Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the ...Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.展开更多
BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and t...BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and the cycle threshold(Ct)measured using the fluorescent polymerase chain reaction(PCR)method were related to pulmonary infections diagnosed via computed tomography(CT).AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values,as determined via PCR.METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2Omicron variant infections were retrospectively collected and categorized into low(<25),medium(25.00-34.99),and high(≥35)Ct groups.The characteristics of chest CT images in each group were statistically analyzed.RESULTS The PCR Ct values ranged from 13.36 to 39.81,with 99 patients in the low,155 in the medium,and 77 in the high Ct groups.Six abnormal chest CT signs were detected,namely,focal infection,patchy consolidation shadows,patchy groundglass shadows,mixed consolidation ground-glass shadows,subpleural interstitial changes,and pleural changes.Focal infections were less frequent in the low Ct group than in the medium and high Ct groups;these infections were the most common sign in the medium and high Ct groups.Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups.The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARSCoV-2 varied depending on the Ct values.Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.展开更多
The appearance of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant Omicron(B.1.1.529)has caused panic responses around the world because of its high transmission rate and number of mutations.This rev...The appearance of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant Omicron(B.1.1.529)has caused panic responses around the world because of its high transmission rate and number of mutations.This review summarizes the highly mutated regions,the essential infectivity,transmission,vaccine breakthrough and antibody resistance of the Omicron variant of SARSCoV-2.The Omicron is highly transmissible and is spreading faster than any previous variant,but may cause less severe symptoms than previous variants.The Omicron is able to escape the immune system’s defenses and coronavirus disease 2019 vaccines are less effective against the Omicron variant.Early careful preventive steps including vaccination will always be key for the suppression of the Omicron variant.展开更多
Objective:To evaluate the efficacy and safety of Huashi Baidu Granules(HSBD)in treating patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant.Methods:A single-center retrospective co...Objective:To evaluate the efficacy and safety of Huashi Baidu Granules(HSBD)in treating patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant.Methods:A single-center retrospective cohort study was conducted during COVID-19 Omicron epidemic in the Mobile Cabin Hospital of Shanghai New International Expo Center from April 1st to May 23rd,2022.All COVID-19 patients with asymptomatic or mild infection were assigned to the treatment group(HSBD users)and the control group(non-HSBD users).After propensity score matching in a 1:1 ratio,496 HSBD users of treatment group were matched by propensity score to 496 non-HSBD users.Patients in the treatment group were administrated HSBD(5 g/bag)orally for 1 bag twice a day for 7 consecutive days.Patients in the control group received standard care and routine treatment.The primary outcomes were the negative conversion time of nucleic acid and negative conversion rate at day 7.Secondary outcomes included the hospitalized days,the time of the first nucleic acid negative conversion,and new-onset symptoms in asymptomatic patients.Adverse events(AEs)that occurred during the study were recorded.Further subgroup analysis was conducted in vaccinated(378 HSBD users and 390 non-HSBD users)and unvaccinated patients(118 HSBD users and 106 non-HSBD users).Results:The median negative conversion time of nucleic acid in the treatment group was significantly shortened than the control group[3 days(IQR:2-5 days)vs.5 days(IQR:4-6 days);P<0.01].The negative conversion rate of nucleic acid in the treatment group were significantly higher than those in the control group at day 7(91.73%vs.86.90%,P=0.014).Compared with the control group,the hospitalized days in the treatment group were significantly reduced[10 days(IQR:8-11 days)vs.11 days(IQR:10.25-12 days);P<0.01].The time of the first nucleic acid negative conversion had significant differences between the treatment and control groups[3 days(IQR:2-4 days)vs.5 days(IQR:4-6 days);P<0.01].The incidence of new-onset symptoms including cough,pharyngalgia,expectoration and fever in the treatment group were lower than the control group(P<0.05 or P<0.01).In the vaccinated patients,the median negative conversion time and hospitalized days were significantly shorter than the control group after HSDB treatment[3days(IQR:2-5days)vs.5 days(IQR:4-6 days),P<0.01;10 days(IQR:8-11 days)vs.11 days(IQR:10-12 days),P<0.01].In the unvaccinatedpatients,HSBD treatment efficiently shorten the median negative conversion time and hospitalized days[4 days(IQR:2-6 days)vs.5 days(IQR:4-7 days),P<0.01;10.5 days(IQR:8.75-11 days)vs.11.0 days(IQR:10.75-13 days);P<0.01].No serious AEs were reported during the study.Conclusion:HSBD treatment significantly shortened the negative conversion time of nuclear acid,the length of hospitalization,and the time of the first nucleic acid negative conversion in patients infectedwith SARS-COV-2Omicronvariant(Trial registry No.ChiCTR2200060472).展开更多
Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omi...Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omicron variant.Methods:Ninety-three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated.Informa-tion was collected on general health status,medication,and adverse drug reactions(ADRs)according to whether nirmatrelvir-ritonavir and azvudine were administered sequentially or concomitantly.Data on times of onset,clinical manifestations,and outcomes of ADRs and on conversion to a nega-tive nucleic acid test were also recorded.Results:Possible ADRs were recorded in 41 patients(44.1%).There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir-ritonavir and azvudine.Liver enzyme levels increased in nine cases and creatinine clearance decreased in two.Cases of atrial fibrillation(n=1),sleep disorder(n=2),rash(n=2),dizziness(n=1),and weakness(n=5)were also documented.Only vomiting,poor appetite,diarrhea,xerostomia,bitter taste,and rash were considered probable ADRs;others were thought to be possible ADRs.In all cases,the nucleic acid test did not turn negative after the first antiviral was applied.The nucleic acid test of 28 patients did not turn negative before discharge.The remaining 65 patients(69.9%)returned a negative nucleic acid test after receiving the second antiviral agent.Conclusions:Treatment with nirmatrelvir-ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID-19 caused by the Omicron variant.展开更多
The continuous emergence of new severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variants meansthere is a need to explore additional strategies to develop broad-spectrum vaccines or therapeutics for individu...The continuous emergence of new severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variants meansthere is a need to explore additional strategies to develop broad-spectrum vaccines or therapeutics for individuals remaining at risk of coronavirus disease 2019(COVID-19).Neutralizing monoclonal antibody(mAb)that binds to theconserved S2 subunit of the SARS-CoV-2 spike(S)protein alone,or in combination with mAb that binds to the receptor-binding domain(RBD)of S protein,might be effective in eliciting protection from infection by a variety of SARS-CoV2 variants.Using high-throughput single-cell immunoglobulin sequencing of B cells from COVID-19-convalescent donors,we identified a high-affinity S2-specific mAb-39,that could inhibit original SARS-CoV-2 strain,Omicron BA.1,BA.2.86,BA.4,BA.5,and EG.5.1 S protein-mediated membrane fusion,leading to the neutralization of these pseudoviralinfections.Moreover,mAb-39 could also improve the neutralizing activity of anti-RBD antibody against the highlyneutralization-resistant Omicron variants.Molecular docking and point mutation analyses revealed that mAb-39 recognized epitopes within the conserved upstream region of the heptad repeat 2(HR2)motif of the S2 subunit.Collectively,these findings demonstrate that targeting the conserved upstream region of the HR2 motif(e.g.,using mAbs)provides anovel strategy for preventing the infection of SARS-CoV-2 and its variants.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To anal...BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To analyze and compare laboratory values in the"omicron"and"delta"variants of the coronavirus by conducting follow-up examinations and laboratory audits on COVID-19 patients admitted to our institution.METHODS A retrospective study,two groups,50 patients in each group.Patients examined positive for COVID-19 were divided into groups according to the common variant at the given time.We reviewed demographic data and laboratory results such as complete blood count and full chemistry,including electrolytes and coagulation parameters.RESULTS The mean age was 52%,66.53±21.7 were female.No significance was found comparing laboratory results in the following disciplines:Blood count,hemo-globin,and lymphocytes(P=0.41,P=0.87,P=0.97).Omicron and delta variants have higher neutrophil counts,though they are not significantly different(P=0.38).Coagulation tests:Activated paritial thromoplastin test and international normalized ratio(P=0.72,P=0.68).We found no significance of abnormality for all electrolytes.CONCLUSION The study compares laboratory results of blood tests between two variants of the COVID-19 virus–omicron and delta.We found no significance between the variants.Our results show the need for further research with larger data as well as the need to compare all COVID-19 variants.展开更多
Background The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant has increased.Here,we describe the clinical characteristics of children in a te...Background The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant has increased.Here,we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai.Methods A total of 676 pediatric coronavirus disease 2019(COVID-19)cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30,2022 were enrolled in this single-center,prospective,observational real-world study.Patient demographics and clinical characteristics,especially COVID-19 vaccine status,were assessed.Results Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant,with no significant difference between sexes.A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia,neutropenia,and thrombocytopenia(P=0.003,P=0.021,and P=0.017,respectively)but not with physical symptoms or radiographic chest abnormalities.Univariable linear regression models indicated that comorbidities(P=0.001)were associated with a longer time until viral clearance,and increasing age(P<0.001)and two doses of COVID-19 vaccine(P=0.001)were associated with a shorter time to viral clearance.Multivariable analysis revealed an independent effect of comorbidities(P<0.001)and age(P=0.003).The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases(P<0.001).Conclusion This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children.展开更多
