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Journal of Infectious Diseases, 4.08.2022
Tilføjet 3.08.2022
AbstractThe aim of this randomized, controlled trial is to determine whether anti-SARS-CoV-2 hyperimmune globulin protects against severe COVID-19 in severely immunocompromised, hospitalized, COVID-19 patients. Patients were randomly assigned to receive anti-SARS-CoV-2 hyperimmune globulin (COVIG) or intravenous immunoglobulin without SARS-CoV-2 antibodies. Severe COVID-19 was observed in two out of ten (20%) patients treated with COVIG compared to seven out of eight (88%) in the IVIG control group (p = 0.015, Fisher’s exact test). COVIG may be a valuable treatment in severely immunocompromised, hospitalized, COVID-19 patients and should be considered when no monoclonal antibody therapies are available. The trial was registered at www.trialregister.nl (#NL9436).
Læs mere Tjek på PubMedFEMS Microbiology Reviews, 29.07.2022
Tilføjet 3.08.2022
AbstractThe earth is home to environments characterized by low pH, including the gastrointestinal tract of vertebrates and large areas of acidic soil. Most bacteria are neutralophiles, but can survive fluctuations in pH. Herein, we review how Escherichia, Salmonella, Helicobacter, Brucella, and other acid-resistant Gram-negative bacteria adapt to acidic environments. We discuss the constitutive and inducible defense mechanisms that promote survival, including proton-consuming or ammonia-producing processes, cellular remodeling affecting membranes and chaperones, and chemotaxis. We provide insights into how Gram-negative bacteria sense environmental acidity using membrane-integrated and cytosolic pH sensors. Finally, we address in more detail the powerful proton-consuming decarboxylase systems by examining the phylogeny of their regulatory components and their collective functionality in a population.
Læs mere Tjek på PubMedFEMS Microbiology Reviews, 26.07.2022
Tilføjet 3.08.2022
AbstractEnterococcus faecalis and Enterococcus faecium are Gram-positive commensal gut bacteria that can also cause fatal infections. To study clinically relevant multi-drug resistant E. faecalis and E. faecium strains, methods are needed to overcome physical (thick cell wall) and enzymatic barriers that limit the transfer of foreign DNA and thus prevent facile genetic manipulation. Enzymatic barriers to DNA uptake identified in E. faecalis and E. faecium include type I, II and IV restriction modification systems and CRISPR-Cas. This review examines E. faecalis and E. faecium DNA defence systems and the methods with potential to overcome these barriers. DNA defence system bypass will allow the application of innovative genetic techniques to expedite molecular-level understanding of these important, but somewhat neglected, pathogens.
Læs mere Tjek på PubMedKarin Sauer, Paul Stoodley, Darla M. Goeres, Luanne Hall-Stoodley, Mette Burmølle, Philip S. Stewart, Thomas Bjarnsholt
Nat Rev Microbiol, 3.08.2022
Tilføjet 3.08.2022
Nature Reviews Microbiology, Published online: 03 August 2022; doi:10.1038/s41579-022-00767-0In this Review, Bjarnsholt and colleagues propose a revised conceptual model of the biofilm life cycle that encompasses the three major steps of biofilm formation — aggregation, growth and disaggregation — independently of surfaces, and initiation from single-cell planktonic bacteria, and thus represents a broader range of biofilm systems.
