Background: SARS COV-2 pandemic has significant impact on hematopoietic system. Objective: To report the incidence and pattern of baseline hematological parameters in patients with COVID-19 and their association with severity of disease and outcome. Methods: Retrospective observational study. Results: A total of 440 patients were included in the study. The mean age of the study cohort was 47.5 years. Fifty percent of patients had at least 1 comorbidity. ICU stay was required in 125 (39.6%) patients. Overall mortality in the study cohort was 3.52%. The average age of patients who died was significantly higher than that of patients who were alive (65.1 years vs 46.5 years; p= 0.000). DM, HTN, CAD and CKD were all associated with higher incidence of ICU stay and mortality. Lymphopenia < 1x109 was observed in 24.3% and eosinopenia was noted in 44.3% patients. Leukocytosis>11x109 was seen in 8.2 % of patients. The median neutrophil lymphocyte ratio (NLR) of whole cohort was 2.63. NLR, Lymphopenia, eosinopenia, leucocytosis, D dimer, lactate dehydrogenase (LDH), ferritin and IL6 levels all were associated with need for ICU transfer and mortality. Hemoglobin, red cell distribution width (RDW), PT and aPTT correlated with need for ICU transfer but not with mortality. Ferritin cutoff >751 ng/ml and IL6 levels >64pg/ml was able to identify all deaths. Ferritin (0.989) and IL-6 (0.985) had very high negative predictive value. Conclusions: Peripheral blood counts at time of hospitalization is a simple tool to predict outcomes in patients admitted with Covid-19.
Background Severe Acute Respiratory Syndrome Coronavirus (SARSCoV) is a respiratory disease causing coronavirus. SARSCoV has caused the Middle East Respiratory Syndrome (MERS), SARSCoV in Hong King and SARSCoV2 (COVID19). COVID19, to date, have had the highest mortality and morbidity globally, thus reaching the pandemic status. In comparison to research conducted to explore the impact of pandemics on the general wellbeing, there appears to be a paucity on its association with womens mental health. Many pregnant women have reported that the pandemic negatively impacted their mental health. Aim This study aimed is to explore the prevalence of the impact of the COVID19, MERS and SARS pandemics on the mental health of pregnant women. Method A study protocol was developed and published in PROSPERO (CRD42021235356) to explore a number of key objectives. For the purpose of this study PubMed, Science direct, Ovid PsycINFO and EMBASE databases were searched from December 2000 to July 2021. The search results were screened, first by title, and then by abstract. A metaanalysis was conducted to report the findings. Results There were no studies reporting the mental health impact due to MERS and SARS. We systematically identified 316 studies that reported on the mental health of women that were pregnant and soon after birth. The metaanalysis indicated 24.9% (21.37% to 29.02%) of pregnant women reported symptoms of depression, 32.8% (29.05% to 37.21%) anxiety, 29.44% (18.21% to 47.61%) stress, 27.93% (9.05%to 86.15 %) PTSD, and 24.38% (11.89% to 49.96%) sleep disorders during the COVID19 pandemic. Furthermore, the I2 test showed a high heterogeneity value. Conclusion The importance of managing the mental health during pregnancy and after delivery improves the quality of life and wellbeing of mothers. Developing an evidence based mental health framework as part of pandemic preparedness to help pregnant women would improve the quality of care received during challenging times. Keywords: Covid19, Mental ill health, Depression, Anxiety, Stress, Pregnancy, Antenatal care, Postnatal care, Wellbeing
Abstract Immunocompromised patients have been at an increased risk of succumbing to COVID-19 already since the beginning of the pandemic. Here we analyzed data from patients with end stage renal disease, including those on dialysis and patients with a kidney transplant, and compared them to the general population. We found that kidney patients remain at increased risk of succumbing to COVID-19 despite all available countermeasures. The analyses underline the need for additional protection for this vulnerable population.