Homologous booster,heterologous booster,and Omicron variants breakthrough infection(OBI)could improve the humoral immunity against Omicron variants.Questions concerning about memory B cells(MBCs)and T cells immunity a...Homologous booster,heterologous booster,and Omicron variants breakthrough infection(OBI)could improve the humoral immunity against Omicron variants.Questions concerning about memory B cells(MBCs)and T cells immunity against Omicron variants,features of long-term immunity,after booster and OBI,needs to be explored.Here,comparative analysis demonstrate antibody and T cell immunity against ancestral strain,Delta and Omicron variants in Omicron breakthrough infected patients(OBIPs)are comparable to that in Ad5-nCoV boosted healthy volunteers(HVs),higher than that in inactivated vaccine(InV)boosted HVs.However,memory B cells(MBCs)immunity against Omicron variants was highest in OBIPs,followed by Ad5-nCoV boosted and InV boosted HVs.OBIPs and Ad5-nCoV boosted HVs have higher classical MBCs and activated MBCs,and lower naïve MBCs and atypical MBCs relative to both vaccine boosted HVs.Collectively,these data indicate Omicron breakthrough infection elicit higher MBCs and T cells against SARS-CoV-2 especially Omicron variants relative to homologous InV booster and heterologous Ad5-nCoV booster.展开更多
A compartmental,epidemiological,mathematical model was developed in order to analyze the transmission dynamics of Delta and Omicron variant,of SARS-CoV-2,in Greece.The model was parameterized twice during the 4th and ...A compartmental,epidemiological,mathematical model was developed in order to analyze the transmission dynamics of Delta and Omicron variant,of SARS-CoV-2,in Greece.The model was parameterized twice during the 4th and 5th wave of the pandemic.The 4th wave refers to the period during which the Delta variant was dominant(approximately July to December of 2021)and the 5th wave to the period during which the Omicron variant was dominant(approximately January to May of 2022),in accordance with the official data from the National Public Health Organization(NPHO).Fitting methods were applied to evaluate important parameters in connection with the transmission of the variants,as well as the social behavior of population during these periods of interest.Mathematical models revealed higher numbers of contagiousness and cases of asymptomatic disease during the Omicron variant period,but a decreased rate of hospitalization compared to the Delta period.Also,parameters related to the behavior of the population in Greece were also assessed.More specifically,the use of protective masks and the abidance of social distancing measures.Simulations revealed that over 5,000 deaths could have been avoided,if mask usage and social distancing were 20%more efficient,during the short period of the Delta and Omicron outbreak.Furthermore,the spread of the variants was assessed using viral load data.The data were recorded from PCR tests at 417 Army Equity Fund Hospital(NIMTS),in Athens and the Ct values from 746 patients with COVID-19 were processed,to explain transmission phenomena and disease severity in patients.The period when the Delta variant prevailed in the country,the average Ct value was calculated as 25.19(range:12.32e39.29),whereas during the period when the Omicron variant prevailed,the average Ct value was calculated as 28(range:14.41e39.36).In conclusion,our experimental study showed that the higher viral load,which is related to the Delta variant,may interpret the severity of the disease.However,no correlation was confirmed regarding contagiousness phenomena.The results of the model,Ct analysis and official data from NPHO are consistent.展开更多
Potent neutralizing antibodies(nAbs)against SARS-CoV-2 are a promising therapeutic against the ongoing COVID-19 pandemic.However,the continuous emergence of neutralizing antibody escape variants makes it challenging f...Potent neutralizing antibodies(nAbs)against SARS-CoV-2 are a promising therapeutic against the ongoing COVID-19 pandemic.However,the continuous emergence of neutralizing antibody escape variants makes it challenging for antibody therapeutics based on monospecific nAbs.Here,we generated an IgG-like bispecific antibody(bsAb),Bi-Nab,based on a pair of human neutralizing antibodies targeting multiple and invariant sites of the spike receptor binding domain(RBD):35B5 and 32C7.We demonstrated that Bi-Nab exhibited higher binding affinity to the Delta spike protein than its parental antibodies and presented an extended inhibition breadth of preventing RBD binding to angiotensin-converting enzyme 2(ACE2),the cellular receptor of SARS-CoV-2.In addition,pseudovirus neutralization results showed that Bi-Nab improved the neutralization potency and breadth with a lower half maximum inhibitory concentration(IC50)against wild-type SARS-CoV-2,variants being monitored(VBMs)and variants of concern(VOCs).Notably,the IgG-like Bi-Nab enhanced the neutralizing activity against Omicron variants with potent capabilities for transmission and immune evasion in comparison with its parental monoclonal antibody(mAb)32C7 and a cocktail(with the lowest IC50 values of 31.6 ng/mL against the Omicron BA.1 and 399.2 ng/mL against the Omicron BA.2),showing evidence of synergistic neutralization potency of Bi-Nab against the Omicron variants.Thus,Bi-Nab represents a feasible and effective strategy against SARS-CoV-2 variants of concern.展开更多
目的探讨基于临床及影像特征多元Logistic回归模型在肺部新冠病毒Omicron变异株合并细菌感染诊断中的应用价值。方法回顾性收集新冠病毒Omicron变异株合并细菌感染者74例,为A组。同时段新冠病毒Omicron变异株感染者90例,为B组。通过单...目的探讨基于临床及影像特征多元Logistic回归模型在肺部新冠病毒Omicron变异株合并细菌感染诊断中的应用价值。方法回顾性收集新冠病毒Omicron变异株合并细菌感染者74例,为A组。同时段新冠病毒Omicron变异株感染者90例,为B组。通过单因素与多因素Logistic回归分析,分别构建临床特征、CT影像特征及联合诊断模型。采用受试者操作特征(receiver operating characteristic,ROC)曲线、校准曲线和决策曲线(decision curve analysis,DCA)评估各个模型的预测能力、校准能力和临床效能。采用DeLong检验比较不同模型之间曲线下面积(area under the curve,AUC)的差异。结果多因素Logistic回归显示,慢性阻塞性肺疾病(简称慢阻肺)、重症肺炎、实变影、胸腔积液4个自变量是独立预测因子。临床模型、CT影像模型及联合诊断模型AUC分别为0.893(95%CI:0.843~0.943)、0.838(95%CI:0.773~0.903)、0.948(95%CI:0.915~0.981)。临床与CT影像模型之间差异不具有统计学意义(Z=1.467,P=0.142)。联合诊断模型与临床、CT影像模型间差异均具有统计学意义(Z分别为3.236、4.293,P分别为0.001、<0.001)。校准曲线表明,联合诊断模型预测概率与实际概率之间的良好一致性。DCA示联合诊断模型的净收益最大。结论基于临床及影像学特征的构建的联合诊断模型诊断效能优异,可用于新型冠状病毒Omicron变异株合并细菌感染的诊断与鉴别。展开更多
