The emergence of two distinct SARS-CoV-2 Gamma related variants during the second wave of COVID-19 in Santa Catarina, Southern Brazil and the rapid spread of P.1-like-II SARS-CoV-2 variant transmission and a regionalization in the Western region

COVID-19 has assumed significant and lasting proportions worldwide. Following initial cases in the Western mesoregion, the State of Santa Catarina (SC), southern Brazil, was heavily affected as a whole by the pandemic in early 2021. This study aimed to evaluate the dynamics of the SARS-CoV-2 virus spreading patterns in the SC state through March 2020 to April 2021 using genomic surveillance. During this period, 23 distinct variants, including two VOCs (Beta and Gamma) were identified, among which, the Gamma and related lineages were predominant in the second pandemic wave within SC. However, a regionalization of P.1-like-II in the Western region was observed, concomitant to the increase in cases, mortality, and case fatality rate (CFR) index. This is the first evidence of the regionalization of the SARS-CoV-2 transmission in the and highlight the importance of tracking variants, dispersion and their impact of SARS-CoV-2 on the public health system in Brazilian states.

Psychological impact of caring during the COVID-19 pandemic on HIV nurses

The COVID-19 pandemic has created a set of unprecedented challenges for healthcare services and staff. The authors conducted a national online survey of nurses employed to work in HIV services in England, Wales, Scotland, Northern Ireland and the Republic of Ireland to establish how the COVID-19 pandemic has impacted on the professional quality of life of HIV nurses. Professional quality of life was assessed using the ProQOL scale; 132 nurses completed the survey, 99 of whom completed the ProQOL scale. Just over 1 in 3 were redeployed in the first pandemic wave, dropping to 1 in 6 in subsequent waves. In multivariate analysis, redeployment in both waves increased burnout scores by nearly 10 points and decreased compassion satisfaction scores by nearly 5 points, with no effect on secondary traumatic stress scores. A supportive workplace environment will have a key role in supporting the path to recovery.

Reconstructing transmission chains of SARS-CoV-2 amid multiple outbreaks in a geriatric acute-care hospital

Background There is ongoing uncertainty regarding transmission chains and the respective roles of healthcare workers (HCWs) and elderly patients in nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) in geriatric settings. Methods We performed a retrospective cohort study including patients with nosocomial coronavirus disease 2019 (COVID–19) in four outbreak–affected wards, and all SARS–CoV–2 RT–PCR positive HCWs from a Swiss university–affiliated geriatric acute–care hospital that admitted both Covid–19 and non–Covid–19 patients during the first pandemic wave in Spring 2020. We combined epidemiological and genetic sequencing data using a Bayesian modelling framework, and reconstructed transmission dynamics of SARS–CoV–2 involving patients and HCWs, in order to determine who infected whom. We evaluated general transmission patterns according to type of case (HCWs working in dedicated Covid–19 cohorting wards: HCWcovid; HCWs working in non–Covid–19 wards where outbreaks occurred: HCWoutbreak; patients with nosocomial Covid–19: patientnoso) by deriving the proportion of infections attributed to each type of case across all posterior trees and comparing them to random expectations. Results During the study period (March 1 to May 7, 2020) we included 180 SARS–CoV–2 positive cases: 127 HCWs (91 HCWcovid, 36 HCWoutbreak) and 53 patients. The attack rates ranged from 10–19% for patients, and 21% for HCWs. We estimated that there were 16 importation events (3 patients, 13 HCWs) that jointly led to 16 secondary cases. Most patient–to–patient transmission events involved patients having shared a ward (97.6%, 95% credible interval [CrI] 90.4–100%), in contrast to those having shared a room (44.4%, 95%CrI 27.8–62.5%). Transmission events tended to cluster by type of case: patientnoso were almost twice as likely to be infected by other patientnoso than expected (observed:expected ratio 1.91, 95%CrI 1.08 – 4.00, p = 0.02); similarly, HCWoutbreak were more than twice as likely to be infected by other HCWoutbreak than expected (2.25, 95%CrI 1.00–8.00, p = 0.04). The proportion of infectors of HCWcovid were as expected as random. The proportions of high transmitters (≥2 secondary cases) were significantly higher among HCWoutbreak than patientnoso in the late phases (26.2% vs. 13.4%, p<2.2e–16) of the outbreak. Conclusions Most importation events were linked to HCW. Unexpectedly, transmission between HCWcovid was more limited than transmission between patients and HCWoutbreak. This highlights gaps in infection control and suggests possible areas of improvements to limit the extent of nosocomial transmission.

