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This case series study describes cutaneous T-cell–rich lymphoid infiltrates characterized by papulonodules on the trunk and/or extremities in 6 patients after receiving the Pfizer/BioNTech COVID-19 mRNA vaccine.
Annals of Internal Medicine, Volume 175, Issue 10, Page 1401-1410, October 2022.
Objectives
Gathering population-based data on prevalence of SARS-CoV-2 infection is vital to the public health response and planning. Current seroprevalence data in BC are limited with respect to considerations of how socioeconomic and demographic factors, such as age, sex, gender, income, identifying as a visibility minority and occupation, are related to SARS-CoV-2 antibody detection due to infection-acquired immunity. We aimed to estimate the SARS-CoV-2 seropositivity in a cohort of British Columbians, using at-home self-collected dried blood spot (DBS) samples.
Design
This cross-sectional study included online surveys that collected sociodemographic and COVID-19 vaccine receipt information, and an at-home DBS collection kit.
Setting
British Columbia (BC), Canada.
Participants
Eligible participants were aged 25–69 years and residents of BC.
Primary outcome measure
SARS-CoV-2 anti-spike IgG antibody detection in unvaccinated individuals. Adjusted incidence rate ratios (aIRR) explored factors associated with seropositivity.
Results
SARS-CoV-2 serology was performed on a total of 4048 unvaccinated participants 25–69 years of age who submitted DBS samples taken from November 2020 to June 2021. A total of 118 seropositive cases were identified, for an estimated overall seropositivity of 2.92% (95% CI 2.42% to 3.48%). Participants identifying as a visible minority had a higher seropositivity, 5.1% vs 2.6% (p=0.003), compared with non-visible minority participants. After adjustment by age and sex, identifying as a visible minority (aIRR=1.85, 95% CI 1.20 to 2.84) remained the only significant factor associated with SARS-CoV-2 antibody detection in this cohort of unvaccinated individuals.
Conclusions
SARS-CoV-2 seropositivity in the BC population due to infection-acquired immunity was low. Seropositivity indicated that among those unvaccinated, visible minority communities have been most impacted. Continued monitoring of SARS-CoV-2 serology due to both infection-acquired and vaccine-acquired immunity will be vital in public health planning and pandemic response.
Objectives
To investigate changes in beliefs and behaviours following news of the Omicron variant and changes to guidance understanding of Omicron-related guidance, and factors associated with engaging with protective behaviours.
Design
Series of cross-sectional surveys (1 November to 16 December 2021, five waves of data collection).
Setting
Online.
Participants
People living in England, aged 16 years or over (n=1622–1902 per wave).
Primary and secondary outcome measures
Levels of worry and perceived risk, and engagement with key behaviours (out-of-home activities, risky social mixing, wearing a face covering and testing uptake).
Results
Degree of worry and perceived risk of COVID-19 (to oneself and people in the UK) fluctuated over time, increasing slightly around the time of the announcement about Omicron (p
Objective
To answer the question: Why do people consent to being vaccinated with novel vaccines against SARS-CoV-2?
Design
Representative survey.
Setting
Online panel.
Participants
1032 respondents of the general German population.
Method
A representative survey among German citizens in November/December 2021 that resulted in 1032 complete responses on vaccination status, sociodemographic parameters and opinions about the COVID-19 situation.