Læs mere Tjek på PubMedThe PLOS ONE Staff
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
Xiaofei Yan, Mingjun Liu, Sangang He, Ting Tong, Yiyong Liu, Keqi Ding, Haifeng Deng, Peiming Wang
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Xiaofei Yan, Mingjun Liu, Sangang He, Ting Tong, Yiyong Liu, Keqi Ding, Haifeng Deng, Peiming Wang
Læs mere Tjek på PubMedBogusz Jan Aksak-Wąs, Miłosz Parczewski, Anna Urbańska, Małgorzata Hackiewicz, Justyna D. Kowalska
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Bogusz Jan Aksak-Wąs, Miłosz Parczewski, Anna Urbańska, Małgorzata Hackiewicz, Justyna D. Kowalska
Læs mere Tjek på PubMedC. Christina Mehta, Kimberly S. Hagen, Anna A. Rubtsova, Cecile D. Lahiri, Vasiliki Michopoulos, Caitlin A. Moran, Lisa B. Haddad, Kehmia Titanji, Lauren F. Collins, Arshed A. Quyyumi, Gretchen Neigh, Leslee J. Shaw, M. Neale Weitzmann, Lance Waller, Ighovwerha Ofotokun
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by C. Christina Mehta, Kimberly S. Hagen, Anna A. Rubtsova, Cecile D. Lahiri, Vasiliki Michopoulos, Caitlin A. Moran, Lisa B. Haddad, Kehmia Titanji, Lauren F. Collins, Arshed A. Quyyumi, Gretchen Neigh, Leslee J. Shaw, M. Neale Weitzmann, Lance Waller, Ighovwerha Ofotokun
Purpose We describe the rationale for and design of an innovative, nested, tripartite prospective observational cohort study examining whether relative estrogen insufficiency-induced inflammation amplifies HIV-induced inflammation to cause end organ damage and worsen age-related co-morbidities affecting the neuro-hypothalamic-pituitary-adrenal axis (Brain), skeletal (Bone), and cardiovascular (Heart/vessels) organ systems (BBH Study). Methods The BBH parent study is the Multicenter AIDS Cohort/Women’s Interagency HIV Study Combined Cohort Study (MWCCS) with participants drawn from the Atlanta MWCCS site. BBH will enroll a single cohort of n = 120 women living with HIV and n = 60 HIV-negative women, equally distributed by menopausal status. The innovative multipart nested study design of BBH, which draws on data collected by the parent study, efficiently leverages resources for maximum research impact and requires extensive oversight and management in addition to careful implementation. The presence of strong infrastructure minimized BBH study disruptions due to changes in the parent study and the COVID-19 pandemic. Conclusion BBH is poised to provide insight into sex and HIV associations with the neuro-hypothalamic-pituitary-adrenal axis, skeletal, and cardiovascular systems despite several major, unexpected challenges.
Læs mere Tjek på PubMedThinley Dorji, Karma Wangmo, Dendup Tshering, Ugyen Tashi, Kinley Wangdi
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Thinley Dorji, Karma Wangmo, Dendup Tshering, Ugyen Tashi, Kinley Wangdi
Objectives The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under Royan University of Bhutan (RUB). Methods This was a cross-sectional study using an online questionnaire. The questionnaire was developed in Google forms and the link was shared through the college WeChat groups. The questionnaire consisted of four parts on socio-demographic, sexual behaviour and contraceptive use, knowledge, and attitude on STIs. All the students under RUB were invited to participate voluntarily in this study. The socio-demography was presented in frequency and proportion. Result A total of 1,283 students participated in this survey and 55.0% (701) were females. Of this, 29.4% (377) were sexually active and 94.4% reported using modern contraception. Commonly used contraceptives were: condoms (83.8%, 316) and emergency contraceptives (20.6%, 78), respectively. The mean knowledge and attitude scores on STI were 9.94 (range 2–20) and 12 (range 2–14), respectively. Good knowledge and attitude on STI were reported in 53.2% (683) and 70.1% (899) of participants. Conclusion Students reported average knowledge and a good attitude towards STI. Contraceptive use among university students was low. There is a need to strengthen health education on STIs in schools and universities. All forms of contraceptives especially condoms should be made easily available to sexually active people.
Læs mere Tjek på PubMedHongli Xu, Jingyao Gao, Roxana Portieles, Lihua Du, Xiangyou Gao, Orlando Borras-Hidalgo
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Hongli Xu, Jingyao Gao, Roxana Portieles, Lihua Du, Xiangyou Gao, Orlando Borras-Hidalgo
In nature, plants interact with a wide range of microorganisms, and most of these microorganisms could induce growth through the activation of important molecular pathways. The current study evaluated whether the endophytic bacterium Bacillus aryabhattai encourages plant growth and the transcriptional changes that might be implicated in this effect. The endophytic bacterium promotes the growth of Arabidopsis and tobacco plants. The transcriptional changes in Arabidopsis plants treated with the bacterium were also identified, and the results showed that various genes, such as cinnamyl alcohol dehydrogenase, apyrase, thioredoxin H8, benzaldehyde dehydrogenase, indoleacetaldoxime dehydratase, berberine bridge enzyme-like and gibberellin-regulated protein, were highly expressed. Also, endophytic bacterial genes, such as arginine decarboxylase, D-hydantoinase, ATP synthase gamma chain and 2-hydroxyhexa-2,4-dienoate hydratase, were activated during the interaction. These findings demonstrate that the expression of novel plant growth-related genes is induced by interaction with the endophytic bacterium B. aryabhattai and that these changes may promote plant growth in sustainable agriculture.