Multiple new variants of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)have constantly emerged,as the delta and omicron variants,which have developed resistance to currently gained neutralizing antibodie...Multiple new variants of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)have constantly emerged,as the delta and omicron variants,which have developed resistance to currently gained neutralizing antibodies.This highlights a critical need to discover new therapeutic agents to overcome the variants mutations.Despite the availability of vaccines against coronavirus disease 2019(COVID-19),the use of broadly neutralizing antibodies has been considered as an alternative way for the prevention or treatment of SARS-Co V-2 variants infection.Here,we show that the nasal delivery of two previously characterized broadly neutralizing antibodies(F61 and H121)protected K18-h ACE2 mice against lethal challenge with SARS-Co V-2 variants.The broadly protective efficacy of the F61 or F61/F121 cocktail antibodies was evaluated by lethal challenge with the wild strain(WIV04)and multiple variants,including beta(B.1.351),delta(B.1.617.2),and omicron(B.1.1.529)at 200or 1000 TCID_(50),and the minimum antibody administration doses(5-1.25 mg/kg body weight)were also evaluated with delta and omicron challenge.Fully prophylactic protections were found in all challenged groups with both F61 and F61/H121 combination at the administration dose of 20 mg/kg body weight,and corresponding mice lung viral RNA showed negative,with almost all alveolar septa and cavities remaining normal.Furthermore,low-dose antibody treatment induced significant prophylactic protection against lethal challenge with delta and omicron variants,whereas the F61/H121 combination showed excellent results against omicron infection.Our findings indicated the potential use of broadly neutralizing monoclonal antibodies as prophylactic and therapeutic agent for protection of current emerged SARS-Co V-2 variants infection.展开更多
Omicron(B.1.1.529),the fifth variant of concern(VOC)of severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2),was firstly identified in November 2021 in South Africa.Omicron contains far more genome mutations t...Omicron(B.1.1.529),the fifth variant of concern(VOC)of severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2),was firstly identified in November 2021 in South Africa.Omicron contains far more genome mutations than any other VOCs ever found,raising significant concerns about its increased transmissibility and immune evasion.Here,we report the importation of the Omicron variant into Beijing,China,in December 2021.Full‐length genome sequences of five imported strains were obtained,with their genetic features characterized.Each strain contained 57 to 61 nucleotide substitutions,39 deletions,and 9 insertions in the genome.Thirty to thirty‐two amino acid changes were found in the spike proteins of the five strains.The phylogenetic tree constructed by the maximum likelihood method showed that all five imported genomes belonged to Omicron(BA.1)(alias of B.1.1.529.1),which is leading to the current surge of coronavirus disease 2019(COVID‐19)cases worldwide.The globally increased COVID‐19 cases driven by the Omicron variant pose a significant challenge to disease prevention and control in China.Continuous viral genetic surveillance and increased testing among international travellers are required to contain this highly contagious variant.展开更多
The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has evolved rapidly into new variants throughout the pandemic.The Omicron variant has more than 50 mutations when compared with the original wild-type str...The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has evolved rapidly into new variants throughout the pandemic.The Omicron variant has more than 50 mutations when compared with the original wild-type strain and has been identified globally in numerous countries.In this report,we analyzed the mutational profiles of several variants,including the per-site mutation rate,to determine evolutionary relationships.The Omicron variant was found to have a unique mutation profile when compared with that of other SARS-CoV-2 variants,containing mutations that are rare in clinical samples.Moreover,the presence of five mouse-adapted mutation sites suggests that Omicron may have evolved in a mouse host.Mutations in the Omicron receptor-binding domain(RBD)region,in particular,have potential implications for the ongoing pandemic.展开更多
文摘Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.
文摘BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and the cycle threshold(Ct)measured using the fluorescent polymerase chain reaction(PCR)method were related to pulmonary infections diagnosed via computed tomography(CT).AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values,as determined via PCR.METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2Omicron variant infections were retrospectively collected and categorized into low(<25),medium(25.00-34.99),and high(≥35)Ct groups.The characteristics of chest CT images in each group were statistically analyzed.RESULTS The PCR Ct values ranged from 13.36 to 39.81,with 99 patients in the low,155 in the medium,and 77 in the high Ct groups.Six abnormal chest CT signs were detected,namely,focal infection,patchy consolidation shadows,patchy groundglass shadows,mixed consolidation ground-glass shadows,subpleural interstitial changes,and pleural changes.Focal infections were less frequent in the low Ct group than in the medium and high Ct groups;these infections were the most common sign in the medium and high Ct groups.Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups.The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARSCoV-2 varied depending on the Ct values.Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.
