Population-level vaccine efficacy is a critical component of understanding COVID-19 risk, informing public health policy, and mitigating disease impacts. Unlike individual-level clinical trials, population-level analysis characterizes how well vaccines worked in the face of real-world challenges like emerging variants, differing mobility patterns, and policy changes. In this study, we analyze the association between time-dependent vaccination rates and COVID-19 health outcomes for 48 U.S. states. We primarily focus on case-hospitalization risk (CHR) as the outcome of interest, using it as a population-level proxy for disease burden on healthcare systems. Performing the analysis using Generalized Additive Models (GAMs) allowed us to incorporate real-world nonlinearities and control for critical dynamic (time-changing) and static (temporally constant) factors. Dynamic factors include testing rates, activity-related engagement levels in the population, underlying population immunity, and policy. Static factors incorporate comorbidities, social vulnerability, race, and state healthcare expenditures. We used SARS-CoV-2 genomic surveillance data to model the different COVID-19 variant-driven waves separately, and evaluate if there is a changing role of the potential drivers of health outcomes across waves. Our study revealed a strong and statistically significant negative association between vaccine uptake and COVID-19 CHR across each variant wave, with boosters providing additional protection during the Omicron wave. Higher underlying population immunity is shown to be associated with reduced COVID-19 CHR. Additionally, more stringent government policies are generally associated with decreased CHR. However, the impact of activity-related engagement levels on COVID-19 health outcomes varied across different waves. Regarding static variables, the social vulnerability index consistently exhibits positive associations with CHR, while Medicaid spending per person consistently shows a negative association. However, the impacts of other static factors vary in magnitude and significance across different waves. This study concludes that despite the emergence of new variants, vaccines remain highly correlated with reduced COVID-19 harm. Therefore, given the ongoing threat posed by COVID-19, vaccines remain a critical line of defense for protecting the public and reducing the burden on healthcare systems.
Predictive models have been able to foresee outbreaks of mosquito-borne diseases such as malaria and map Ebola outbreaks. This has allowed health organizations to plan the amount of resources and the number of healthcare workers n eeded more effectively, on top of finding out other useful data such as the locations most vulnerable to the disease and the demographics most affected. It can therefore be assumed that predictive analytics can reduce the amount of economic and non-economic burden caused by other epidemics as well, with COVID-19 being an obvious example.
Objective: We aimed to investigate cardiac effects of severe SARS-CoV-2 and the importance of echocardiography-assessment and biomarkers. Methods: This is an observational study of the first patients admitted to intensive care due to SARS-CoV-2-respiratory failure. Thirty-four underwent echocardiography of which twenty-five were included, compared to forty-four non-echo patients. Exclusion was based on absence of normofrequent sinus rhythm and/or mechanical respiratory support. Biomarkers were analysed on clinical indication. Results: Mortality was higher in the echo- compared to non-echo group (44 % vs. 16%, p<0.05). Right-sided parameters were not under significant strain. Tricuspid valve regurgitation velocity indicated how increased pulmonary pressure was associated with mortality (survivors: 2.51 +/- 0.01 m/s vs. non-survivors: 3.06 +/- 0.11 m/s, p<0.05), before multiple comparison-correction. Setting cut-off for pulmonary hypertension to 2.8 m/s generated p<0.01 using frequency distribution testing. Cardiac markers, high sensitivity cardiac troponin I and N-terminal pro brain natriuretic peptide, and D-dimer were higher in the echocardiography group. (hs-TnI (ng/L): echo : 133 +/- 45 vs. non-echo: 81.3 +/- 45, p<0.01; NT-proBNP (ng/L): echo: 2959 +/- 573 vs. non-echo: 1641 +/- 420, p<0.001; D-dimer (mg/L): echo: 16.1 +/- 3.7 vs. non-echo: 6.1 +/- 1.5, p<0.01) and non-survivor group (hs-TnI (ng/L): survivors: 59.1 +/- 21 vs. non-survivors: 211 +/- 105, p<0.0001; NT-proBNP (ng/L): survivors: 1310 +/- 314 vs. non-survivors: 4065 +/- 740, p<0.0001; D-dimer (mg/L): survivors: 7.2 +/- 1.5 vs. non-survivors: 17.1 +/- 4.8, p<0.01). Tricuspid regurgitation velocity was positively correlated with cardiac troponin I (r=0.93, r2=0.74, p<0.001). Conclusions: These results suggest there is no negative effect on cardiac function in critical SARS-CoV-2. Pulmonary pressure appears higher amongst non-survivors indicating pulmonary disease as the driver of mortality. Echocardiography was more commonly performed in the non-survivor group, and cardiac biomarkers as well as D-dimer was higher in the non-survivor group suggesting they carry negative prognostic values.