Læs mere Tjek på PubMedIkemsinachi C. Nzenwa, Hassan A. Iqbal, Claire Hardie, George E. Smith, Paolo L. Matteucci, Joshua P. Totty
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Ikemsinachi C. Nzenwa, Hassan A. Iqbal, Claire Hardie, George E. Smith, Paolo L. Matteucci, Joshua P. Totty
Background Malignancies that spread to the lymph nodes may be identified through surgical biopsy, and treatment of metastatic disease may be through lymph node dissection. These surgeries, however, may be associated with significant adverse outcomes, particularly wound complications, the true incidence of which remains unknown. Multiple studies have reported their individual rates of complications in isolation. The aim of this study will be to systematically evaluate data that presents the incidence of wound complications in patients undergoing these surgeries. Methods We have designed and registered a protocol for a systematic review and meta-analysis of studies presenting incidence data. We will search MEDLINE, EMBASE and CENTRAL for relevant articles. Meta-analysis will be undertaken to synthesise an overall incidence of surgical site infection, wound dehiscence, haematoma and seroma. Subgroup analyses will investigate the effects of anatomical location, primary malignancy and study design on pooled incidence. Risk of bias will be evaluated for each included study using bespoke tools matched to the study design. Discussion The results of this study will provide the incidence of wound complications and secondary complications following lymph node surgery. This will directly impact upon the consent process, and may influence the nature of future research studies aimed at reducing post-operative complications.
Læs mere Tjek på PubMedAmare Getu, Haileab Fekadu Wolde, Yaregal Animut, Anteneh Ayelign Kibret
PLoS One Infectious Diseases, 3.08.2022
Tilføjet 3.08.2022
by Amare Getu, Haileab Fekadu Wolde, Yaregal Animut, Anteneh Ayelign Kibret
Introduction Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV) and almost one-third of deaths in the world are attributed to it and many of these deaths occur in developing countries. Despite these evidences, after the implementation of universal test and treat (UTT) strategy, information regarding the incidence and predictors of tuberculosis among PLHIV is limited in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of tuberculosis among patients enrolled in Anti-Retroviral Therapy (ART) after universal test and treat program at St. Peter hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods Institutional-based retrospective cohort study was conducted from November 1 to 30, 2020. Simple random sampling was used to select a total of 539 adults records which was enrolled on ART. Data was collected and entered into EPI DATA 3.1 and analyzed using STATA version 14.1. Time-to-event distributions were estimated using Kaplan–Meier estimates. Hazards across different categories were compared using log-rank tests. Predictors were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. Variables having P-value < 0.05 from the multivariable analysis were considered as a statistically significant. Result Among 539 records reviewed, 529 (98%) were included in the final analysis. The total follow-up period was 1529 Person-Year (PY). The incidence rate in this cohort was found to be 4.84 per 100-person year (95%CI,3.83–6.11). CD4 count
Læs mere Tjek på PubMedAlberto Domingo López-Muñoz, Ivan Kosik, Jaroslav Holly, Jonathan W. Yewdell
Science Advances, 3.08.2022
Tilføjet 3.08.2022
Nicholas C. Poulton, Zachary A. Azadian, Michael A. DeJesus, Jeremy M. Rock aLaboratory of Host-Pathogen Biology, The Rockefeller University, New York, New York, USA
Antimicrobial Agents And Chemotherapy, 3.08.2022
Tilføjet 3.08.2022
Infection, 2.08.2022
Tilføjet 3.08.2022
Malaria Journal, 3.08.2022
Tilføjet 3.08.2022
Abstract
Background
Rapid diagnostic tests (RDTs) that rely on the detection of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) have become key tools for diagnosing P. falciparum infection. The utility of RDTs can be limited by PfHRP2 persistence, however it can be a potential benefit in low transmission settings where detection of persistent PfHRP2 using newer ultra-sensitive PfHRP2 based RDTs can serve as a surveillance tool to identify recent exposure. Better understanding of the dynamics of PfHRP2 over the course of a malaria infection can inform optimal use of RDTs.
