Nevin Manimala

Vaccines (Basel). 2023 Nov 8;11(11):1702. doi: 10.3390/vaccines11111702.

ABSTRACT

Although the anti-COVID-19 vaccination has proved to be an effective preventive tool, “breakthrough infections” have been documented in patients with complete primary vaccination courses. Most of the SARS-CoV-2 neutralizing antibodies produced after SARS-CoV-2 infection target the spike protein receptor-binding domain which has an important role in facilitating viral entry and the infection of the host cells. SARS-CoV-2 has demonstrated the ability to evolve by accumulating mutations in the spike protein to escape the humoral response of a host. The aim of this study was to compare the titers of neutralizing antibodies (NtAbs) against the variants of SARS-CoV-2 by analyzing the sera of recovered and vaccinated healthcare workers (HCWs). A total of 293 HCWs were enrolled and divided into three cohorts as follows: 91 who had recovered from SARS-CoV-2 infection (nVP); 102 that were vaccinated and became positive after the primary cycle (VP); and 100 that were vaccinated with complete primary cycles and concluded the follow-up period without becoming positive (VN). Higher neutralization titers were observed in the vaccinated subjects’ arms compared to the nVP subjects’ arms. Differences in neutralization titers between arms for single variants were statistically highly significant (p < 0.001), except for the differences between titers against the Alpha variant in the nVP and in VP groups, which were also statistically significant (p < 0.05). Within the nVP group, the number of subjects with an absence of neutralizing antibodies was high. The presence of higher titers in patients with a complete primary cycle compared to patients who had recovered from infection suggested the better efficacy of artificial immunization compared to natural immunization, and this further encourages the promotion of vaccination even in subjects with previous infections.

PMID:38006034 | DOI:10.3390/vaccines11111702

Vaccines (Basel). 2023 Nov 7;11(11):1696. doi: 10.3390/vaccines11111696.

ABSTRACT

Vaccination is the most cost-effective method of preventing COVID-19; however, data on its effect on patients with multimorbidity is limited. The aim was to evaluate the effect of vaccination against new coronavirus infection (NCI) in patients with multimorbid pathology in hospital treatment on the outcome of COVID-19 disease. An analysis was carried out of 1832 records of patients in one of the COVID-19 hospitals in Moscow for 2020-2022. Statistical analysis was carried out using the StatTech v. 3.1.3 software, and the binary logistic regression (BLR) method was used to obtain prognostic models. The median age of patients was 69 years, and 76% of them had received two vaccine doses. To assess the outcome of the disease, two prognostic models were obtained depending on the presence of a multimorbidity in patients: cardiovascular pathology and/or atherosclerosis and/or type 2 diabetes mellitus (Model 1) or atherosclerosis and/or type 2 diabetes mellitus and/or encephalopathy (Model 2), against the background of the presence or absence of vaccination against NCI. When assessing the outcome of NCI in Model 1, the odds of death decreased by 3.228 times with two doses of Sputnik V in patients with multimorbidity. According to Model 2, for patients with multimorbidity, the chances of death decreased by 3.281 times with two doses of Sputnik V. The presence of two doses of Sputnik V increased the likelihood of recovery in patients with multimorbidity by more than three times.

PMID:38006028 | DOI:10.3390/vaccines11111696

Vaccines (Basel). 2023 Oct 30;11(11):1659. doi: 10.3390/vaccines11111659.

ABSTRACT

BACKGROUND: The effective development of COVID-19 vaccination has mitigated its harm. Using two laboratory methods, we investigated the efficacy of the BNT162b2 mRNA and BBIBP-CorV COVID-19 vaccines on seroconversion rates in cancer patients undergoing active cancer treatment.

METHODS: SARS-CoV-2 vaccines were scheduled for 134 individuals. The consenting participants submitted three venous blood samples. Three samples: T0, T1, and T2. The ABBOTT-SARS-CoV-2 IgG II Quant and Elecsys^® Anti-SARS-CoV-2 assays were used to evaluate the samples and convert the antibody titers to WHO (BAU)/mL units.