文摘The appearance of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant Omicron(B.1.1.529)has caused panic responses around the world because of its high transmission rate and number of mutations.This review summarizes the highly mutated regions,the essential infectivity,transmission,vaccine breakthrough and antibody resistance of the Omicron variant of SARSCoV-2.The Omicron is highly transmissible and is spreading faster than any previous variant,but may cause less severe symptoms than previous variants.The Omicron is able to escape the immune system’s defenses and coronavirus disease 2019 vaccines are less effective against the Omicron variant.Early careful preventive steps including vaccination will always be key for the suppression of the Omicron variant.
基金Supported by Traditional Chinese Medicine Emergency Project on Novel Coronavirus-Infected Pneumonia of State Administration of Traditional Chinese Medicine (No. 2022ZYLCYJ05-4)Shanghai Key Clinical Specialty Project (No. shslczdzk04401)+1 种基金National Traditional Chinese Medicine Emergency Medical Rescue Base Construction Project [No. ZY(2021-2023)-0101-01]National Traditional Chinese Medicine Multidisciplinary Cross Innovation Team Project (No. ZYYCXTD-D-202203)
文摘Objective:To evaluate the efficacy and safety of Huashi Baidu Granules(HSBD)in treating patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant.Methods:A single-center retrospective cohort study was conducted during COVID-19 Omicron epidemic in the Mobile Cabin Hospital of Shanghai New International Expo Center from April 1st to May 23rd,2022.All COVID-19 patients with asymptomatic or mild infection were assigned to the treatment group(HSBD users)and the control group(non-HSBD users).After propensity score matching in a 1:1 ratio,496 HSBD users of treatment group were matched by propensity score to 496 non-HSBD users.Patients in the treatment group were administrated HSBD(5 g/bag)orally for 1 bag twice a day for 7 consecutive days.Patients in the control group received standard care and routine treatment.The primary outcomes were the negative conversion time of nucleic acid and negative conversion rate at day 7.Secondary outcomes included the hospitalized days,the time of the first nucleic acid negative conversion,and new-onset symptoms in asymptomatic patients.Adverse events(AEs)that occurred during the study were recorded.Further subgroup analysis was conducted in vaccinated(378 HSBD users and 390 non-HSBD users)and unvaccinated patients(118 HSBD users and 106 non-HSBD users).Results:The median negative conversion time of nucleic acid in the treatment group was significantly shortened than the control group[3 days(IQR:2-5 days)vs.5 days(IQR:4-6 days);P<0.01].The negative conversion rate of nucleic acid in the treatment group were significantly higher than those in the control group at day 7(91.73%vs.86.90%,P=0.014).Compared with the control group,the hospitalized days in the treatment group were significantly reduced[10 days(IQR:8-11 days)vs.11 days(IQR:10.25-12 days);P<0.01].The time of the first nucleic acid negative conversion had significant differences between the treatment and control groups[3 days(IQR:2-4 days)vs.5 days(IQR:4-6 days);P<0.01].The incidence of new-onset symptoms including cough,pharyngalgia,expectoration and fever in the treatment group were lower than the control group(P<0.05 or P<0.01).In the vaccinated patients,the median negative conversion time and hospitalized days were significantly shorter than the control group after HSDB treatment[3days(IQR:2-5days)vs.5 days(IQR:4-6 days),P<0.01;10 days(IQR:8-11 days)vs.11 days(IQR:10-12 days),P<0.01].In the unvaccinatedpatients,HSBD treatment efficiently shorten the median negative conversion time and hospitalized days[4 days(IQR:2-6 days)vs.5 days(IQR:4-7 days),P<0.01;10.5 days(IQR:8.75-11 days)vs.11.0 days(IQR:10.75-13 days);P<0.01].No serious AEs were reported during the study.Conclusion:HSBD treatment significantly shortened the negative conversion time of nuclear acid,the length of hospitalization,and the time of the first nucleic acid negative conversion in patients infectedwith SARS-COV-2Omicronvariant(Trial registry No.ChiCTR2200060472).
基金Analysis of Omicron Variant Mutation Patterns and Research on Prevention and Control,Grant/Award Number:2023YFC3041500。
文摘Background:This study assessed the safety and efficacy of nirmatrelvir-ritonavir(Paxlovid®)and azvudine when administered sequentially or concomitantly in patients with coronavirus 2019(COVID-19)caused by the Omicron variant.Methods:Ninety-three patients confirmed to be infected with the Omicron variant by nucleic acid detection were retrospectively investigated.Informa-tion was collected on general health status,medication,and adverse drug reactions(ADRs)according to whether nirmatrelvir-ritonavir and azvudine were administered sequentially or concomitantly.Data on times of onset,clinical manifestations,and outcomes of ADRs and on conversion to a nega-tive nucleic acid test were also recorded.Results:Possible ADRs were recorded in 41 patients(44.1%).There were 22 gastrointestinal reactions in 18 patients and 18 hematological abnormalities in 16 after sequential or concomitant treatment with nirmatrelvir-ritonavir and azvudine.Liver enzyme levels increased in nine cases and creatinine clearance decreased in two.Cases of atrial fibrillation(n=1),sleep disorder(n=2),rash(n=2),dizziness(n=1),and weakness(n=5)were also documented.Only vomiting,poor appetite,diarrhea,xerostomia,bitter taste,and rash were considered probable ADRs;others were thought to be possible ADRs.In all cases,the nucleic acid test did not turn negative after the first antiviral was applied.The nucleic acid test of 28 patients did not turn negative before discharge.The remaining 65 patients(69.9%)returned a negative nucleic acid test after receiving the second antiviral agent.Conclusions:Treatment with nirmatrelvir-ritonavir and azvudine is safe and effective whether administered sequentially or concomitantly in patients with COVID-19 caused by the Omicron variant.