Methods
A previously published mathematical model was refined to mimic the production and decay of PfHRP2 during a malaria infection. Data from 15 individuals from volunteer infection studies were used to update the original model and estimate key model parameters. The refined model was applied to a cohort of patients from Namibia who received treatment for clinical malaria infection for whom longitudinal PfHRP2 concentrations were measured.
Results
The refinement of the PfHRP2 dynamic model indicated that in malaria naïve hosts, P. falciparum parasites of the 3D7 strain produce 33.6 × 10−15 g (95% CI 25.0–42.1 × 10−15 g) of PfHRP2 in vivo per parasite replication cycle, with an elimination half-life of 1.67 days (95% CI 1.11–3.40 days). The refined model included these updated parameters and incorporated individualized body fluid volume calculations, which improved predictive accuracy when compared to the original model. The performance of the model in predicting clearance of PfHRP2 post treatment in clinical samples from six adults with P. falciparum infection in Namibia improved when using a longer elimination half-life of 4.5 days, with 14% to 67% of observations for each individual within the predicted range.
Conclusions
The updated mathematical model can predict the growth and clearance of PfHRP2 during the production and decay of a mono-infection with P. falciparum, increasing the understanding of PfHRP2 antigen dynamics. This model can guide the optimal use of PfHRP2-based RDTs for reliable diagnosis of P. falciparum infection and re-infection in endemic settings, but also for malaria surveillance and elimination programmes in low transmission areas.
Læs mere Tjek på PubMed
Boer, A.-K., Deneer, R., Maas, M., Ammerlaan, H. S. M., van Balkom, R. H. H., Thijssen, W. A. H. M., Bennenbroek, S., Leers, M., Martens, R. J. H., Buijs, M. M., Kerremans, J. J., Messchaert, M., van Suijlen, J. J., van Riel, N. A. W., Scharnhorst, V.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Objectives
Identifying patients with a possible SARS-CoV-2 infection in the emergency department (ED) is challenging. Symptoms differ, incidence rates vary and test capacity may be limited. As PCR-testing all ED patients is neither feasible nor effective in most centres, a rapid, objective, low-cost early warning score to triage ED patients for a possible infection is developed.
Design
Case–control study.
Setting
Secondary and tertiary hospitals in the Netherlands.
Participants
The study included patients presenting to the ED with venous blood sampling from July 2019 to July 2020 (n=10 417, 279 SARS-CoV-2-positive). The temporal validation cohort covered the period from July 2020 to October 2021 (n=14 080, 1093 SARS-CoV-2-positive). The external validation cohort consisted of patients presenting to the ED of three hospitals in the Netherlands (n=12 061, 652 SARS-CoV-2-positive).
Primary outcome measures
The primary outcome was one or more positive SARS-CoV-2 PCR test results within 1 day prior to or 1 week after ED presentation.
Results
The resulting ‘CoLab-score’ consists of 10 routine laboratory measurements and age. The score showed good discriminative ability (AUC: 0.930, 95% CI 0.909 to 0.945). The lowest CoLab-score had high sensitivity for COVID-19 (0.984, 95% CI 0.970 to 0.991; specificity: 0.411, 95% CI 0.285 to 0.520). Conversely, the highest score had high specificity (0.978, 95% CI 0.973 to 0.983; sensitivity: 0.608, 95% CI 0.522 to 0.685). The results were confirmed in temporal and external validation.
Conclusions
The CoLab-score is based on routine laboratory measurements and is available within 1 hour after presentation. Depending on the prevalence, COVID-19 may be safely ruled out in over one-third of ED presentations. Highly suspect cases can be identified regardless of presenting symptoms. The CoLab-score is continuous, in contrast to the binary outcome of lateral flow testing, and can guide PCR testing and triage ED patients.