RESULTS: Cancer patients exhibited a higher seroconversion rate at T2, regardless of vaccination type, and the mean antibody titers at T1 and T2 were higher than those at T0. BBIBP-CorV patients required a booster because BNT162b2 showed a higher seroconversion rate between T0 and T1. Statistics indicate that comparing Abbott and Roche quantitative antibody results without considering the sample collection time is inaccurate.

CONCLUSIONS: COVID-19 vaccines can still induce a humoral immune response in patients undergoing cancer-targeted therapy. The strength of this study is the long-term monitoring of antibody levels after vaccination in cancer patients on active therapy using two different immunoassays. Further multicenter studies with a larger number of patients are required to validate these findings.

PMID:38005991 | DOI:10.3390/vaccines11111659

Viruses. 2023 Nov 13;15(11):2250. doi: 10.3390/v15112250.

ABSTRACT

OBJECTIVE: Severe coronavirus disease 19 (COVID-19) is characterized by a dysregulated inflammatory response, with humoral immunity playing a central role in the disease course. The objective of this study was to assess the immune response and the effects of vaccination in recovered individuals with variable disease severity up to one year following natural infection.

METHODS: A prospective cohort study was conducted including patients with laboratory-confirmed COVID-19. Disease severity was classified as mild, moderate, and severe based on clinical presentation and outcomes. Anti-RBD (receptor binding domain) and neutralizing antibodies were evaluated at multiple timepoints during the first year after COVID-19 diagnosis.

RESULTS: A total of 106 patients were included; of them, 28 were diagnosed with mild, 38 with moderate, and 40 with severe disease. At least one vaccine dose was administered in 58 individuals during the follow-up. Participants with mild disease presented significantly lower anti-RBD and neutralizing antibodies compared to those with moderate and severe disease up to the 3rd and 6th months after the infection, respectively. After adjusting for covariates, in the third month, severe COVID-19 was associated with significantly higher anti-RBD (β: 563.09; 95% confidence intervals (CI): 257.02 to 869.17) and neutralizing (β: 21.47; 95% CI: 12.04 to 30.90) antibodies. Among vaccinated individuals, at the 12th month, a history of moderate disease was associated with significantly higher anti-RBD levels (β: 5615.19; 95% CI: 657.92 to 10,572.46).

CONCLUSIONS: Severe COVID-19 is associated with higher anti-RBD and neutralizing antibodies up to 6 months after the infection. Vaccination of recovered patients is associated with a remarkable augmentation of antibody titers up to one year after COVID-19 diagnosis, regardless of disease severity.

PMID:38005927 | DOI:10.3390/v15112250

Viruses. 2023 Nov 10;15(11):2242. doi: 10.3390/v15112242.

ABSTRACT

South Africa has a dual high burden of HIV and drug-resistant TB (DR-TB). We sought to understand the association of HIV and antiretroviral therapy status with TB treatment outcomes. This was a retrospective chart review of 246 patients who began treatment at two DR-TB hospitals in Eastern Cape, South Africa between 2017 and 2020. A categorical outcome with three levels was considered: unfavorable, transferred out, and successful. Descriptive statistics and logistic regression were used to compare the individuals without HIV, with HIV and on antiretroviral therapy (ART), and with HIV but not on ART. Sixty-four percent of patients were co-infected with HIV, with eighty-seven percent of these individuals on ART at treatment initiation. The majority (59%) of patients had a successful treatment outcome. Twenty-one percent of patients transferred out, and an additional twenty-one percent did not have a successful outcome. Individuals without HIV had more than three and a half times the odds of success compared to individuals with HIV on ART and more than ten times the odds of a successful outcome compared to individuals with HIV not on ART (OR 3.64, 95% CI 1.11, 11.95; OR 10.24, 95% CI 2.79, 37.61). HIV co-infection, especially when untreated, significantly decreased the odds of treatment success compared to individuals without HIV co-infection.