Background: The COVID-19 pandemic has had a profound impact on the mental health of people worldwide. Mental health also impacts on physical health. In the context of viral illnesses, viral challenge studies have shown that indices of mental health are associated with susceptibility to viral infections, including coronaviruses. Research conducted during the pandemic has shown that people with a history of mental health conditions were at increased risk of infection, hospitalisation, and mortality. However, the relationship between mental health conditions and vaccine outcomes such as vaccine intentions, uptake, and vaccine breakthrough is not yet well-understood. Methods: We conducted a systematic search on the topics of COVID-19 vaccine intentions, vaccine uptake, and vaccine breakthrough, in relation to mental health conditions, in four databases: PubMed, MEDLINE, SCOPUS, and PsychINFO, as well as the publication lists of Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), OpenSAFELY, and QResearch. Inclusion criteria focus on studies reporting either of the aforementioned COVID-19 vaccine outcomes among people with mental health conditions. Results: Thirty-three out of 251 publications met our inclusion criteria for this review. Overall, the evidence is inconclusive regarding the level of intention to accept the COVID-19 vaccine among people with mental health conditions. However, people with mental health conditions were more likely to have lower uptake of the COVID-19 vaccine, compared to people without. Common barriers to COVID-19 vaccine uptake include concerns about the safety, effectiveness, and side effects of the vaccines. Limited evidence also suggests that vaccine breakthrough may be a particular risk for those with substance use disorder. Conclusions: Our findings revealed a possible intention-behaviour gap for receiving the COVID-19 vaccine among people with mental health conditions, yielding interventions to encourage vaccine uptake in this population. There is also the need to enhance our understanding of COVID-19 vaccine breakthrough in people with mental health conditions.
Background: Web-based risk prediction tools for cardiovascular diseases are crucial for providing rapid risk estimates for busy clinicians, but there is none available specifically for Chinese subjects. This study developed ChineseCVD, first-in-world web-based Chinese-specific Cardiovascular Risk Calculator incorporating long COVID, COVID-19 vaccination, SGLT2i and PCSK9i treatment effects. Methods: Adult patients attending government-funded family medicine clinics in Hong Kong between 1st January 2000 and 31st December 2003 were included. The primary outcome was major adverse cardiovascular events (MACE) defined as a composite of myocardial infarction, heart failure, transient ischaemic attacks/ischaemic strokes, and cardiovascular mortality. Results: A total of 155,066 patients were used as the derivation cohort. Over a median follow-up of 16.1 (11.6-17.8) years, 31,061 (20.44%) had MACE. Cox regression identified male gender, age, comorbidities, cardiovascular medications, systolic and diastolic blood pressure, and laboratory test results (neutrophil-lymphocyte ratio, creatinine, ALP, AST, ALT, HbA1c, fasting glucose, triglyceride, LDL and HDL) as significant predictors of the above outcomes. ChineseCVD further incorporates the impact of smoking status, COVID-19 infection, number of COVID-19 vaccination doses, and modifier effects of newest medication classes of PCSK9i and SGLT2i. The calculator enables clinicians to demonstrate to patients how risks vary with different medications. Conclusions: The ChineseCVD risk calculator enables rapid web-based risk assessment for adverse cardiovascular outcomes, thereby facilitating clinical decision-making at the bedside or in the clinic.
