Prevalence and persistence of SARS-CoV2 antibodies among healthcare workers in Oman.
TL;DR: In this article, the prevalence of SARS-CoV2 antibodies persistence among HCWs and specifically among asymptomatic HCWs was determined using the Kaplan-Meier estimator.
About: This article is published in Journal of Infection and Public Health.The article was published on 2021-11-01 and is currently open access. It has received 5 citations till now. The article focuses on the topics: Serology & Seroconversion.
Citations
More filters
TL;DR: Chou et al. as discussed by the authors conducted a living rapid review on the epidemiology of and risk factors for coronavirus infection in health care workers (HCWs) and found that the association between demographic characteristics and risk for SARS-CoV-2 infection in HCWs was consistent with prior updates.
Abstract: LettersAugust 2022Update Alert 11: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care WorkersFREERoger Chou, MD, Tracy Dana, MLS, David I. Buckley, MD, MPH, Shelley Selph, MD, MPH, Rongwei Fu, PhD, Annette M. Totten, PhDRoger Chou, MDPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, Tracy Dana, MLSPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, David I. Buckley, MD, MPHPacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University–Portland State University, Portland, OregonSearch for more papers by this author, Shelley Selph, MD, MPHPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, Rongwei Fu, PhDPacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University–Portland State University, Portland, OregonSearch for more papers by this author, Annette M. Totten, PhDPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0235 SectionsSupplemental MaterialAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This is the 11th and final update alert for a living rapid review on the epidemiology of and risk factors for coronavirus infection in health care workers (HCWs) (1). Updates were monthly through update alert 7 (2), bimonthly for updates 8 (3) and 9 (4), and then biannual. Searches for this update were done from 25 October 2021 to 24 May 2022 using the same search strategies as the original review. The update searches identified 8552 citations. We applied the same inclusion criteria used for prior updates, with previously (5) described protocol modifications to focus on risk factors for coronavirus infections and higher-quality evidence (studies reporting adjusted risk estimates).The original rapid review included 34 studies on risk factors for coronavirus infections (3 studies on SARS-CoV-2) (1); 124 studies (122 studies on SARS-CoV-2) were added in prior updates (2–10). Twenty new studies on risk factors for SARS-CoV-2 infection were added for this update (Supplement Tables 1 to 8) (11–30). The studies were based on data collected through the end of 2020 in 10 studies (11–13, 15–17, 23, 24, 27, 30) and through June 2021 in 9 studies (14, 18–22, 25, 26, 29). One new study collected data in South Africa in November and December 2021 during the initial Omicron variant surge (28). Of the 20 new studies, 7 were cohort studies (14, 16, 20, 23, 25, 26, 29), 12 were cross-sectional studies (11–13, 15, 17–19, 22, 24, 27, 28, 30), and 1 was a case–control study (21) (Supplement Table 1). Ten studies were done in Europe, 3 in Africa, 1 in the Middle East, and 5 in North America. As with previously included studies, the new studies had methodological limitations, including potential recall bias, limited adjustment for potential confounders (including SARS-CoV-2 exposures), and low or unclear participation rates.The new studies were generally consistent with prior updates on the association between demographic characteristics and risk for SARS-CoV-2 infection in HCWs (Supplement Table 2). There was no consistent association between age (16 studies [11, 13, 14, 16–27, 29]) or sex (16 studies [11, 13, 14, 16–27, 29]) and risk for SARS-CoV-2 infection. Seven new studies were consistent with prior evidence suggesting an increased risk for