COVID-19 may cause a dysregulation of the immune system and has complex relationships with multiple autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, little is known about their common genetic architecture. We analysed summary-level genetic data from the latest COVID‐19 host genetics consortium and consortia on RA and SLE to examine the shared genetic etiology and causal relationship between COVID-19 and RA/SLE. The cross-trait meta-analysis identified 46, 47, and 19 shared genetic loci for severe COVID-19, COVID-19 hospitalization, and SARS-CoV-2 infection with RA, and 19, 24, and 11 shared loci with SLE, respectively. Shared genes were significantly enriched in the spleen, lung, whole blood, and small intestine, and involved in immune function, inflammation and coagulation process. Co-localization analysis identified eight shared loci in TYK2, IKZF3, COL11A2, PSORS1C1, MANEAL and COG6 genes for COVID-19 with RA, and four in CRHR1, FUT2 and NXPE3 genes for COVID-19 with SLE. Bi-directional Mendelian randomization analysis suggested RA is associated with a higher risk of COVID-19 hospitalization, and COVID-19 is not related to RA or SLE. Our novel findings improved the understanding of the common genetic aetiology shared by COVID-19, RA and SLE, and suggested an increased risk of COVID-19 hospitalization in people with higher genetic liability to RA.
Background: Vaccine protection from COVID-19 has been shown to decline with time-since-vaccination and against SARS-CoV-2 variants. Protection against severe COVID-19 is higher than against symptomatic infection, and also appears relatively preserved over time and against variants. Although Protection protection from symptomatic SARS-CoV-2 infection has been shown to be strongly correlated with neutralising antibody titres, however, this relationship has been is less well described for severe COVID-19. Protection against severe COVID-19 is higher than against symptomatic infection, and also appears relatively preserved over time and against variants. Here we analyse whether neutralising antibody titre remains predictive of protection against severe COVID-19 in the face of waning neutralising antibody levels and emerging variants. Methods: We extracted data from 15 studies reporting on protection against a range of SARS-CoV-2 clinical endpoints (“any infection”, “symptomatic infection” and “severe COVID-19”). We then estimated the concurrent neutralising antibody titres using existing parameters on vaccine potency, neutralising antibody decay, and loss of recognition of variants and investigated the relationship between neutralising antibody titre and vaccine effectiveness against severe COVID-19. Findings: Predicted neutralising antibody titres are strongly correlated with vaccine effectiveness against symptomatic and severe COVID-19 (Spearman rho = .94 and 0.63 respectively, p<.001 for both), consistent with previous estimates of the relationship between neutralisation and protection. Indeed 82% (137 of 167) of reported values of protection against severe COVID-19 across a range of vaccines and variants lie within the 95% confidence intervals of the published model. Interpretation: Neutralising antibody titres are predictive of vaccine effectiveness against severe COVID-19 including in realistic scenarios of waning immunity and viral variants. Funding: National Health and Medical Research Council (Australia), Medical Research Future Fund (Australia).
Background: Coronavirus disease 2019 (COVID-19) is a rapidly changing disease. So, in this study, we evaluated the evolution of COVID-19 presentation and course in hemodialysis patients (HD). Methods: We retrospectively compared clinical data and outcomes of HD patients affected by COVID-19 during the first pandemic waves of 2020 (from March to December 2020- Group 1) with patients diagnosed with COVID-19 from September 2021 to February 2022 (Group 2), after the full completion of vaccination. Then, we distinguished among them patients responsive (antibody levels > 13 BAU/ml) and unresponsive to the vaccine. We collected data on COVID-19 clinical presentation, laboratory examinations, and outcomes. Results: Group 1 was constituted of 44 patients (69.3±14.6 years) and Group 2 of 55 patients (67.4±15.3 years). Among Group 2, fifty-two patients (95%) were vaccinated, 43 of them (83%) with three doses. Patients of Group 2, compared with Group 1, were more often asymptomatic (38 vs 10%, p=0.002), and reported less frequent fever and pulmonary involvement. At diagnosis, the Group 2 showed a significantly higher number of lymphocytes (0.97±0.45 vs 0.69±0.35 cells x10 9 /L, p=0.008) and lower levels of circulating IL-6 (16±13.3 vs 41±39.4 pg/ml, p=0.002). Moreover, in Group 2, inflammatory parameters significantly improved after a few days from diagnosis. Patients of Group 2 presented a lower hospitalization rate (12.7 vs 38%, p=0.004), illness duration (18.8±7.7 vs 29.2±19.5 days, p=0.005), and mortality rate (5.4 vs 25%, p= 0.008). Finally, responders to the vaccination (80% of the vaccinated patients) compared with non-responders showed a reduction in infection duration and hospitalization (5 vs 40%, p=0.018). Conclusions: COVID-19 presentation and course in HD patients have improved over time after the implementation of vaccine campaigns. However, due to the evolving nature of the disease, active surveillance is necessary.
