Project description:ObjectiveTo estimate the optimal quarantine period for inbound travelers and identify key risk factors to provide scientific reference for emerging infectious diseases.MethodsA parametric survival analysis model was used to calculate the time interval between entry and first positive nucleic acid test of imported cases in Guangzhou, to identify the influencing factors. And the COVID-19 epidemic risk prediction model based on multiple risk factors among inbound travelers was constructed.ResultsThe approximate 95th percentile of the time interval was 14 days. Multivariate analysis found that the mean time interval for inbound travelers in entry/exit high-risk occupations was 29% shorter (OR 0.29, 95% CI 0.18-0.46, p < 0.0001) than that of low-risk occupations, those from Africa were 37% shorter (OR 0.37, 95% CI 0.17-0.78, p = 0.01) than those from Asia, those who were fully vaccinated were 1.88 times higher (OR 1.88, 95% CI 1.13-3.12, p = 0.01) than that of those who were unvaccinated, and those in other VOC periods were lower than in the Delta period. Decision tree analysis showed that a combined entry/exit low-risk occupation group with Delta period could create a high indigenous epidemic risk by 0.24.ConclusionDifferent strata of imported cases can result in varying degrees of risk of indigenous outbreaks. "low-risk groups" with entry/exit low-risk occupations, fully vaccinated, or from Asia deserve more attention than "high-risk groups."
Project description:BackgroundCOVID-19 manifests with huge heterogeneity in susceptibility and severity outcomes. UK Black Asian and Minority Ethnic (BAME) groups have demonstrated disproportionate burdens. Some variability remains unexplained, suggesting potential genetic contribution. Polygenic Risk Scores (PRS) can determine genetic predisposition to disease based on Single Nucleotide Polymorphisms (SNPs) within the genome. COVID-19 PRS analyses within non-European samples are extremely limited. We applied a multi-ethnic PRS to a UK-based cohort to understand genetic contribution to COVID-19 variability.MethodsWe constructed two PRS for susceptibility and severity outcomes based on leading risk-variants from the COVID-19 Host Genetics Initiative. Scores were applied to 447,382 participants from the UK-Biobank. Associations with COVID-19 outcomes were assessed using binary logistic regression and discriminative power was validated using incremental area under receiver operating curve (ΔAUC). Variance explained was compared between ethnic groups via incremental pseudo-R2 (ΔR2).ResultsCompared to those at low genetic risk, those at high risk had a significantly greater risk of severe COVID-19 for White (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.42-1.74), Asian (OR 2.88, 95% CI 1.63-5.09) and Black (OR 1.98, 95% CI 1.11-3.53) ethnic groups. Severity PRS performed best within Asian (ΔAUC 0.9%, ΔR2 0.98%) and Black (ΔAUC 0.6%, ΔR2 0.61%) cohorts. For susceptibility, higher genetic risk was significantly associated with COVID-19 infection risk for the White cohort (OR 1.31, 95% CI 1.26-1.36), but not for Black or Asian groups.ConclusionsSignificant associations between PRS and COVID-19 outcomes were elicited, establishing a genetic basis for variability in COVID-19. PRS showed utility in identifying high-risk individuals. The multi-ethnic approach allowed applicability of PRS to diverse populations, with the severity model performing well within Black and Asian cohorts. Further studies with larger sample sizes of non-White samples are required to increase statistical power and better assess impacts within BAME populations.
Project description:ObjectivesIn the wake of the coronavirus disease 2019 (COVID-19) pandemic, we have witnessed a rise in the instances of mental health problems and the suicide-related mortality rates. This study aims to identify the suicide-related risk factors and stressors to determine the groups at a greater risk of attempting suicide during the COVID-19 lockdown.MethodsThis retrospective study examined 29 cases of attempted suicide during the 3-month COVID-19 lockdown in KSA. The suicide risk factors were evaluated using specific instrument the modified (SAD PERSONS) scale. It is an acronym for sex, age, depression, previous attempt, excess alcohol, rational thinking loss, social status, organized plan, no social supports and stated future intent.ResultsThe lockdown stressors that may have triggered suicidal behaviours were identified as follows: psychological distress, relationship problems, financial difficulties, and extreme fear of the COVID-19 infection. While all age groups carried the risk of attempting suicide during the lockdown, patients with psychiatric disorders and women accounted for 69% and 65.5% of the cohort, respectively. Factors like hopelessness and depression were highly related to suicide attempts, as well as the statement of future intent to repeat the attempt, at 72.4% and 65.5% respectively. Almost two-thirds of the attempts made were serious, and many women felt unsafe in their own homes during the lockdown.ConclusionPatients with pre-existing psychiatric disorders and women carry high risk of attempting suicide during the COVID-19 lockdown. This study offers insights on the greater outreach efforts that can be carried out for these patients by calling for the prioritization of mental health care, improvement of domestic violence services, and strengthening of suicide prevention strategies.