Healthcare institutions’ recommendation regarding the use of FFP-2 masks and SARS-CoV-2 seropositivity among healthcare workers: a multicenter longitudinal cohort study

Background Health care workers (HCW) are heavily exposed to SARS-CoV-2 from the beginning of the pandemic. We aimed to analyze risk factors for SARS-CoV-2 seroconversion among HCW with a special emphasis on the respective healthcare institutions’ recommendation regarding the use of FFP-2 masks. Methods We recruited HCW from 13 health care institutions (HCI) with different mask policies (type IIR surgical face masks vs. FFP-2 masks) in Southeastern Switzerland (canton of Grisons). Sera of participants were analyzed for the presence of SARS-CoV-2 antibodies 6 months apart, after the first and during the second pandemic wave using an electro-chemiluminescence immunoassay (ECLIA, Roche Diagnostics). We captured risk factors for SARS-CoV-2 infection by using an online questionnaire at both time points. The effects of individual COVID-19 exposure, regional incidence and FFP-2 mask policy on the probability of seroconversion were evaluated with univariable and multivariable logistic regression. Results SARS-CoV-2 antibodies were detected in 99 of 2794 (3.5%) HCW at baseline and in 376 of 2315 (16.2%) participants 6 months later. In multivariable analyses the strongest association for seroconversion was exposure to a household member with known COVID-19 (aOR: 19.82, 95% CI 8.11–48.43, p < 0.001 at baseline and aOR: 8.68, 95% CI 6.13–12.29, p < 0.001 at follow-up). Significant occupational risk factors at baseline included exposure to COVID-19 patients (aOR: 2.79, 95% CI 1.28–6.09, p = 0.010) and to SARS-CoV-2 infected co-workers (aOR: 2.50, 95% CI 1.52–4.12, p < 0.001). At follow up 6 months later, non-occupational exposure to SARS-CoV-2 infected individuals (aOR: 2.54, 95% CI 1.66–3.89 p < 0.001) and the local COVID-19 incidence of the corresponding HCI (aOR: 1.98, 95% CI 1.30–3.02, p = 0.001) were associated with seroconversion. The healthcare institutions’ mask policy (surgical masks during usual exposure vs. general use of FFP-2 masks) did not affect seroconversion rates of HCW during the first and the second pandemic wave. Conclusion Contact with SARS-CoV-2 infected household members was the most important risk factor for seroconversion among HCW. The strongest occupational risk factor was exposure to COVID-19 patients. During this pandemic, with heavy non-occupational exposure to SARS-CoV-2, the mask policy of HCIs did not affect the seroconversion rate of HCWs.