Background: We evaluate the diagnostic performance of dried blood microsampling combined with a high-throughput microfluidic nano-immunoassay (NIA) for the identification of anti-SARS-CoV-2 Spike IgG seropositivity. Methods: We conducted a serological study among 192 individuals with documented prior SARS-CoV- 2 infection and 44 SARS-CoV-2 negative individuals. Participants with prior SARS-CoV-2 infection had a long interval of 11 months since their qRT-PCR positive test. Serum was obtained after venipuncture and tested with an automated electrochemiluminescence anti-SARS-CoV-2 S total Ig reference assay, a commercial ELISA anti-S1 IgG assay, and the index test NIA. 109 participants from the positive co- hort and 44 participants from the negative cohort also participated in capillary blood collection using three microsampling devices: Mitra, repurposed glucose test strips, and HemaXis. Samples were dried, shipped by regular mail, extracted, and measured with NIA. Findings: Using serum samples, we achieve a clinical sensitivity of 98.33% and specificity of 97.62% on NIA, affirming the high performance of NIA in participants 11 months post infection. Combining microsampling with NIA, we obtain a clinical sensitivity of 95.05% using Mitra, 61.11% using glucose test strips, 83.16% using HemaXis, and 91.49% for HemaXis after automated extraction, without any drop in specificity. Interpretation: High sensitivity and specificity was demonstrated when testing micro-volume capillary dried blood samples using NIA, which is expected to facilitate its use in large-scale studies using home- based sampling or samples collected in the field. Funding: Swiss National Science Foundation NRP 78 Covid-19 grant 198412 and Private Foundation of the Geneva University Hospital.
The advent and distribution of vaccines against SARS-CoV-2 in late 2020 was thought to represent an effective means to control the ongoing COVID-19 pandemic. This optimistic expectation was dashed by the omicron waves that emerged over the winter of 2021/2020 even in countries that had managed to vaccinate a large fraction of their populations, raising questions about whether it is possible to use scientific knowledge along with predictive models to anticipate changes and design management measures for the pandemic. Here, we used an extended SEIR model for SARS-CoV-2 transmission sequentially calibrated to data on cases and interventions implemented in Florida until Sept. 24th 2021, and coupled to scenarios of plausible changes in key drivers of viral transmission, to evaluate the capacity of such a tool for exploring the future of the pandemic in the state. We show that while the introduction of vaccinations could have led to the permanent, albeit drawn-out, ending of the pandemic if immunity acts over the long-term, additional futures marked by complicated repeat waves of infection become possible if this immunity wanes over time. We demonstrate that the most recent omicron wave could have been predicted by this hybrid system, but only if timely information on the timing of variant emergence and its epidemiological features were made available. Simulations for the introduction of a new variant exhibiting higher transmissibility than omicron indicated that while this will result in repeat waves, forecasted peaks are unlikely to reach that observed for the omicron wave owing to levels of immunity established over time in the population. These results highlight that while limitations of models calibrated to past data for precisely forecasting the futures of epidemics must be recognized, insightful predictions of pandemic futures are still possible if uncertainties about changes in key drivers are captured appropriately through plausible scenarios.