Background: Long COVID encompasses a heterogeneous set of ongoing symptoms that affect many individuals after recovery from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The underlying biological mechanisms nonetheless remain obscure, precluding accurate diagnosis and effective intervention. Complement dysregulation is a hallmark of acute COVID-19 but has not been investigated as a potential determinant of long COVID. Methods: We quantified a series of complement proteins, including markers of activation and regulation, in plasma samples from healthy convalescent individuals with a confirmed history of infection with SARS-CoV-2 and age/ethnicity/gender/infection/vaccine-matched patients with long COVID. Findings: Markers of classical (C1s-C1INH complex), alternative (Ba, iC3b), and terminal pathway (C5a, TCC) activation were significantly elevated in patients with long COVID. These markers in combination had a receiver operating characteristic predictive power of 0.794. Other complement proteins and regulators were also quantitatively different between healthy convalescent individuals and patients with long COVID. Generalized linear modeling further revealed that a clinically tractable combination of just four of these markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power of 0.785. Conclusions: These findings suggest that complement biomarkers could facilitate the diagnosis of long COVID and further suggest that currently available inhibitors of complement activation could be used to treat long COVID. Funding: This work was funded by the National Institute for Health Research (COV-LT2-0041), the PolyBio Research Foundation, and the UK Dementia Research Institute.
Background. Acute kidney injury (AKI) is common in hospitalized patients with SARS-CoV2 infection despite vaccination and leads to long-term kidney dysfunction. However, peripheral blood molecular signatures in AKI from COVID-19 and their association with long-term kidney dysfunction are yet unexplored. Methods. In patients hospitalized with SARS-CoV2, we performed bulk RNA sequencing using peripheral blood mononuclear cells (PBMCs). We applied linear models accounting for technical and biological variability on RNA-Seq data accounting for false discovery rate (FDR) and compared the functional enrichment and pathway results to a historical sepsis-AKI cohort. Finally, we evaluated the association of these signatures with long-term trends in kidney function. Results. Of 283 patients, 106 had AKI. After adjustment for sex, age, mechanical ventilation, and chronic kidney disease (CKD), we identified 2635 significant differential gene expressions at FDR<0.05. Top canonical pathways were EIF2 signaling, oxidative phosphorylation, mTOR signaling, and Th17 signaling, indicating mitochondrial dysfunction and endoplasmic reticulum (ER) stress. Comparison with sepsis associated AKI showed considerable overlap of key pathways (48.14%). Using follow-up estimated glomerular filtration rate (eGFR) measurements from 115 patients, we found that 164/2635 (6.2%) of the significantly differentiated genes were associated with overall decrease in long-term kidney function. The strongest associations were autophagy, renal impairment via fibrosis and cardiac structure/function. Conclusions. We show that AKI in SARS-CoV2 is a multifactorial process with mitochondrial dysfunction driven by ER stress whereas long-term kidney function decline is associated with cardiac structure and function, and immune dysregulation. Functional overlap with sepsis-AKI also highlights common signatures indicating generalizability in therapeutic approaches.
Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Renal Function - Conditions: COVID-19 Pneumonia
Interventions: Drug: GST-HG171 Tablets
Sponsors: Fujian Akeylink Biotechnology Co., Ltd.
Recruiting
Preoperative Educational Videos on Maternal Stress Whose Children Received Congenital Heart Disease Surgery: During COVID-19 Panic - Conditions: COVID-19; Educational Videos; Maternal; Uncertainty; Anxiety; Depression; Congenital Heart Disease; Children
Interventions: Other: Preoperative educational videos plus routine education; Other: Preoperative routine education
Sponsors: Chung Shan Medical University
Completed
Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Liver Function - Conditions: COVID-19 Pneumonia
Interventions: Drug: GST-HG171 Tablets
Sponsors: Fujian Akeylink Biotechnology Co., Ltd.
Completed
Evaluation of Concordance Between Exhaled Air Test (eBAM-CoV) and RT-PCR to Detect SARS-CoV-2 - Conditions: SARS-CoV-2 Infection; COVID-19; Coronavirus
Interventions: Device: eBAM Cov Testing
Sponsors: Centre Hospitalier Universitaire de Nīmes; University of Nimes; brains’ laboratory sas, FRANCE
Not yet recruiting
Study to Safety, Tolerability and Immunogenicity of EG-COVII in Healthy Adult - Conditions: COVID-19
Interventions: Biological: EG-COVII
Sponsors: EyeGene Inc.