Results
Almost 83% of the respondents were vaccinated. The major motivation was fear of medical consequences of an infection and the wish to lead a normal life again. The major motivation to be not vaccinated was the fear of side effects and scepticism about long-term effectiveness and safety. Sixteen per cent of vaccinated respondents reported some serious side effect, while more than 30% reported health improvements, mostly due to the relief of psychological stress and social reintegration. We also validated a ‘Corona Orthodoxy Score—COS’ consisting of seven items reflecting opinions on COVID-19. The scale is reliable (alpha=0.76) and unidimensional. The COS was a highly significant predictor of vaccination status and readiness to be vaccinated in a multivariable logistic regression model. Those who were vaccinated were more likely to live in smaller households (OR=0.82, p=0.024), had a higher income (OR=1.27, p
The effect of immunomodulator and biological therapy for IBD on the immune response to SARS-CoV-2 is of substantial interest to patients and clinicians worldwide. The CLARITY IBD study recently reported attenuated serological responses in patients with IBD treated with infliximab in comparison with vedolizumab,1 with the effect greatest in those on infliximab/thiopurine combination therapy. Independently, the global SECURE-IBD registry highlighted that infliximab/thiopurine combination therapy, but not infliximab or vedolizumab monotherapies, was associated with more severe clinical outcomes upon SARS-CoV-2 infection.2 3 However, these studies have not addressed treatment effects on neutralising antibody responses, which are associated with protection to SARS-CoV-2; nor have they analysed the range of serological signatures that may influence clinical outcomes.4 5 To answer these questions, we performed an extended analysis of serological responses to SARS-CoV-2 infection in patients with seropositive IBD treated with either infliximab…
We read with interest the recent findings by Kennedy et al, which concluded that infliximab (IFX) impairs antibody responses to a single dose of the mRNA-BNT162b2 SARS-CoV-2 vaccine in adult patients with IBD.1 2 Interestingly, another study showed that antibodies against SARS-CoV-2 diminish over time following infection in adult patients with IBD.3 In general, more robust antibody responses have been observed in adolescents compared with adults in the BNT162b2 vaccine trial.4 However, the true impact of immunosuppressant therapies on SARS-CoV-2 vaccine efficacy in paediatric IBD (PIBD) patients is unknown as they were excluded from the trials. Therefore, analysing vaccine responses directly in these patients is necessary to determine the best strategy.5 6 We undertook a study to evaluate immunogenicity of mRNA-based SARS-CoV-2 vaccines in PIBD patients treated with anti-TNF therapies. Given the urgent need for data, we…
Objectives
To determine the diagnostic yield of screening patients for SARS-CoV-2 who were admitted with a diagnosis unrelated to COVID-19 and to identify risk factors for positive tests.
Design
Cohort from the Canadian COVID-19 Emergency Department Rapid Response Network registry.
Setting
30 acute care hospitals across Canada.
Participants
Patients hospitalised for non-COVID-19-related diagnoses who were tested for SARS-CoV-2 between 1 March and 29 December 2020.
Main outcome
Positive nucleic acid amplification test for SARS-CoV-2.
Outcome measure
Diagnostic yield.
Results
We enrolled 15 690 consecutive eligible adults who were admitted to hospital without clinically suspected COVID-19. Among these patients, 122 tested positive for COVID-19, resulting in a diagnostic yield of 0.8% (95% CI 0.64% to 0.92%). Factors associated with a positive test included presence of fever, being a healthcare worker, having a positive household contact or institutional exposure, and living in an area with higher 7-day average incident COVID-19 cases.
Conclusions
Universal screening of hospitalised patients for COVID-19 across two pandemic waves had a low diagnostic yield and should be informed by individual-level risk assessment in addition to regional COVID-19 prevalence.
Trial registration number
NCT04702945.
Objective
To evaluate the durability of response 3 months after the third BNT162b2 vaccine in adults aged 60 years and older.
Design
Prospective cohort study.
Setting
Single tertiary centre.
Participants
Healthcare workers/family members aged ≥60 years old who received the third BNT162b2 dose.
Interventions
Blood samples were drawn immediately before (T0), 10–19 days (T1) and 74–103 days (T2) after the third dose.
Primary and secondary outcome measures
Anti-spike IgG titres were determined using a commercial assay and seropositivity was defined as ≥50 arbitrary units (AU)/mL. Neutralising antibody titres were determined at T2. Adverse events, COVID-19 infections and Clinical Frailty Scale (CFS) levels were documented.
Results
The analysis included 97 participants (median age, 70 years (IQR, 66–74), 58% CFS level 2). IgG titres, which increased significantly from T0 to T1 (median, 440 AU/mL (IQR, 294–923) and median, 25 429 AU/mL (IQR, 14 203–36 114), respectively; p
This cohort study examines the association of COVID-19 vaccination during pregnancy with reduced risk of COVID-19 in Norwegian infants up to age 4 months during COVID-19 pandemic periods dominated by Delta and Omicron variants.
This cross-sectional study assesses the association of the first dose of the SARS-CoV-2 mRNA-1273 vaccine with delayed large local reactions by sex and age in Japan.
All’Università di Pittsburgh hanno dimostrato che anche gli anticorpi che riconoscono le proteine interne di Sars-CoV2 potrebbero essere importanti per migliorare le terapie ed essere di supporto allo sviluppo di vaccini pan-coronavirus
Objectives
Dynamics of antibody responses following SARS-CoV-2 infection are controversial in terms of immunity and persistence. We aimed to assess longitudinally the trend of antibody serological titres, their correlation with clinical severity as well as clinical reinfection during a follow-up.
Design
Longitudinal cohort, 12 months follow-up study.
