%. Anti-RBD IgG and sVNT against Delta were higher among older individuals post-COVID-19 infection. Older individuals expressed anti-RBD IgG and sVNT for a more extended period after two-dose vaccination than other age groups. Conclusions: After a full vaccination course, breakthrough mild-to-moderate Delta and Omicron infections have limited immunogenicity. Prior infections exert reduced protection against later reinfection or infection from novel variants. However, this protection may be sufficient to prevent hospitalization and death, particularly in countries where vaccine supplies are limited. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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Review

Jump to: Research, Other

9 pages, 271 KiB

Open AccessReview

Understanding COVID-19 Vaccines Today: Are T-cells Key Players?

by Areez Shafqat, Tarek Z. Arabi, Belal N. Sabbah, Humzah S. Abdulkader, Shameel Shafqat, Adhil Razak, Junaid Kashir, Khaled Alkattan and Ahmed Yaqinuddin

Vaccines 2022, 10(6), 904; https://doi.org/10.3390/vaccines10060904 - 06 Jun 2022

Cited by 7 | Viewed by 2294

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has heavily mutated since the beginning of the coronavirus-2019 (COVID-19) pandemic. In this regard, the so-called variants of concern (VOCs) feature mutations that confer increased transmissibility and evasion of antibody responses. The VOCs have caused significant spikes [...] Read more.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has heavily mutated since the beginning of the coronavirus-2019 (COVID-19) pandemic. In this regard, the so-called variants of concern (VOCs) feature mutations that confer increased transmissibility and evasion of antibody responses. The VOCs have caused significant spikes in COVID-19 cases, raising significant concerns about whether COVID-19 vaccines will protect against current and future variants. In this context, whereas the protection COVID-19 vaccines offer against the acquisition of infection appears compromised, the protection against severe COVID-19 is maintained. From an immunologic standpoint, this is likely underpinned by the maintenance of T-cell responses against VOCs. Therefore, the role of T-cells is essential to understanding the broader adaptive immune response to COVID-19, which has the potential to shape public policies on vaccine protocols and inform future vaccine design. In this review, we survey the literature on the immunology of T-cell responses upon SARS-CoV-2 vaccination with the current FDA-approved and Emergency Use Authorized COVID-19 vaccines. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

Other

Jump to: Research, Review

8 pages, 1263 KiB

Open AccessBrief Report

The Impact of Past COVID-19 Infection on Selected Lymphocyte Subsets in Pediatric Patients

by Oskar Budziło, Ninela Irga-Jaworska, Marcelina Myszyńska, Magdalena Malanowska and Maciej Niedźwiecki

Vaccines 2023, 11(3), 659; https://doi.org/10.3390/vaccines11030659 - 15 Mar 2023

Viewed by 1320

Abstract

The impact of past COVID-19 infection on the immune system remains unidentified. So far, several papers have revealed the dependence between the count of lymphocytes and their subsets and the outcome of an acute disease. However, still there is little information about long-term [...] Read more.

The impact of past COVID-19 infection on the immune system remains unidentified. So far, several papers have revealed the dependence between the count of lymphocytes and their subsets and the outcome of an acute disease. However, still there is little information about long-term consequences, particularly in the pediatric population. We attempted to verify whether a dysregulation of the immune system may be the reason for observed complications after past COVID-19 infection. Hence, we tried to prove that abnormalities in lymphocyte subpopulations are found in patients a certain time after the COVID-19 infection. In our paper, we enrolled 466 patients after SARS-CoV-2 infection, and evaluated their subsets of lymphocytes within 2–12 months after infection and compared them to the control group assessed several years before the pandemic. It occurred that main differences are observed in CD19⁺ lymphocytes and the index CD4⁺/CD8⁺ lymphocytes. We believe that this is only the introduction to further investigation of the immune system of pediatric patients post-COVID-19 infection. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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8 pages, 852 KiB

Open AccessBrief Report

Utility of IL-6 in the Diagnosis, Treatment and Prognosis of COVID-19 Patients: A Longitudinal Study

by Vikram Jain, Pratap Kumar, Prasan Kumar Panda, Mohan Suresh, Karanvir Kaushal, Anissa A. Mirza, Rohit Raina, Sarama Saha, Balram J. Omar and Vivekanandhan Subbiah

Vaccines 2022, 10(11), 1786; https://doi.org/10.3390/vaccines10111786 - 24 Oct 2022

Cited by 5 | Viewed by 1135

Abstract

COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of [...] Read more.

COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of COVID-19-related cytokine storm. Patients with COVID-19 who were admitted at AIIMS Rishikesh from March to December 2020 were included in the study. Patients with no baseline IL-6 value at admission and for whom clinical data were not available were excluded. Clinical and laboratory data of these patients were collected from the e-hospital portal and entered in an excel sheet. Correlation was seen with other inflammatory markers and outcomes were assessed using MS Excel 2010 and SPSS software. A total of 131 patients were included in the study. Of these, 74.8% were males, with mean age 55.03 ± 13.57 years, and mean duration from symptom onset being 6.69 ± 6.3 days. A total of 82.4% had WHO severe category COVID-19, with 46.56% having severe hypoxia at presentation and 61.8% of them having some comorbidity. Spearman rank correlation coefficient of IL-6 with D-dimer was 0.203, with LDH was −0.005, with ferritin was 0.3, and with uric acid was 0.123. A total of 11 patients received Tocilizumab at a mean duration from symptom onset of 18.09 days, and 100% mortality was observed. Deaths were reported more in the group with IL-6 ≥ 40 pg/mL (57.1% vs. 40.2%, p = 0.06). ICU admissions and ventilator requirement were higher in the IL-6 ≥ 40 pg/mL group (95.9% vs. 91.4%, p = 0.32 and 55.1% vs. 37.8%, p = 0.05). The study showed that IL-6 can be used as a possible “thrombotic cytokine marker”. Higher values of IL-6 (≥40 pg/mL) are associated with more deaths, ICU admissions, and ventilator requirement. Full article

(This article belongs to the Special Issue Global Trends of COVID-19 Vaccination and Immunology)

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