基金funded bythe National Natural Science Foundation of China(81972753,32170712,and 32170937)R&D Program of Guangzhou National Laboratory(SRPG22-003)+6 种基金the China Postdoctoral Science Foundation(2019M663093)Prevention and Control ofCOVID-2019 Research Program in University of GuangdongProvince(2020KZDZX1176)the Science and TechnologyProgram of Guangdong Province,China(2020A1515110410and 2021A1515010917)the Guangdong Medical Scienceand Technology Research Foundation(A2021336)ShenzhenKey Laboratory Foundation(ZDSYS20200811143757022)theShenzhen Science and Technology Basic Research Program(JCYJ20180507182203049 and JCYJ20230807142815034)and the Shenzhen University(SZU)Top Ranking Project(86000000210).
文摘The continuous emergence of new severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variants meansthere is a need to explore additional strategies to develop broad-spectrum vaccines or therapeutics for individuals remaining at risk of coronavirus disease 2019(COVID-19).Neutralizing monoclonal antibody(mAb)that binds to theconserved S2 subunit of the SARS-CoV-2 spike(S)protein alone,or in combination with mAb that binds to the receptor-binding domain(RBD)of S protein,might be effective in eliciting protection from infection by a variety of SARS-CoV2 variants.Using high-throughput single-cell immunoglobulin sequencing of B cells from COVID-19-convalescent donors,we identified a high-affinity S2-specific mAb-39,that could inhibit original SARS-CoV-2 strain,Omicron BA.1,BA.2.86,BA.4,BA.5,and EG.5.1 S protein-mediated membrane fusion,leading to the neutralization of these pseudoviralinfections.Moreover,mAb-39 could also improve the neutralizing activity of anti-RBD antibody against the highlyneutralization-resistant Omicron variants.Molecular docking and point mutation analyses revealed that mAb-39 recognized epitopes within the conserved upstream region of the heptad repeat 2(HR2)motif of the S2 subunit.Collectively,these findings demonstrate that targeting the conserved upstream region of the HR2 motif(e.g.,using mAbs)provides anovel strategy for preventing the infection of SARS-CoV-2 and its variants.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To analyze and compare laboratory values in the"omicron"and"delta"variants of the coronavirus by conducting follow-up examinations and laboratory audits on COVID-19 patients admitted to our institution.METHODS A retrospective study,two groups,50 patients in each group.Patients examined positive for COVID-19 were divided into groups according to the common variant at the given time.We reviewed demographic data and laboratory results such as complete blood count and full chemistry,including electrolytes and coagulation parameters.RESULTS The mean age was 52%,66.53±21.7 were female.No significance was found comparing laboratory results in the following disciplines:Blood count,hemo-globin,and lymphocytes(P=0.41,P=0.87,P=0.97).Omicron and delta variants have higher neutrophil counts,though they are not significantly different(P=0.38).Coagulation tests:Activated paritial thromoplastin test and international normalized ratio(P=0.72,P=0.68).We found no significance of abnormality for all electrolytes.CONCLUSION The study compares laboratory results of blood tests between two variants of the COVID-19 virus–omicron and delta.We found no significance between the variants.Our results show the need for further research with larger data as well as the need to compare all COVID-19 variants.
基金This work was funded by the Innovative Research Team of High-Level Local Universities in Shanghai(SHSMUZDCX20212800)Science and Technology Commission Shanghai Municipality(20JC1410200,20JC1410204)+2 种基金2021 Shanghai University Teacher Training Plan-Industry University Research Practice Plan Project(EYJ26.RLO17)Shanghai Municipal Health Commission(2019SY049)Shanghai Medical Leading Talents Program(2019LJ22).
文摘Background The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant has increased.Here,we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai.Methods A total of 676 pediatric coronavirus disease 2019(COVID-19)cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30,2022 were enrolled in this single-center,prospective,observational real-world study.Patient demographics and clinical characteristics,especially COVID-19 vaccine status,were assessed.Results Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant,with no significant difference between sexes.A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia,neutropenia,and thrombocytopenia(P=0.003,P=0.021,and P=0.017,respectively)but not with physical symptoms or radiographic chest abnormalities.Univariable linear regression models indicated that comorbidities(P=0.001)were associated with a longer time until viral clearance,and increasing age(P<0.001)and two doses of COVID-19 vaccine(P=0.001)were associated with a shorter time to viral clearance.Multivariable analysis revealed an independent effect of comorbidities(P<0.001)and age(P=0.003).The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases(P<0.001).Conclusion This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children.