Objectives: To compare the effectiveness of a primary COVID-19 vaccine series plus a booster dose with a primary series alone for the prevention of Omicron variant COVID-19 hospitalization. Design: Multicenter observational case-control study using the test-negative design to evaluate vaccine effectiveness (VE). Setting: Twenty-one hospitals in the United States (US). Participants: 3,181 adults hospitalized with an acute respiratory illness between December 26, 2021 and April 30, 2022, a period of SARS-CoV-2 Omicron variant (BA.1, BA.2) predominance. Participants included 1,572 (49%) case-patients with laboratory confirmed COVID-19 and 1,609 (51%) control patients who tested negative for SARS-CoV-2. Median age was 64 years, 48% were female, and 21% were immunocompromised; 798 (25%) were vaccinated with a primary series plus booster, 1,326 (42%) were vaccinated with a primary series alone, and 1,057 (33%) were unvaccinated. Main Outcome Measures: VE against COVID-19 hospitalization was calculated for a primary series plus a booster and a primary series alone by comparing the odds of being vaccinated with each of these regimens versus being unvaccinated among cases versus controls. VE analyses were stratified by immune status (immunocompetent; immunocompromised) because the recommended vaccine schedules are different for these groups. The primary analysis evaluated all COVID-19 vaccine types combined and secondary analyses evaluated specific vaccine products. Results: Among immunocompetent patients, VE against Omicron COVID-19 hospitalization for a primary series plus one booster of any vaccine product dose was 77% (95% CI: 71-82%), and for a primary series alone was 44% (95% CI: 31-54%) (p<0.001). VE was higher for a boosted regimen than a primary series alone for both mRNA vaccines used in the US (BNT162b2: primary series plus booster VE 80% (95% CI: 73-85%), primary series alone VE 46% (95% CI: 30-58%) [p<0.001]; mRNA-1273: primary series plus booster VE 77% (95% CI: 67-83%), primary series alone VE 47% (95% CI: 30-60%) [p<0.001]). Among immunocompromised patients, VE for a primary series of any vaccine product against Omicron COVID-19 hospitalization was 60% (95% CI: 41-73%). Insufficient sample size has accumulated to calculate effectiveness of boosted regimens for immunocompromised patients. Conclusions: Among immunocompetent people, a booster dose of COVID-19 vaccine provided additional benefit beyond a primary vaccine series alone for preventing COVID-19 hospitalization due to the Omicron variant.
Purpose: to describe lung mechanics in Pediatric Acute Respiratory Disease Syndrome (PARDS) associated with COVID-19. We hypothesize two phenotypes according to respiratory system mechanics and clinical diagnosis. Methods: a concurrent multicenter observational study was performed, analyzing clinical variables and pulmonary mechanics of PARDS associated with COVID-19 in 4 Pediatric intensive care units (PICUs) of Peru. Subgroup analysis included PARDS associated with multisystem inflammatory syndrome in children (MIS-C), MIS-PARDS, and PARDS with COVID-19 primary respiratory infection, C-PARDS. In addition, receiver operator curve analysis (ROC) for mortality was performed. Results: 30 patients were included. Age was 7.5(4-11) years, 60% male, and mortality 23%. 47% corresponded to MIS-PARDS and 53% to C-PARDS phenotypes. C-PARDS had positive RT-PCR in 67% and MIS-PARDS none (p<0.001). C-PARDS group had more profound hypoxemia (P/Fratio<100, 86%vs38%,p<0.01) and higher driving-pressure (DP) [14(10-22)vs10(10-12)cmH2O], and lower compliance of the respiratory system (CRS)[0.5(0.3-0.6)vs 0.7(0.6-0.8)ml/kg/cmH2O] compared to MIS-PARDS (all p<0.05). ROC-analysis for mortality showed that DP had the best performance [AUC 0.91(95%CI0.81-1.00), with the best cut-point of 15 cmH2O (100% sensitivity and 87% of specificity). Mortality in C-PARDS was 38% and 7% in MIS-PARDS(p=0.09). MV free-days were 12(0-23) in C-PARDS and 23(21-25) in MIS-PARDS(p=0.02) Conclusion: critical pediatric COVID-19 is heterogeneous in children. COVID-19 PARDS had two phenotypes with distinctive pulmonary mechanics features. Characteristics of C-PARDS are like a classic primary PARDS, while a decoupling between compliance and hypoxemia was more frequent in MIS-PARDS. In addition, C-PARDS had fewer MV free-days. DP ≥ 15 cmH2O had the best performance of the quasi-static calculations to discriminate for mortality. Standardized pulmonary mechanics measurements in PARDS might reveal essential information to tailor the ventilatory strategy in pediatric critical COVID-19.
Phase I Clinical Trial of GEN2-Recombinant COVID-19 Vaccine (CHO Cells) in Healthy People Aged 18 and Above - Condition: COVID-19 Pneumonia
Interventions: Biological: Experimental Vaccine 1; Biological: Experimental Vaccine 2; Biological: Experimental Vaccine 3; Biological: placebo
Sponsors: National Vaccine and Serum Institute, China; Lanzhou Institute of Biological Products Co., Ltd; Beijing Institute of Biological Products Co Ltd.