Recruiting
Pharmacokinetics and Bioequivalence of Aterixen 100 mg Tablets and Aterixen 100 mg Film-coated Tablets in Healthy Volunteers - Conditions: Viral Infection COVID-19
Interventions: Drug: Aterixen
Sponsors: Valenta Pharm JSC
Not yet recruiting
Long COVID Brain Fog: Cognitive Rehabilitation Trial - Conditions: Long COVID; Brain Fog; Cognitive Impairment; Cognitive Dysfunction; Post-Acute COVID-19 Syndrome
Interventions: Behavioral: Speed of Processing Training; Behavioral: In-lab Instrumental Activities of Daily Living Training; Behavioral: In-lab Brain Health Training; Behavioral: Transfer Package; Behavioral: Follow Up Phone Calls; Behavioral: Vocational Rehabilitation; Behavioral: Peer Mentoring
Sponsors: University of Alabama at Birmingham; National Institute on Disability, Independent Living, and Rehabilitation Research
Not yet recruiting
Paradoxical Response to Chest Wall Loading in Mechanically Ventilated Patients - Conditions: ARDS; COVID-19; Mechanical Ventilation Pressure High; Ventilator-Induced Lung Injury
Interventions: Diagnostic Test: Manual loading of the chest wall
Sponsors: HealthPartners Institute
Withdrawn
A Practical RCT of TCM in the Treatment of LCOVID and Analysis of Syndrome Types and Medication Characteristics. - Conditions: Long COVID
Interventions: Drug: Traditional Chinese medicine treatment; Drug: Western medicine treatment
Sponsors: Chinese University of Hong Kong
Not yet recruiting
Narrative Intervention for Long COVID-19 (NICO) - Conditions: Long COVID; Long Covid19
Interventions: Behavioral: Narrative Intervention for Long COVID-19 (NICO)
Sponsors: University of Colorado, Denver
Active, not recruiting
Immunogenicity of Concomitant Administration of COVID-19 Vaccines With Influenza Vaccines - Conditions: COVID-19; Influenza; Vaccine Reaction; Contaminant Injected
Interventions: Biological: Omicron-containing COVID-19 vaccine; Biological: influenza vaccine
Sponsors: Catholic Kwandong University; Korea University Guro Hospital
Recruiting
Inspiratory Muscle Training in People With Long COVID-19- A Pilot Investigation. - Conditions: Long COVID
Interventions: Device: PrO2
Sponsors: University of Bath; Swansea University
Not yet recruiting
Inspiratory Muscle Strength Training in Post-Covid Syndrome - Conditions: Cardiovascular Abnormalities; Post-COVID-19 Syndrome; Physical Exercise
Interventions: Other: Inspiratory muscle strength training
Sponsors: D’Or Institute for Research and Education
Recruiting
Home-Based Respiratory Muscle Strength Training Program for Individuals With Post-COVID-19 Persistent Dyspnea - Conditions: Post-COVID-19 Syndrome; Dyspnea
Interventions: Device: Respiratory Muscle Strength Trainers
Sponsors: University of South Florida
Not yet recruiting
Rural Tailored Communication to Promote SARS-CoV-2 Antibody Testing in Saliva - Conditions: SARS-CoV2 Infection
Interventions: Behavioral: General SARS-CoV-2 Communication; Behavioral: Rural-Targeted SARS-CoV-2 Communication
Sponsors: Michigan State University; National Cancer Institute (NCI); Johns Hopkins University
Recruiting
Identifying the Potential of miRNAs in Houttuynia cordata-Derived Exosome-Like Nanoparticles Against Respiratory RNA Viruses - INTRODUCTION: Pathogenic respiratory RNA viruses, including influenza A virus (IAV), respiratory syncytial virus (RSV), and SARS-CoV-2, are major causes of causes of acute respiratory infection globally. Plant-derived exosome-like nanoparticles containing miRNAs have shown substantial cross-kingdom regulatory effects on both viral and human transcripts. Houttuynia cordata (H. cordata), a traditional Chinese medicine frequently used to treat respiratory diseases. However, the role of H….