SARS-CoV-2 infection among Black or Hispanic HCWs compared with White or non-Hispanic HCWs (12, 13, 18, 20, 23, 26, 27). Sixteen new studies evaluated the association between various HCW roles and risk for infection, most commonly nurse versus physician (12–14, 17–27, 29, 30). Among 11 studies, 8 studies found that being a nurse was associated with a higher risk for SARS-CoV-2 infection than being a physician, and 3 studies found similar risk. The new studies did not change the overall finding of no clear association between nurse versus physician HCW role and risk for SARS-CoV-2 infection given inconsistency in findings, including prior studies showing physicians being at higher risk.New for this update, 3 studies found that prior SARS-CoV-2 infection or positive vaccination status was associated with decreased risk for SARS-CoV-2 reinfection or infection among HCWs (Supplement Table 3) (26, 28, 29). In 1 study done during the Omicron variant surge, prior SARS-CoV-2 infection confirmed by polymerase chain reaction test was associated with decreased risk for reinfection (adjusted odds ratio, 0.55 [95% CI, 0.36 to 0.84]) (28). In this study, HCWs with 2 doses of the BNT162b2 vaccine were at decreased risk for infection compared with those who were unvaccinated, although the difference was not statistically significant (adjusted odds ratio, 0.59 [CI, 0.23 to 1.57]). One pre-Omicron study found that prior infection was associated with a reduced risk for reinfection among unvaccinated persons (adjusted incidence rate ratio, 0.15 [CI, 0.08 to 0.26]) and that full vaccination (2 doses) was associated with decreased risk versus no vaccination (adjusted incidence rate ratio, 0.10 [CI, 0.02 to 0.38]) (26); another pre-Omicron study found that full vaccination was associated with decreased risk versus no vaccination (adjusted hazard ratio, 0.37 [CI, 0.29 to 0.69]) (29).Fourteen new studies reported on the association between exposures and likelihood of SARS-CoV-2 infection among HCWs (Supplement Table 4) (11–13, 15–22, 24, 26, 30). As in prior updates, greater exposure was generally associated with increased risk for SARS-CoV-2 infection. Thirteen studies found that direct contact with a patient with COVID-19 or working in a setting at high risk for exposure to a patient with COVID-19 was associated with increased risk for SARS-CoV-2 infection versus no direct contact or working in a lower-risk setting, but risk estimates were imprecise or not consistently statistically significant in most studies, and exposure definitions and comparisons varied (11–13, 15–22, 24, 26). No new study evaluated the association between education or training and risk for SARS-CoV-2 infection (Supplement Table 5).Three new studies reported on the association between mask use and SARS-CoV-2 infection (Supplement Table 6). One new publication for a previously included study found that use of an N95 mask was associated with an increased risk for SARS-CoV-2 infection versus nonuse in a univariate analysis (odds ratio, 7.8 [CI, 4.0 to 15.2]) (16). However, N95 use was not included in the multivariate model, and the observed association is likely related to confounding from increased exposures or other factors in HCWs using N95 masks. Two other new studies of mask use are consistent with prior updates that suggest mask use reduces risk for SARS-CoV-2 infection, but risk estimates were not statistically significant (20, 23). Neither study reported mask type, and both were susceptible to potential recall bias.Consistent with previously reviewed evidence, 1 new study found that appropriate use of personal protective equipment was associated with decreased risk for SARS-CoV-2 infection compared with suboptimal use when participating in several patient care activities (Supplement Table 7) (15). However, findings were limited by unclear definitions for “appropriate” and “suboptimal” personal protective equipment use.A summary of all evidence identified through this final update is shown Supplement Table 8. Despite large numbers of studies