Not yet recruiting
COVID-19 Algorithm Treatment at Home - Condition: COVID-19
Interventions: Drug: Recommended treatment schedule; Drug: Usual care
Sponsor: Mario Negri Institute for Pharmacological Research
Not yet recruiting
Eucalyptus Oil as Adjuvant Therapy for Coronavirus Disease 19 (COVID-19) - Condition: COVID-19
Interventions: Drug: Eucalyptus Oil; Drug: Standard COVID medication
Sponsors: Hasanuddin University; Ministry of Agriculture, Republic of Indonesia
Completed
Study of Oral High/Low-dose Cepharanthine Compared With Placebo in Non Hospitalized Adults With COVID-19 - Condition: Asymptomatic COVID-19
Interventions: Drug: Cepharanthine; Drug: Placebo
Sponsors: Shanghai Jiao Tong University School of Medicine; YUNNAN BAIYAO GROUP CO.,LTD
Not yet recruiting
Immunosuppression and COVID-19 Boosters - Condition: COVID-19
Interventions: Biological: diphtheria and tetanus toxoids (adsorbed) vaccine; Biological: COVID-19 vaccine
Sponsors: Kirby Institute; Seqirus Pty Ltd, Australia; Medical Research Future Fund (MRFF)
Not yet recruiting
Epidemiological Monitoring of COVID-19 Patients Hospitalized on Reunion Island - Condition: COVID-19
Intervention: Other: telephone interview 24 months after hospitalization for Covid-19
Sponsor: Centre Hospitalier Universitaire de la Réunion
Not yet recruiting
α-synuclein Seeding Activity in the Olfactory Mucosa in COVID-19 - Condition: COVID-19
Intervention: Other: Real-time Quaking-Induced Conversion (RT-QuIC)
Sponsor: Medical University Innsbruck
Recruiting
Randomized, Single-blinded, Multicenter Trial Comparing the Immune Response to a 2nd Booster Dose of COVID-19 mRNA Vaccine (Pfizer-BioNTech) or Sanofi /GSK B.1.351 Adjuvanted Vaccine in Adults - Condition: COVID-19 Vaccines
Interventions: Biological: 2nd booster with Comirnaty® (Pfizer-BioNTech); Biological: CoV2 preS dTM adjuvanted vaccine (B.1.351), Sanofi/GSK
Sponsors: Assistance Publique - Hôpitaux de Paris; IREIVAC/COVIREIVAC Network
Recruiting
Immunogenicity and Safety of a Third Dose of COVID-19 Vaccine(Vero Cell), Inactivated in the Elderly - Condition: COVID-19
Intervention: Biological: COVID-19 Vaccine (Vero cell), Inactivated
Sponsor: Sinovac Life Sciences Co., Ltd.
Active, not recruiting
Efficacy, Safety and Immunogenicity Study of the Recombinant Two-component COVID-19 Vaccine (CHO Cell)(Recov) - Condition: COVID-19
Interventions: Biological: Recombinant two-component COVID-19 vaccine (CHO cell); Biological: Placebo
Sponsor: Jiangsu Rec-Biotechnology Co., Ltd.
Not yet recruiting
Immunogenicity and Safety Study of Booster Vaccine With the COVID-19 Vaccine (Vero Cell), Inactivated, Omicron Strain - Condition: COVID-19
Intervention: Biological: COVID-19 Vaccine (Vero Cell), Inactivated, Omicron Strain
Sponsor: Sinovac Biotech (Hong Kong) Limited
Not yet recruiting
Plerixafor in Acute Respiratory Distress Syndrome Related to COVID-19 (Phase IIb) - Conditions: COVID-19 Acute Respiratory Distress Syndrome; COVID-19
Interventions: Drug: Plerixafor 20 MG/ML [Mozobil]; Other: Placebo
Sponsor: 4Living Biotech
Not yet recruiting
Calcitriol Supplementation in COVID-19 Patients - Conditions: COVID-19; Vitamin D Deficiency
Intervention: Drug: Calcitriol
Sponsor: RenJi Hospital
Not yet recruiting
Effects of Telerehabilitative Aerobic and Relaxation Exercises Patients With Type 2 Diabetes With and Without COVID-19 - Conditions: COVID-19; Type 2 Diabetes Mellitus
Intervention: Other: Aerobic and Relaxation Exercises
Sponsor: Bozyaka Training and Research Hospital
Active, not recruiting
COVID-19 Vaccine Uptake Trial - Conditions: Vaccination Refusal; COVID-19
Interventions: Other: Short Message Service (SMS) + Website Link Strategy; Other: Phone Call with Peer Strategy
Sponsor: Washington University School of Medicine
Not yet recruiting