Hypercapnia increases ACE2 expression and pseudo-SARS-CoV-2 entry in bronchial epithelial cells by augmenting cellular cholesterol - Patients with chronic lung disease, obesity, and other co-morbid conditions are at increased risk of severe illness and death when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hypercapnia, the elevation of CO(2) in blood and tissue, commonly occurs in patients with severe acute and chronic lung disease, including those with pulmonary infections, and is also associated with high mortality risk. We previously reported that hypercapnia increases viral replication and…
Clinical and Immunological Impacts of Latent Toxoplasmosis on COVID-19 Patients - Background Parasites are well-known immune-modulators. They inhibit some aspects of the immune system to ensure persistence inside the host for a long time; meanwhile, they stimulate other immune aspects to assure the survival of the host. Wide variations in the severity of coronavirus disease 2019 (COVID-19) among developed and developing countries were reported during the COVID-19 pandemic. Parasitic infections, including Toxoplasma gondii (T. gondii), were claimed to contribute to such…
IgG antibody levels against the SARS-CoV-2 spike protein in mother-child dyads after COVID-19 vaccination - CONCLUSIONS: COVID-19 mRNA vaccines induce high anti-SARS-CoV-2 S titers in pregnant women, which can inhibit the binding of ACE2 to protein S and are efficiently transferred to the fetus. However, there was a rapid decrease in antibody levels at 2 to 3 months post-partum, particularly in infants.
Neurotoxic effects of chloroquine and its main transformation product formed after chlorination - Pharmaceutical transformation products (TPs) generated during wastewater treatment have become an environmental concern. However, there is limited understanding regarding the TPs produced from pharmaceuticals during wastewater treatment. In this study, chloroquine (CQ), which was extensively used for treating coronavirus disease-19 (COVID-19) infections during the pandemic, was selected for research. We identified and fractionated the main TP produced from CQ during chlorine disinfection and…
Development of Pan-Anti-SARS-CoV-2 Agents through Allosteric Inhibition of nsp14/nsp10 Complex - SARS-CoV-2 nsp14 functions both as an exoribonuclease (ExoN) together with its critical cofactor nsp10 and as an S-adenosyl methionine-dependent (guanine-N7) methyltransferase (MTase), which makes it an attractive target for the development of pan-anti-SARS-CoV-2 drugs. Herein, we screened a panel of compounds (and drugs) and found that certain compounds, especially Bi(III)-based compounds, could allosterically inhibit both MTase and ExoN activities of nsp14 potently. We further demonstrated…
Unraveling bioactive metabolites of mangroves as putative inhibitors of SARS-CoV-2 Mpro and RBD proteins: molecular dynamics and ADMET analysis - COVID-19 is a deadly pandemic caused by Corona virus leading to millions of deaths worldwide. Till today no medicine was available to cure this disease. This study selected 262 potential bioactive natural products derived from mangroves to inhibit the main protease (Mpro) and receptor-binding domain (RBD) protein of the COVID-19 virus. All the ligands were subjected to Adsorption Digestion Metabolism Excretion and Toxicity (ADMET) predictions and docking studies using AutodockVina. Among all the…
Immunogenicity of Co-Administered Omicron BA.4/BA.5 Bivalent COVID-19 and Quadrivalent Seasonal Influenza Vaccines in Israel during the 2022-2023 Winter Season - Vaccination against COVID-19 and influenza provides the best defense against morbidity and mortality. Administering both vaccines concurrently may increase vaccination rates and reduce the burden on the healthcare system. This study evaluated the immunogenicity of healthcare workers in Israel who were co-administered with the Omicron BA.4/BA.5 bivalent COVID-19 vaccine and the 2022-2023 quadrivalent influenza vaccine. SARS-CoV-2 neutralizing antibody titers were measured via microneutralization…