and participants, evidence remains low for most risk factors because of limited evidence, methodological limitations, imprecision, and inconsistency. Moderate evidence indicates no association between age, sex, or HCW role (nurse vs. physician) and risk for SARS-CoV-2 infection; an association between Black race or Hispanic ethnicity (vs. White race or non-Hispanic ethnicity) and increased risk for SARS-CoV-2 infection; and an association between personal protective equipment use and decreased risk for SARS-CoV-2 infection.References1. Chou R, Dana T, Buckley DI, et al. Epidemiology of and risk factors for coronavirus infection in health care workers. A living rapid review. Ann Intern Med. 2020;173:120-136. [PMID: 32369541] doi:10.7326/M20-1632 LinkGoogle Scholar2. Chou R, Dana T, Selph S, et al. Update alert 7: epidemiology of and risk factors for coronavirus infection in health care workers. Ann Intern Med. 2021;174:W45-W46. [PMID: 33556273] doi:10.7326/L21-0034 LinkGoogle Scholar3. Chou R, Dana T, Buckley DI, et al. Update alert 8: epidemiology of and risk factors for coronavirus infection in health care workers. Ann Intern Med. 2021;174:W48-W49. [PMID: 33780293] doi:10.7326/L21-0143 LinkGoogle Scholar4. Chou R, Dana T, Selph S, et al. Update alert 9: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2021;174:W63-W64. [PMID: 34058107] doi:10.7326/L21-0302 LinkGoogle Scholar5. Chou R, Dana T, Buckley DI, et al. Update alert 2: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2020;173:W77. [PMID: 32663033] doi:10.7326/M20-4806 LinkGoogle Scholar6. Chou R, Dana T, Buckley DI, et al. Update alert 3: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2020;173:W123-W124. [PMID: 32744870] doi:10.7326/L20-1005 LinkGoogle Scholar7. Chou R, Dana T, Buckley DI, et al. Update alert 4: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2020;173:143-144. [PMID: 32915642] doi:10.7326/L20-1134 LinkGoogle Scholar8. Chou R, Dana T, Buckley DI, et al. Update alert 5: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2020;173:W154-W55. [PMID: 33076695] doi:10.7326/L20-1227 LinkGoogle Scholar9. Chou R, Dana T, Selph S, et al. Update alert 6: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2021;174:W18-W19. [PMID: 33226856] doi:10.7326/L20-1323 LinkGoogle Scholar10. Chou R, Dana T, Buckley DI, et al. Update alert 10: epidemiology of and risk factors for coronavirus infection in health care workers [Letter]. Ann Intern Med. 2022;175:W8-W9. [PMID: 34781714] doi:10.7326/M21-4294 LinkGoogle Scholar11. Al-Naamani K, Al-Jahdhami I, Al-Tamtami W, et al. Prevalence and persistence of SARS-CoV2 antibodies among healthcare workers in Oman. J Infect Public Health. 2021;14:1578-1584. [PMID: 34688980] doi:10.1016/j.jiph.2021.09.006 CrossrefMedlineGoogle Scholar12. Brousseau N, Morin L, Ouakki M, et al. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ. 2021;193:E1868-E1877. [PMID: 34903591] doi:10.1503/cmaj.202783 CrossrefMedlineGoogle Scholar13. Gohil SK, Quan KA, Madey KM, et al. Infection prevention strategies are highly protective in COVID-19 units while main risks to healthcare professionals come from coworkers and the community. Antimicrob Resist Infect Control. 2021;10:163. [PMID: 34809702] doi:10.1186/s13756-021-01031-5 CrossrefMedlineGoogle Scholar14. Modenese A, Casolari L, Rossi G, et al. Factors associated with SARS-CoV-2 infection risk among healthcare workers of an Italian university hospital. Healthcare (Basel). 2021;9. [PMID: 34828540] doi:10.3390/healthcare9111495 CrossrefMedlineGoogle Scholar15. Paris C, Tadié E, Heslan C, et al. Risk factors for SARS-CoV-2 infection among health care workers. Am J Infect Control. 2022;50:375-382. [PMID: 34774895] doi:10.1016/j.ajic.2021.11.001 CrossrefMedlineGoogle Scholar16. Piapan L, De Michieli P, Ronchese F, et al. COVID-19 outbreaks in hospital workers during the first COVID-19 wave. Occup Med (Lond). 