基金Guangzhou Health Science and Technology Project(20201A011078)Guangzhou Science and Technology Project(202102010094)+5 种基金Guangdong Basic and Applied Basic Research Foundation(2021A1515012550)Clinical research project of Guangzhou Medical University Second Affiliated Hospital(2021-LCYJ-05)Guangdong Medical Research Fund(A2022255)Key Clinical Specialty of Guangzhou Medical University(0F03031)Guangzhou Laboratory(EKPG21-30-3)Guangzhou key discipline of urology.The funding sources had no role in the study design,data collection,analysis,interpretation,or writing of the report.
文摘Homologous booster,heterologous booster,and Omicron variants breakthrough infection(OBI)could improve the humoral immunity against Omicron variants.Questions concerning about memory B cells(MBCs)and T cells immunity against Omicron variants,features of long-term immunity,after booster and OBI,needs to be explored.Here,comparative analysis demonstrate antibody and T cell immunity against ancestral strain,Delta and Omicron variants in Omicron breakthrough infected patients(OBIPs)are comparable to that in Ad5-nCoV boosted healthy volunteers(HVs),higher than that in inactivated vaccine(InV)boosted HVs.However,memory B cells(MBCs)immunity against Omicron variants was highest in OBIPs,followed by Ad5-nCoV boosted and InV boosted HVs.OBIPs and Ad5-nCoV boosted HVs have higher classical MBCs and activated MBCs,and lower naïve MBCs and atypical MBCs relative to both vaccine boosted HVs.Collectively,these data indicate Omicron breakthrough infection elicit higher MBCs and T cells against SARS-CoV-2 especially Omicron variants relative to homologous InV booster and heterologous Ad5-nCoV booster.
文摘A compartmental,epidemiological,mathematical model was developed in order to analyze the transmission dynamics of Delta and Omicron variant,of SARS-CoV-2,in Greece.The model was parameterized twice during the 4th and 5th wave of the pandemic.The 4th wave refers to the period during which the Delta variant was dominant(approximately July to December of 2021)and the 5th wave to the period during which the Omicron variant was dominant(approximately January to May of 2022),in accordance with the official data from the National Public Health Organization(NPHO).Fitting methods were applied to evaluate important parameters in connection with the transmission of the variants,as well as the social behavior of population during these periods of interest.Mathematical models revealed higher numbers of contagiousness and cases of asymptomatic disease during the Omicron variant period,but a decreased rate of hospitalization compared to the Delta period.Also,parameters related to the behavior of the population in Greece were also assessed.More specifically,the use of protective masks and the abidance of social distancing measures.Simulations revealed that over 5,000 deaths could have been avoided,if mask usage and social distancing were 20%more efficient,during the short period of the Delta and Omicron outbreak.Furthermore,the spread of the variants was assessed using viral load data.The data were recorded from PCR tests at 417 Army Equity Fund Hospital(NIMTS),in Athens and the Ct values from 746 patients with COVID-19 were processed,to explain transmission phenomena and disease severity in patients.The period when the Delta variant prevailed in the country,the average Ct value was calculated as 25.19(range:12.32e39.29),whereas during the period when the Omicron variant prevailed,the average Ct value was calculated as 28(range:14.41e39.36).In conclusion,our experimental study showed that the higher viral load,which is related to the Delta variant,may interpret the severity of the disease.However,no correlation was confirmed regarding contagiousness phenomena.The results of the model,Ct analysis and official data from NPHO are consistent.
基金supported by the National Natural Science Foundation of China(32192453)the Chinese Universities Scientific Funds(2022RC019 and 2022TC163)+1 种基金the China Agricultural University Graduate Independent Innovation Research Fund(2022TC163)the 2115 Talent Development Program of China Agricultural University.
文摘Potent neutralizing antibodies(nAbs)against SARS-CoV-2 are a promising therapeutic against the ongoing COVID-19 pandemic.However,the continuous emergence of neutralizing antibody escape variants makes it challenging for antibody therapeutics based on monospecific nAbs.Here,we generated an IgG-like bispecific antibody(bsAb),Bi-Nab,based on a pair of human neutralizing antibodies targeting multiple and invariant sites of the spike receptor binding domain(RBD):35B5 and 32C7.We demonstrated that Bi-Nab exhibited higher binding affinity to the Delta spike protein than its parental antibodies and presented an extended inhibition breadth of preventing RBD binding to angiotensin-converting enzyme 2(ACE2),the cellular receptor of SARS-CoV-2.In addition,pseudovirus neutralization results showed that Bi-Nab improved the neutralization potency and breadth with a lower half maximum inhibitory concentration(IC50)against wild-type SARS-CoV-2,variants being monitored(VBMs)and variants of concern(VOCs).Notably,the IgG-like Bi-Nab enhanced the neutralizing activity against Omicron variants with potent capabilities for transmission and immune evasion in comparison with its parental monoclonal antibody(mAb)32C7 and a cocktail(with the lowest IC50 values of 31.6 ng/mL against the Omicron BA.1 and 399.2 ng/mL against the Omicron BA.2),showing evidence of synergistic neutralization potency of Bi-Nab against the Omicron variants.Thus,Bi-Nab represents a feasible and effective strategy against SARS-CoV-2 variants of concern.