Læs mere Tjek på PubMed
Dias Goncalves Lima, F., van der Zee, R. P., Dick, S., van Noesel, C. J. M., Berkhof, J., Schim van der Loeff, M. F., Prins, J. M., Steenbergen, R. D. M., de Vries, H. J. C.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Introduction
Anal cancer precursors, or high-grade anal intraepithelial neoplasia (HGAIN), are highly prevalent in HIV-seropositive (HIV+) men who have sex with men (MSM). Around 30% of lesions regress within 1 year, but current histopathological assessment is unable to distinguish between HGAIN likely to regress and HGAIN likely to persist or progress to cancer. We aim to assess if host cell DNA methylation markers can predict regression of HGAIN, thus determining the need for immediate treatment or active surveillance. This could reduce overtreatment and the associated anal and psycho-sexual morbidity.
Methods and analysis
This is an active surveillance cohort study in three centres located in Amsterdam, the Netherlands, in 200 HIV+ MSM diagnosed with HGAIN. Participants will not be treated, but closely monitored during 24 months of follow-up with 6 monthly visits including cytology, and high-resolution anoscopy with biopsies. The primary study endpoint is histopathological regression of each baseline HGAIN lesion at the end of the study. Regression is defined as ≤low grade anal intraepithelial neoplasia in the exit biopsy at 24 months. Regression proportions in lesions with low versus high methylation levels (ASCL1, ZNF582), other biomarkers (HPV genotype, HPV-E4, p16INK4A, Ki-67) and immunological markers at baseline will be compared. Main secondary endpoints are the histological and clinical outcome (ie, the number of octants affected by HGAIN) of each baseline HGAIN lesion and overall HGAIN disease (i.e., all lesions combined) after each visit. The health-related quality of life of the study group will be compared with that of a control group of 50 HIV+ MSM receiving regular HGAIN treatment.
Ethics and dissemination
Ethics approval was obtained from the Institutional Review Board of the Academic Medical Center (Amsterdam, The Netherlands; reference no. 2021_099). Participants are required to provide written informed consent. Findings will be disseminated through publication in peer-reviewed scientific journals and presentations at international scientific conferences; dissemination to policy makers and the target patient group will be achieved through our (inter-)national network, professional associations and collaboration with a patient representative organisation.
Trial registration number
NL9664.
Læs mere Tjek på PubMed
Cortes-Albornoz, M. C., Ramirez-Guerrero, S., Rojas-Carabali, W., de-la-Torre, A., Talero-Gutierrez, C.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Objectives
Increased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children’s visual health.
Design
Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Data sources
Scopus, PubMed and ScienceDirect databases from the year 2020 onwards.
Eligibility criteria
We included cross-sectional, case–control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children.
Data extraction and synthesis
We included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoy et al to assess cross-sectional studies; the Murad et al tool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies.
Results
All but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia.
Conclusions
Increased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown.
PROSPERO registration number
CRD42022307107.
Læs mere Tjek på PubMed
Specht, I. O., Winckler, K., Christensen, R., Bomhoff, C., Raffing, R., Waehrens, E. E.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Objectives
The COVID-19 pandemic has changed the working environment, how we think of it and how it stands to develop into the future. Knowledge about how people have continued to work on-site and adjusted to working from home during the COVID-19 lockdown will be vital for planning work arrangements in the post-pandemic period. Our primary objective was to investigate experiences of working from home or having colleagues working from home during a late stage of the COVID-19 lockdown among researchers and healthcare providers in a hospital research setting. Second, we aimed to investigate researchers’ productivity through changes in various proxy measures during lockdown as compared with pre-lockdown.
Design
Mixed-method participatory Group Concept Mapping (GCM).
Setting and participants
GCM, based on a mixed-method participatory approach, was applied involving researchers’ and healthcare providers’ online sorting and rating experiences working from home during the COVID-19 pandemic. At a face-to-face meeting, participants achieved consensus on the number and labelling of domains—the basis for developing a conceptual model.
Results
Through the GCM approach, 47 participants generated 125 unique statements of experiences related to working from home, which were organised into seven clusters. Using these clusters, we developed a conceptual model that illustrated the pros and cons of working from home.