Project description:BackgroundEpidemiological data on seasonal coronaviruses (sCoVs) may provide insight on transmission patterns and demographic factors that favor coronaviruses (CoVs) with greater disease severity. This study describes the incidence of CoVs in several high-risk groups in Ottawa, Canada, from October 2020 to March 2022.MethodsSerological assays quantified IgG and IgM antibodies to SARS-CoV-2, HCoV-OC43, HCoV-NL63, HCoV-HKU1, and HCoV-229E. Incident infections were compared between four population groups: individuals exposed to children, transit users, immunocompromised, and controls. Associations between antibody prevalence indicative of natural infection and demographic variables were assessed using regression analyses.ResultsTransit users and those exposed to children were at no greater risk of infection compared to the control group. Fewer infections were detected in the immunocompromised group (p = .03). SARS-CoV-2 seroprevalence was greater in individuals with low income and within ethnic minorities.ConclusionsOur findings suggest that nonpharmaceutical interventions intended to reduce SAR-CoV-2 transmission protected populations at high risk of exposure. The re-emergence of sCoVs and other common respiratory viruses alongside SARS-CoV-2 may alter infection patterns and increase the risk in vulnerable populations.
Project description:It is a known fact that there are a particular set of people who are at higher risk of getting COVID-19 infection. Typically, these high-risk individuals are recommended to take more preventive measures. The use of non-pharmaceutical interventions (NPIs) and the vaccine are playing a major role in the dynamics of the transmission of COVID-19. We propose a COVID-19 model with high-risk and low-risk susceptible individuals and their respective intervention strategies. We find two equilibrium solutions and we investigate the basic reproduction number. We also carry out the stability analysis of the equilibria. Further, this model is extended by considering the vaccination of some non-vaccinated individuals in the high-risk population. Sensitivity analyses and numerical simulations are carried out. From the results, we are able to obtain disease-free and endemic equilibrium solutions by solving the system of equations in the model and show their global stabilities using the Lyapunov function technique. The results obtained from the sensitivity analysis shows that reducing the hospitals' imperfect efficacy can have a positive impact on the control of COVID-19. Finally, simulations of the extended model demonstrate that vaccination could adequately control or eliminate COVID-19.
Project description:COVID-19 inequities have been well-documented. We evaluated whether higher rates of severe COVID-19 in racial and ethnic minority groups were driven by higher infection rates by evaluating if disparities remained when analyses were restricted to people with infection. We conducted a retrospective cohort study of adults insured through Kaiser Permanente (Colorado, Northwest, Washington), follow-up in March-September 2020. Laboratory results and hospitalization diagnosis codes identified individuals with COVID-19. Severe COVID-19 was defined as invasive mechanical ventilation or mortality. Self-reported race and ethnicity, demographics, and medical comorbidities were extracted from health records. Modified Poisson regression estimated adjusted relative risks (aRRs) of severe COVID-19 in full cohort and among individuals with infection. Our cohort included 1,052,774 individuals, representing diverse racial and ethnic minority groups (e.g., 68,887 Asian, 41,243 Black/African American, 93,580 Hispanic or Latino/a individuals). Among 7,399 infections, 442 individuals experienced severe COVID-19. In the full cohort, severe COVID-19 aRRs for Asian, Black/African American, and Hispanic individuals were 2.09 (95% CI: 1.36, 3.21), 2.02 (1.39, 2.93), and 2.09 (1.57, 2.78), respectively, compared to non-Hispanic Whites. In analyses restricted to individuals with COVID-19, all aRRs were near 1, except among Asian Americans (aRR 1.82 [1.23, 2.68]). These results indicate increased incidence of severe COVID-19 among Black/African American and Hispanic individuals is due to higher infection rates, not increased susceptibility to progression. COVID-19 disparities most likely result from social, not biological, factors. Future work should explore reasons for increased severe COVID-19 risk among Asian Americans. Our findings highlight the importance of equity in vaccine distribution.
Project description:This article is a narrative review of the rapidly moving coronavirus disease 2019 vaccine field with an emphasis on clinical efficacy established in both randomized trials and postmarketing surveillance of clinically available vaccines. We review the major clinical trials that supported authorization for general use of the Janssen (Ad.26.CoV2), Pfizer-BioNTech (BNT162b2), and Moderna (mRNA-1273) vaccines and the publicly available postmarketing information with the goal of providing a broad, clinically relevant comparison of efficacy and safety. This review is primarily focused on the US market.
Project description:COVID-19 is a pandemic of unprecedented proportions in recent human history. Less than 18 months since the onset of the pandemic, there are close to two hundred million confirmed cases and four million deaths worldwide. There have also been massive efforts geared towards finding safe and effective vaccines. By July 2021 there were 184 COVID-19 vaccine candidates in pre-clinical development, 105 in clinical development, and 18 vaccines approved for emergency use by at least one regulatory authority. These vaccines include whole virus live attenuated or inactivated, protein-based, viral vector, and nucleic acid vaccines. By mid-2021 three billion doses of COVID-19 vaccine have been administered around the world, mostly in high-income countries. COVID-19 vaccination provides hope for an end to the pandemic, if and only if there would be equal access and optimal uptake in all countries around the world.