文摘目的探讨基于临床及影像特征多元Logistic回归模型在肺部新冠病毒Omicron变异株合并细菌感染诊断中的应用价值。方法回顾性收集新冠病毒Omicron变异株合并细菌感染者74例,为A组。同时段新冠病毒Omicron变异株感染者90例,为B组。通过单因素与多因素Logistic回归分析,分别构建临床特征、CT影像特征及联合诊断模型。采用受试者操作特征(receiver operating characteristic,ROC)曲线、校准曲线和决策曲线(decision curve analysis,DCA)评估各个模型的预测能力、校准能力和临床效能。采用DeLong检验比较不同模型之间曲线下面积(area under the curve,AUC)的差异。结果多因素Logistic回归显示,慢性阻塞性肺疾病(简称慢阻肺)、重症肺炎、实变影、胸腔积液4个自变量是独立预测因子。临床模型、CT影像模型及联合诊断模型AUC分别为0.893(95%CI:0.843~0.943)、0.838(95%CI:0.773~0.903)、0.948(95%CI:0.915~0.981)。临床与CT影像模型之间差异不具有统计学意义(Z=1.467,P=0.142)。联合诊断模型与临床、CT影像模型间差异均具有统计学意义(Z分别为3.236、4.293,P分别为0.001、<0.001)。校准曲线表明,联合诊断模型预测概率与实际概率之间的良好一致性。DCA示联合诊断模型的净收益最大。结论基于临床及影像学特征的构建的联合诊断模型诊断效能优异,可用于新型冠状病毒Omicron变异株合并细菌感染的诊断与鉴别。
基金supported by National Key Research and Development Program of China(2021YFC2600200,2017YFA0205100)。
文摘Multiple new variants of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)have constantly emerged,as the delta and omicron variants,which have developed resistance to currently gained neutralizing antibodies.This highlights a critical need to discover new therapeutic agents to overcome the variants mutations.Despite the availability of vaccines against coronavirus disease 2019(COVID-19),the use of broadly neutralizing antibodies has been considered as an alternative way for the prevention or treatment of SARS-Co V-2 variants infection.Here,we show that the nasal delivery of two previously characterized broadly neutralizing antibodies(F61 and H121)protected K18-h ACE2 mice against lethal challenge with SARS-Co V-2 variants.The broadly protective efficacy of the F61 or F61/F121 cocktail antibodies was evaluated by lethal challenge with the wild strain(WIV04)and multiple variants,including beta(B.1.351),delta(B.1.617.2),and omicron(B.1.1.529)at 200or 1000 TCID_(50),and the minimum antibody administration doses(5-1.25 mg/kg body weight)were also evaluated with delta and omicron challenge.Fully prophylactic protections were found in all challenged groups with both F61 and F61/H121 combination at the administration dose of 20 mg/kg body weight,and corresponding mice lung viral RNA showed negative,with almost all alveolar septa and cavities remaining normal.Furthermore,low-dose antibody treatment induced significant prophylactic protection against lethal challenge with delta and omicron variants,whereas the F61/H121 combination showed excellent results against omicron infection.Our findings indicated the potential use of broadly neutralizing monoclonal antibodies as prophylactic and therapeutic agent for protection of current emerged SARS-Co V-2 variants infection.
基金supported by the Capital's Funds for Health Improvement and Research(Project No.2021-1G-3012,2022-2G-30115)the Beijing Science and Technology Planning Project of Beijing Science and Technology Commission(Project No.Z211100002521019).
文摘Omicron(B.1.1.529),the fifth variant of concern(VOC)of severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2),was firstly identified in November 2021 in South Africa.Omicron contains far more genome mutations than any other VOCs ever found,raising significant concerns about its increased transmissibility and immune evasion.Here,we report the importation of the Omicron variant into Beijing,China,in December 2021.Full‐length genome sequences of five imported strains were obtained,with their genetic features characterized.Each strain contained 57 to 61 nucleotide substitutions,39 deletions,and 9 insertions in the genome.Thirty to thirty‐two amino acid changes were found in the spike proteins of the five strains.The phylogenetic tree constructed by the maximum likelihood method showed that all five imported genomes belonged to Omicron(BA.1)(alias of B.1.1.529.1),which is leading to the current surge of coronavirus disease 2019(COVID‐19)cases worldwide.The globally increased COVID‐19 cases driven by the Omicron variant pose a significant challenge to disease prevention and control in China.Continuous viral genetic surveillance and increased testing among international travellers are required to contain this highly contagious variant.
文摘The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has evolved rapidly into new variants throughout the pandemic.The Omicron variant has more than 50 mutations when compared with the original wild-type strain and has been identified globally in numerous countries.In this report,we analyzed the mutational profiles of several variants,including the per-site mutation rate,to determine evolutionary relationships.The Omicron variant was found to have a unique mutation profile when compared with that of other SARS-CoV-2 variants,containing mutations that are rare in clinical samples.Moreover,the presence of five mouse-adapted mutation sites suggests that Omicron may have evolved in a mouse host.Mutations in the Omicron receptor-binding domain(RBD)region,in particular,have potential implications for the ongoing pandemic.