Conclusion
The future work setting, the role of the office and the overall work environment need to respond to workers’ increased wish for flexible work arrangements and co-decision.
Læs mere Tjek på PubMed
Prados-Bo, A., Rabassa, M., Bosch, M., Casino, G.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Objective
To examine the certainty of the evidence supporting health claims about probiotics, yoghurt, kefir, kombucha, fibre and prebiotics, and to assess the quality of online information in Spanish.
Design
Content analysis.
Methods
We compiled a data set of 114 web pages by searching six popular search phrases in Spanish relating to probiotics, yoghurt, kefir, kombucha, fibre and prebiotics on Google.es and coded them for typology and health claims. We examined the certainty of the evidence for health claims from systematic reviews. Information quality was assessed according to 10 criteria, where a web page: mentions scientific publications and reports their conclusions; quantifies relative and absolute effects; acknowledges some limitations; discusses certainty of evidence; reports the potential harms, alternatives and costs; and does not argue based on personal experiences.
Results
Gastrointestinal health (86.0%), general health (57.9%), cardiovascular health (53.5%) and immune system health (50.9%) were the most widely mentioned topics. Half of claims (52.6%, 70/133) were supported by evidence from systematic reviews. Probiotics had the highest number of claims supported by evidence and kombucha the lowest. The highest certainty was found for antibiotic-associated diarrhoea, necrotising enterocolitis and otitis (moderate) in probiotics and yoghurt, infectious diarrhoea and hepatic encephalopathy (moderate) in prebiotics, and cardiovascular health (high to moderate) and colorectal cancer (moderate) in fibre. On a scale of 0–10, the median information quality score for all web pages was 3. Only 18.4% reported study conclusions, 7.9% quantified the effects, 28.9% acknowledged some limitations in the research and 42.1% reported potential harms.
Conclusions
Most online health claims for dietary interventions intended for improving health through the gut microbiome are supported by low or very low certainty of evidence. Online information does not align with the evidence and is incomplete or unbalanced.
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Young-Xu, Y., Zwain, G. M., Izurieta, H. S., Korves, C., Powell, E. I., Smith, J., Balajee, A., Holodniy, M., Beenhouwer, D. O., Rodriguez-Barradas, M. C., Brown, S. T., Marconi, V. C.
BMJ Open, 3.08.2022
Tilføjet 3.08.2022
Objective
To estimate the effectiveness of messenger RNA (mRNA) booster doses during the period of Delta and Omicron variant dominance.
Design
We conducted a matched test-negative case–control study to estimate the vaccine effectiveness (VE) of three and two doses of mRNA vaccines against infection (regardless of symptoms) and against COVID-19-related hospitalisation and death.
Setting
Veterans Health Administration.
Participants
We used electronic health record data from 114 640 veterans who had a SARS-CoV-2 test during November 2021–January 2022. Patients were largely 65 years or older (52%), male (88%) and non-Hispanic white (59%).
Main outcome measures
First positive result for a SARS-CoV-2 PCR or antigen test.
Results
Against infection, booster doses had higher estimated VE (64%, 95% CI 63 to 65) than two-dose vaccination (12%, 95% CI 10 to 15) during the Omicron period. For the Delta period, the VE against infection was 90% (95% CI 88 to 92) among boosted vaccinees, higher than the VE among two-dose vaccinees (54%, 95% CI 50 to 57). Against hospitalisation, booster dose VE was 89% (95% CI 88 to 91) during Omicron and 94% (95% CI 90 to 96) during Delta; two-dose VE was 63% (95% CI 58 to 67) during Omicron and 75% (95% CI 69 to 80) during Delta. Against death, the VE with a booster dose was 94% (95% CI 90 to 96) during Omicron and 96% (95% CI 87 to 99) during Delta.
Conclusions
Among an older, mostly male, population with comorbidities, we found that an mRNA vaccine booster was highly effective against infection, hospitalisation and death. Although the effectiveness of booster vaccination against infection was moderately higher against Delta than against the Omicron SARS-CoV-2 variant, effectiveness against severe disease and death was similarly high against both variants.
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