2022;72:110-117. [PMID: 34919710] doi:10.1093/occmed/kqab161 CrossrefMedlineGoogle Scholar17. Tomczyk S, Hönning A, Hermes J, et al. Longitudinal SARS-CoV-2 seroepidemiological investigation among healthcare workers at a tertiary care hospital in Germany. BMC Infect Dis. 2022;22:80. [PMID: 35073863] doi:10.1186/s12879-022-07057-3 CrossrefMedlineGoogle Scholar18. Allen N, Brady M, Ni Riain U, et al. Prevalence of antibodies to SARS-CoV-2 following natural infection and vaccination in Irish hospital healthcare workers: changing epidemiology as the pandemic progresses. Front Med (Lausanne). 2021;8:758118. [PMID: 35186963] doi:10.3389/fmed.2021.758118 CrossrefMedlineGoogle Scholar19. Dávila-Conn V, Soto-Nava M, Caro-Vega YN, et al. Seroepidemiology of SARS-CoV-2 in healthcare personnel working at the largest tertiary COVID-19 referral hospitals in Mexico City. PLoS One. 2022;17:e0264964. [PMID: 35298500] doi:10.1371/journal.pone.0264964 CrossrefMedlineGoogle Scholar20. Doernberg SB, Holubar M, Jain V, et al; CHART Study Consortium. Incidence and prevalence of COVID-19 within a healthcare worker cohort during the first year of the SARS-CoV-2 pandemic. Clin Infect Dis. 2022. [PMID: 35279023] doi:10.1093/cid/ciac210 CrossrefMedlineGoogle Scholar21. Dusefante A, Negro C, D’Agaro P, et al. Occupational risk factors for SARS-CoV-2 infection in hospital health care workers: a prospective nested case-control study. Life (Basel). 2022;12. [PMID: 35207550] doi:10.3390/life12020263 CrossrefMedlineGoogle Scholar22. Gelanew T, Seyoum B, Mulu A, et al. High seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers. BMC Infect Dis. 2022;22:261. [PMID: 35296265] doi:10.1186/s12879-022-07247-z CrossrefMedlineGoogle Scholar23. Howard-Anderson JR, Adams C, Dube WC, et al. Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: a 6-month prospective analysis of the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study. Infect Control Hosp Epidemiol. 2022:1-8. [PMID: 35156597] doi:10.1017/ice.2021.518 CrossrefMedlineGoogle Scholar24. Korona-Glowniak I, Mielnik M, Podgajna M, et al. SARS-CoV-2 seroprevalence in healthcare workers before the vaccination in Poland: evolution from the first to the second pandemic outbreak. Int J Environ Res Public Health. 2022;19. [PMID: 35206504] doi:10.3390/ijerph19042319 CrossrefMedlineGoogle Scholar25. Larese Filon F, Rui F, Ronchese F, et al. Incidence of COVID-19 infection in hospital workers from March 1, 2020 to May 31, 2021 routinely tested, before and after vaccination with BNT162B2. Sci Rep. 2022;12:2533. [PMID: 35169127] doi:10.1038/s41598-021-04665-y CrossrefMedlineGoogle Scholar26. Lumley SF, Rodger G, Constantinides B, et al; Oxford University Hospitals Staff Testing Group. An observational cohort study on the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and B.1.1.7 variant infection in healthcare workers by antibody and vaccination status. Clin Infect Dis. 2022;74:1208-1219. [PMID: 34216472] doi:10.1093/cid/ciab608 CrossrefMedlineGoogle Scholar27. Nunes MC, Baillie VL, Kwatra G, et al; Bara HCW Study Group. Severe acute respiratory syndrome coronavirus 2 infection among healthcare workers in South Africa: a longitudinal cohort study. Clin Infect Dis. 2021;73:1896-1900. [PMID: 33949670] doi:10.1093/cid/ciab398 CrossrefMedlineGoogle Scholar28. Nunes MC, Mbotwe-Sibanda S, Baillie VL, et al. SARS-CoV-2 Omicron symptomatic infections in previously infected or vaccinated South African healthcare workers. Vaccines (Basel). 2022;10. [PMID: 35335091] doi:10.3390/vaccines10030459 CrossrefMedlineGoogle Scholar29. Porru S, Spiteri G, Monaco MGL, et al. Post-vaccination SARS-CoV-2 infections among health workers at the university hospital of Verona, Italy: a retrospective cohort survey. Vaccines (Basel). 