PMID:38005919 | DOI:10.3390/v15112242

Viruses. 2023 Nov 10;15(11):2238. doi: 10.3390/v15112238.

ABSTRACT

Hantavirus pulmonary syndrome (HPS) is a rodent-borne zoonotic disease that is endemic throughout the Americas. Agricultural activities increase exposure to wild rodents, especially for sugarcane cutters. We carried out a survey of the epidemiological aspects of HPS and investigated the prevalence of hantavirus infection in the sugarcane cutter population from different localities in the Brazilian Midwest region. We conducted a retrospective study of all confirmed HPS cases in the state of Goiás reported to the National HPS surveillance system between 2007 and 2017, along with a seroepidemiological study in a population of sugarcane cutters working in Goiás state in 2016, using the anti-hantavirus (Andes) ELISA IgG. A total of 634 serum samples from cane cutters were tested for hantavirus antibodies, with 44 (6.9%) being IgG-reactive according to ELISA. The destination of garbage was the only statistically significant variable (p = 0.03) related to the detection of hantavirus IgG (p < 0.05). We described the epidemiological profile of reported hantavirus cases in Goiás-a highly endemic area for HPS, and where the seroepidemiological study was conducted. Our results increase our knowledge about hantavirus infections in Brazil and highlight the vulnerability of sugarcane cutters to a highly lethal disease that, to date, has no specific treatment or vaccination.

PMID:38005915 | DOI:10.3390/v15112238

Breast. 2023 Nov 15;73:103603. doi: 10.1016/j.breast.2023.103603. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer-related death among women. However, evidence concerning hematological and biochemical markers influencing the natural history of breast cancer from in situ breast cancer to mortality is limited.

METHODS: In the UK Biobank cohort, 260,079 women were enrolled during 2006-2010 and were followed up until 2019 to test the 59 hematological and biochemical markers associated with breast cancer risk and mortality. The strengths of these associations were evaluated using the multivariable Cox regression models. To understand the natural history of breast cancer, multi-state survival models were further applied to examine the effects of biomarkers on transitions between different states of breast cancer.

RESULTS: Eleven biomarkers were found to be significantly associated with the risk of invasive breast cancer, including mainly inflammatory-related biomarkers and endogenous hormones, while serum testosterone was also associated with the risk of in-situ breast cancer. Among them, C-reactive protein (CRP) was more likely to be associated with invasive breast cancer and its transition to death from breast cancer (HR for the highest quartile = 1.46, 95 % CI = 1.07-1.97), while testosterone and insulin-like growth factor-1 (IGF-1) were more likely to impact the early state of breast cancer development (Testosterone: HR for the highest quartile = 1.31, 95 % CI = 1.12-1.53; IGF-1: HR for the highest quartile = 1.17, 95 % CI = 1.00-1.38).

CONCLUSION: Serum CRP, testosterone, and IGF-1 have different impacts on the transitions of different breast cancer states, confirming the role of chronic inflammation and endogenous hormones in breast cancer progression. This study further highlights the need of closer surveillance for these biomarkers during the breast cancer development course.

PMID:38000092 | DOI:10.1016/j.breast.2023.103603

Int J Surg. 2023 Nov 23. doi: 10.1097/JS9.0000000000000924. Online ahead of print.

ABSTRACT

BACKGROUND: This study employs a meta-analytic approach to investigate the impact of robotic-assisted partial nephrectomy, with and without near-infrared fluorescence imaging (NIRF-RAPN vs S-RAPN), on patients’ perioperative outcomes and postoperative changes in renal function.

MATERIALS AND METHODS: We conducted a comprehensive and rigorous systematic review and cumulative meta-analysis of primary outcomes following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines, and Risk-of-Bias Tool (RoB2). To ensure a thorough search, we systematically searched five major databases, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science, from databases’ inception to April 2023.