Setting
USL Umbria 2.
Participants
Consecutive subjects aged 15–75 who were discharged with the diagnosis of Sars-Cov-2 from the hospitals of the AUSL Umbria 2, or resulted positive to a PCR test for SARS-CoV-2 infection with or without symptoms were recruited. SARS-CoV-2 serological testing for antibodies targeting the Nucleocapside and Spike proteins were determined.
Results
Of 184 eligible subjects, 149 were available for evaluation: 17 were classified as oligo/asymptomatic, 107 as symptomatic, 25 as hospital admitted. Participants differed in terms of signs and symptoms as well as treatment. Overall there was a significant difference in terms of antibody titres between groups (anti-S: p
Objective
To compare outcomes between O and non-O blood groups, and by modified RNA (mRNA) and adenovirus-vectored (Ad-V) vaccines.
Design
Population-based cohort study.
Setting
All of Ontario, Canada. Linked data sets captured clinical encounters, vaccinations and laboratory testing for SARS-CoV-2.
Participants
Individuals aged 12+ years with known ABO blood group and free of SARS-CoV-2 before 15 January 2021.
Main outcomes measures
The main exposure, first SARS-CoV-2 vaccination, was modelled in a time-varying manner. O and non-O blood group was known prior to vaccination. SARS-CoV-2 infection, and severe COVID-19 (hospitalisation or death), were assessed starting 14 days after vaccination, up to 27 June 2021.
Results
2 472 261 individuals were included. 1 743 916 (70.5%) had at least one vaccination, of which 24.6% were fully vaccinated. Those vaccinated were more likely to be women, older in age, residing in a higher-income area and have higher rates of certain comorbid conditions, like cancer, diabetes and hypertension. Relative to unvaccinated, after receiving their first mRNA (adjusted HR (aHR) 0.46, 95% CI 0.44 to 0.47) or Ad-V (aHR 0.49, 95% CI 0.44 to 0.54) vaccine, the risk of SARS-CoV-2 infection was lower, as was severe COVID-19 (aHR 0.29, 95% CI 0.20 to 0.43 (mRNA); aHR 0.29, 95% CI 0.26 to 0.33 (Ad-V)). Stratifying by blood group produced similar results. For example, after first mRNA vaccination, the aHR of severe COVID-19 was 0.31 (95% CI 0.27 to 0.36) among non-O blood groups, and 0.27 (95% CI 0.22 to 0.32) among O blood groups, relative to unvaccinated. Fully vaccinated individuals had the lowest risk of SARS-CoV-2 and severe COVID-19.
Conclusions
SARS-CoV-2 infection and severe COVID-19 are reduced by vaccination. This effect does not vary by vaccine type or blood group, but is more pronounced among fully, than partially, vaccinated individuals.
Objective
To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 online forward triage tool (OFTT) in a pandemic context.
Design
A mixed method sequential explanatory study was employed. Quantitative data of all OFTT users, between 2 March 2020 and 12 May 2020, were collected. Second, qualitative data were collected through key informant interviews (n=19) to explain the quantitative findings, explore tool utility, user experience and elicit recommendations.
Setting
The working group e-emergency medicine at the emergency department developed an OFTT, which was made available online.
Participants
Participants included all users above the age of 18 that used the OFTT between 2 March 2020 and 12 May 2020.
Intervention
An OFTT that displayed the current test recommendations of the Federal Office of Public Health on whether someone needed testing for COVID-19 or not. No diagnosis was provided.
Results
In the study period, 6272 users consulted our OFTT; 40.2% (1626/4049) would have contacted a healthcare provider had the tool not existed. 560 participants consented to a follow-up survey and provided a valid email address. 31.4% (176/560) participants returned a complete follow-up questionnaire. 84.7% (149/176) followed the recommendations given. 41.5% (73/176) reported that their fear was allayed after using the tool. Qualitatively, seven overarching themes emerged namely (1) accessibility of tool, (2) user-friendliness of tool, (3) utility of tool as an information source, (4) utility of tool in allaying fear and anxiety, (5) utility of tool in medical decision-making (6) utility of tool in reducing the potential for onward transmissions and (7) utility of tool in reducing health system burden.
Conclusion
Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden but can also serve as an information source, reduce anxiety and fear, reduce potential for cross infections and facilitate medical decision-making.
Cheung CCL, Goh D, Lim X, et al. Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19. Gut 2022;71:226–9. doi:10.1136/gutjnl-2021-324280
The grant number 202D8226 is incorrect and should be C210112056.