2022;10. [PMID: 35214733] doi:10.3390/vaccines10020272 CrossrefMedlineGoogle Scholar30. West EA, Kotoun OJ, Schori LJ, et al; Corona Immunitas Research Group. Seroprevalence of SARS-CoV-2 antibodies, associated factors, experiences and attitudes of nursing home and home healthcare employees in Switzerland. BMC Infect Dis. 2022;22:259. [PMID: 35296242] doi:10.1186/s12879-022-07222-8 CrossrefMedlineGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonPacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University–Portland State University, Portland, OregonPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonPacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University–Portland State University, Portland, OregonPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonDisclaimer: The original review was funded by the World Health Organization. The World Health Organization staff developed the key questions and scope for the original review but did not have any role in the selection, assessment, or synthesis of evidence for this update.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0235.Corresponding Author: Roger Chou, MD, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code BICC, Portland, OR 97239; e-mail, [email protected]edu.This article was published at Annals.orgon 12 July 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdate Alert: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 2: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 3: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 4: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 5: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 6: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , Shelley Selph , Annette M. Totten , David I. Buckley , and Rongwei Fu Update Alert 7: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , Shelley Selph , Annette M. Totten , David I. Buckley , and Rongwei Fu Update Alert 8: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Update Alert 9: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , Shelley Selph , Annette M. Totten , David I. Buckley , and Rongwei Fu Update Alert 10: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers Roger Chou , Tracy Dana , David I. Buckley , Shelley Selph , Rongwei Fu , and Annette M. Totten Metrics August 2022Volume 175, Issue 8Page: W83-W84 ePublished: 12 July 2022 Issue Published: August 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
3 citations
TL;DR: In this paper , the authors aimed to estimate the seroprevalence in HCWs considering all of their previous contacts with the SARS-CoV-2 virus and/or the immunity acquired through their immunization against COVID-19 before the advent of the Omicron variants BA.4/BA.5.
Abstract: Healthcare workers (HCWs) are a vulnerable and critical population in the ongoing response to the SARS-CoV-2 pandemic. We aimed to estimate the seroprevalence in HCWs considering all of their previous contacts with the SARS-CoV-2 virus and/or the immunity acquired through their immunization against COVID-19 before the advent of the Omicron variants BA.4/BA.5. Serum samples were collected from 28 March to 10 June 2022. We covered 25% out of all the people who worked in some of the government healthcare centers (primary, secondary, and tertiary level) across the entire Autonomous Province of Vojvodina (Northern Serbia). Two serological tests (Anti-SARS-CoV-2 QuantiVac ELISA and LIAISON® SARS-CoV-2 TrimericS) were used to detect anti-spike IgG antibodies. The overall prevalence of the SARS-CoV-2 antibody among the 6936 HCWs was 92.96% [95% CI 92.33–93.55]. Regarding the type of serological test, there was a statistically significant (p = 0.0079) difference of the seropositivity obtained by the LIAISON® SARS-CoV-2 TrimericS (93.87%, 95% CI 92.97–94.69) and Anti-SARS-CoV-2 QuantiVac ELISA (92.23%, 95% CI 91.34–93.06) tests. Seropositivity to SARS-CoV-2 significantly (p < 0.0001) increased with the number of SARS-CoV-2 infections combined with the number of doses of the SARS-CoV-2 vaccines received. A vast majority of the HCWs in Vojvodina had detectable levels of antibodies to the spike protein of SARS-CoV-2, but despite this high seropositivity, it is unknown whether this herd immunity among HCWs is protective against the new variants of concern. Further research should evaluate the rates of reinfections and the associated severity of COVID-19 caused by the Omicron sublineages and/or new variants of SARS-CoV-2 among HCWs.