RESULTS: No significant differences were found between the two groups in terms of age (P=0.19), right side (P=0.54), BMI (P=0.39), complexity score (P=0.89), tumor size (P = 0.88), operating time (P = 0.39), estimated blood loss (P = 0.47), length of stay (P = 0.87), complications (P = 0.20), transfusion (P = 0.36), and positive margins (P = 0.38). However, it is noteworthy that the NIRF-RAPN group exhibited significant reductions in warm ischemia time (P=0.001), the percentage change in estimated glomerular filtration rate at discharge (P=0.01) compared to the S-RAPN group.

CONCLUSION: This meta-analysis provides evidence that the group undergoing NIRF-RAPN showed a statistically significant protective effect on the estimated glomerular filtration rate (eGFR).

PMID:38000056 | DOI:10.1097/JS9.0000000000000924

Int J Surg. 2023 Nov 23. doi: 10.1097/JS9.0000000000000879. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to compare the differences in quality of life (QOL) and overall survival (OS) between DPPHR and PD during long-term follow-up. Duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD) have been shown to be effective in alleviating symptoms and controlling malignancies, but there is ongoing debate over whether DPPHR has an advantage over PD in terms of long-term benefits.

METHOD: We searched the PubMed, Cochrane, Embase, and Web of Science databases for relevant studies comparing DPPHR and PD published before 1 May 2023. This study was registered with PROSPERO. Randomised controlled trials and non-randomised studies were included. The Mantel-Haenszel model and inverse variance method were used as statistical approaches for data synthesis. Subgroup analyses were conducted to evaluate the heterogeneity of the results. The primary outcome was the global QOL score, measured using the QLQ-C30 system.

RESULTS: We analysed ten studies involving 976 patients (456 DPPHR and 520 PD). The global QOL score did not differ significantly between the DPPHR and PD groups (standard mean difference [SMD] 0.21, 95% confidence interval [CI] [-0.05, 0.46], P=0.109, I2=70%); however, the OS time of patients with DPPHR was significantly improved (HR 0.59, 95% CI [0.44, 0.77], P<0.001, I2=0%). The follow-up length may be an important source of heterogeneity. Studies with follow-up length between two to seven years showed better global QOL for DPPHR than for PD (SMD 0.43, 95% CI [0.23, 0.64], P<0.001, I2=0%). There were no significant differences between the two groups in any of the functional scales of the QLQ-C30 system (all P>0.05). On the symptom scale, patients in the DPPHR group had lower scores for fatigue, nausea and vomiting, loss of appetite, insomnia, and diarrhoea than those in the PD group (all P<0.05).

CONCLUSION: There were no significant differences in global QOL scores between the two surgeries; however, DPPHR had advantages over PD in terms of safer perioperative outcomes, lower long-term symptom scores, and longer OS times. Therefore, DPPHR should be recommended over PD for the treatment of benign pancreatic diseases and low-grade malignant tumours.

PMID:38000055 | DOI:10.1097/JS9.0000000000000879

Int J Biostat. 2023 Nov 27. doi: 10.1515/ijb-2023-0052. Online ahead of print.

ABSTRACT

Model-based component-wise gradient boosting is a popular tool for data-driven variable selection. In order to improve its prediction and selection qualities even further, several modifications of the original algorithm have been developed, that mainly focus on different stopping criteria, leaving the actual variable selection mechanism untouched. We investigate different prediction-based mechanisms for the variable selection step in model-based component-wise gradient boosting. These approaches include Akaikes Information Criterion (AIC) as well as a selection rule relying on the component-wise test error computed via cross-validation. We implemented the AIC and cross-validation routines for Generalized Linear Models and evaluated them regarding their variable selection properties and predictive performance. An extensive simulation study revealed improved selection properties whereas the prediction error could be lowered in a real world application with age-standardized COVID-19 incidence rates.

PMID:38000054 | DOI:10.1515/ijb-2023-0052