Longitudinal Analysis of SARS-CoV-2-Specific Cellular and Humoral Immune Responses and Breakthrough Infection following BNT162b2/BNT162b2/BNT162b2 and ChAdOx1/ChAdOx1/BNT162b2 Vaccination: A Prospective Cohort in Naive Healthcare Workers - Assessing immune responses post-SARS-CoV-2 vaccination is crucial for optimizing vaccine strategies. This prospective study aims to evaluate immune responses and breakthrough infection in 235 infection-naïve healthcare workers up to 13-15 months after initial vaccination in two vaccine groups (108 BNT/BNT/BNT and 127 ChAd/ChAd/BNT). Immune responses were assessed using the interferon-gamma enzyme-linked immunospot (ELISPOT) assay, total immunoglobulin, and neutralizing activity through surrogate…
RSL3 Inhibits Porcine Epidemic Diarrhea Virus Replication by Activating Ferroptosis - Porcine epidemic diarrhea virus (PEDV) is a highly contagious coronavirus that induces diarrhea and death in neonatal piglets, resulting in substantial economic losses to the global swine industry. The mechanisms of PEDV infection and the roles of host factors are still under exploration. In this study, we used the ferroptosis pathway downstream target activator (1S,3R)-RSL3 compound as a starting point, combined with the interactions of N-acetylcysteine and deferoxamine, to elucidate the…
Pharmacokinetic and Pharmacodynamic Analysis of the 3CL Protease Inhibitor Ensitrelvir in a SARS-CoV-2 Infection Mouse Model - The small-molecule antiviral drug ensitrelvir targets the 3C-like protease of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study evaluated its inhibitory effect on viral replication in a delayed-treatment mouse model and investigated the relationship between pharmacokinetic (PK) parameters and pharmacodynamic (PD) effects. SARS-CoV-2 gamma-strain-infected BALB/c mice were orally treated with various doses of ensitrelvir starting 24 h post-infection. Effectiveness was…
Viral Entry Inhibitors Protect against SARS-CoV-2-Induced Neurite Shortening in Differentiated SH-SY5Y Cells - The utility of human neuroblastoma cell lines as in vitro model to study neuro-invasiveness and neuro-virulence of SARS-CoV-2 has been demonstrated by our laboratory and others. The aim of this report is to further characterize the associated cellular responses caused by a pre-alpha SARS-CoV-2 strain on differentiated SH-SY5Y and to prevent its cytopathic effect by using a set of entry inhibitors. The susceptibility of SH-SY5Y to SARS-CoV-2 was confirmed at high multiplicity-of-infection,…
The Ubiquitin-Proteasome System Facilitates Membrane Fusion and Uncoating during Coronavirus Entry - Although the involvement of the ubiquitin-proteasome system (UPS) in several coronavirus-productive infections has been reported, whether the UPS is required for infectious bronchitis virus (IBV) and porcine epidemic diarrhea virus (PEDV) infections is unclear. In this study, the role of UPS in the IBV and PEDV life cycles was investigated. When the UPS was suppressed by pharmacological inhibition at the early infection stage, IBV and PEDV infectivity were severely impaired. Further study showed…
Extracellular Vesicles as a Translational Approach for the Treatment of COVID-19 Disease: An Updated Overview - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic in the years 2020-2022. With a high prevalence, an easy route of transmission, and a long incubation time, SARS-CoV-2 spread quickly and affected public health and socioeconomic conditions. Several points need to be elucidated about its mechanisms of infection, in particular, its capability to evade the immune system and escape from neutralizing antibodies. Extracellular vesicles (EVs) are phospholipid…
Anti-Viral Activity of Bioactive Molecules of Silymarin against COVID-19 via In Silico Studies - The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection drove the global coronavirus disease 2019 (COVID-19) pandemic, causing a huge loss of human life and a negative impact on economic development. It is an urgent necessity to explore potential drugs against viruses, such as SARS-CoV-2. Silymarin, a mixture of herb-derived polyphenolic flavonoids extracted from the milk thistle, possesses potent antioxidative, anti-apoptotic, and anti-inflammatory properties. Accumulating…