1 citations
TL;DR: In this paper , the authors evaluated SARS-CoV-2 antibody response in voluntary blood donors in Italy at different timepoints and found that after lockdown easing, 908/25,657 donors (3.5%) had low IgG titers against nucleocapsid.
Abstract: We evaluated SARS-CoV-2 antibody response in voluntary blood donors in Italy at different timepoints. Immediately after lockdown easing, 908/25,657 donors (3.5%) had low IgG titers against nucleocapsid. In the next 2 years, titers increased despite few COVID-19 symptoms. On multivariate analysis, allergic rhinitis was associated with reduced risk for symptomatic COVID-19.
TL;DR: In this article , the authors present a review of the most significant immune reactions to COVID-19, including components of both innate and adaptive immunity, with an additional focus on utilizing humoral and cellular responses as effective diagnostic tools.
Abstract: Abstract Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its mechanisms have been thoroughly studied by researchers all over the world with the hope of finding answers that may aid the discovery of new treatment options or effective means of prevention. Still, over 2 years into the pandemic that is an immense burden on health care and economic systems, there seem to be more questions than answers. The character and multitude of immune responses elicited in coronavirus disease 2019 (COVID-19) vary from uncontrollable activation of the inflammatory system, causing extensive tissue damage and consequently leading to severe or even fatal disease, to mild or asymptomatic infections in the majority of patients, resulting in the unpredictability of the current pandemic. The aim of the study was to systematize the available data regarding the immune response to SARS-CoV-2, to provide some clarification among the abundance of the knowledge available. The review contains concise and current information on the most significant immune reactions to COVID-19, including components of both innate and adaptive immunity, with an additional focus on utilizing humoral and cellular responses as effective diagnostic tools. Moreover, the authors discussed the present state of knowledge on SARS-CoV-2 vaccines and their efficacy in cases of immunodeficiency.
TL;DR: High-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts, and higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were observed.
Abstract: Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.
References
More filters
TL;DR: The epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of patients with laboratory-confirmed 2019-nCoV infection in Wuhan, China, were reported.
36,578 citations
TL;DR: The epidemiological and clinical characteristics of novel coronavirus (2019-nCoV)-infected pneumonia in Wuhan, China, and hospital-associated transmission as the presumed mechanism of infection for affected health professionals and hospitalized patients are described.
Abstract: Importance In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures Documented NCIP. Main Outcomes and Measures Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0). Conclusions and Relevance In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.
16,635 citations
TL;DR: It is suggested that SARS-CoV2-specific IgG or IgM seroconversion occurs within 20 days post symptom onset and may be helpful for the diagnosis of suspected patients with negative RT–PCR results and for the identification of asymptomatic infections.
Abstract: We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.
2,473 citations
TL;DR: In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males and the proportion of infected participants identified through population screening remained stable for the 20-day duration of screening.
Abstract: Background During the current worldwide pandemic, coronavirus disease 2019 (Covid-19) was first diagnosed in Iceland at the end of February. However, data are limited on how SARS-CoV-2, th...
1,199 citations
TL;DR: COVID-19 is thought to have higher mortality than seasonal influenza, even as wide variation is reported, and the pressure on the global health care workforce continues to intensify.
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread internationally. Worldwide, more than 100 000 cases of coronavirus disease 2019 (COVID-19, the disease caused by SARS-CoV-2) and more than 3500 deaths have been reported. COVID-19 is thought to have higher mortality than seasonal influenza, even as wide variation is reported. While the World Health Organization (WHO) estimates global mortality at 3.4\\%, South Korea has noted mortality of about 0.6\\%.Vaccine development and research into medical treatment for COVID-19 are under way, but are many months away. Meanwhile, the pressure on the global health care workforce continues to intensify. This pressure takes 2 forms. The first is the potentially overwhelming burden of illnesses that stresses health system capacity and the second is the adverse effects on health care workers, including the risk of infection.
1,095 citations