Modeling the USA Winter 2021 Resurgence

The current USA 2021 CoVID-19 Winter Resurgence is modeled here with the same function used for analyzing prior USA CoVID-19 waves: N(t)= max[N/o\exp{+(t/[t/R\(1+α/s\t)]exp(-δ/o\t)}]. Here, N(t) gives the total number of CoVID-19 cases above the previous baseline, and t/R\ sets the initial t/dbl\ = [t/R\ ln(2)] pandemic t/dbl\ doubling time. Larger α/s\ values indicate that uninfected people are improving their pandemic mitigation efforts, such as Social Distancing and vaccinations; while δ/o\>0 accelerates the post-peak [(d/dt)N(t)] tail-off, and is empirically associated with mask-wearing. The pandemic wave end is when N(t) no longer increases. Results from the USA Summer 2021 Resurgence (see prior medrxiv.org preprints*) were used as a baseline. By 11/15/2021, an additional N/o\(11/15/2021)=107,000 cases above baseline were found, signaling the USA Winter 2021 Resurgence. This CoVID-19 wave is still in its initial stages. Presently, our analysis indicates that this CoVID-19 wave can infect virtually all susceptible persons; just like the initial stage of the USA Summer 2021 Resurgence. Data up through 12/30/2021 gives these parameter values: t/R\=8.05 days; α/s\=0.011/day. These values are identical to the prior 2020 USA Winter Resurgence results. Also, the present N/o\(11/15/2021) and the prior N/o\(9/25/2020)=89,900 values are similar. However, while the Winter 2020 Resurgence showed a significant mask-wearing effect: δ/o\(2020)= 1.748 x 10^-3 / day, this initial USA Winter 2021 Resurgence shows practically no mask-wearing effects: δ/o\(2021)< 0.001 x 10^-3 / day. If mask-wearing were to quickly rise to the Winter 2020 levels, it would give these projected totals: N(t=[1/1/2022])= 54,705,400; N(t=[3/21/2022])= 83,371,000; N(t=[3/21/2024])= 92,399,000. More robust mask-wearing and enhanced Social Distancing measures could further reduce these values (with 3 Figures). * (10.1101_2021.08.16.21262150; 10.1101_2021.10.15.21265078)

Prevalence of COVID-19 in children affected by allergic rhinoconjunctivitis and asthma: results from the second “SIAIP rhinosinusitis and conjunctivitis committee” survey

Background The role of allergic sensitization seems to be protective against SARS CoV2 infection. The aim of this study was to evaluate, using online surveys, the impact of COVID-19 on Italian allergic children, comparing the prevalence of AR and asthma symptoms between the first and second pandemic wave. Methods Both surveys were emailed to Italian pediatricians in April 2020 (first survey) and in March 2021 (second survey). The first one was related to the impact of COVID-19 and the most frequently reported symptoms. The second one was superimposed on the previous one, taking into account some additional aspects in the management of disease. Results A total of 99 pediatricians participated in the first survey and 267 in the second one. The first survey showed that, asthma and allergic rhinoconjunctivitis prevalence was mostly between 0 and 20% throughout the country. The second survey showed a lower prevalence of both diseases nationwide in comparison to the first one. Comparing the two surveys, statistically significant differences were reported only in the distribution of asthma prevalence in Southern Italy while no differences were highlighted in the North and in the Center. Finally regarding allergic rhinoconjunctivitis prevalence, no differences were noticed nationwide. Conclusions Allergic rhinoconjunctivitis and asthma, if under control, did not represent risk factors for the susceptibility to SARS CoV2. Therefore, it is strongly recommended to continue therapies during COVID-19 outbreak, according to the international guidelines. However, being COVID-19 a new disease, actual knowledge will undergo continuous improvements over time.

Stress, Coping, and Psychiatric Symptoms in Pregnant Women in Outpatient Care During the 2021 Second-Wave COVID-19 Pandemic

Aims: Women face many sources of stress throughout their lives, and some periods are particularly sensitive; pregnancy is one of them. The COVID-19 pandemic is a likely source of additional stress for pregnant women. Moreover, there is evidence that pregnant women have experienced high levels of anxiety and depression symptoms during the pandemic. Our study aimed to evaluate the association of pregnancy-specific stress, pandemic-related stress, and coping strategies with anxiety, depressive and obsessive-compulsive symptomatology in Italian women during the second wave of the COVID-19 pandemic (December 2020–June 2021). We also investigated whether there were differences in these levels of psychopathology compared to a prior study conducted during the first pandemic wave (April–August 2020) in Italian pregnant women.Methods: We assessed 325 pregnant women receiving outpatient prenatal care, using the Revised Prenatal Distress Questionnaire (NuPDQ), Pandemic-Related Pregnancy Stress Scale (PREPS), the Revised Prenatal Coping Inventory (NuPCI), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-2 (PHQ-2), and Obsessive-Compulsive Disorder (OCD) screening. The main analysis was conducted comparing multiple logistic regression models predicting each psychopathological outcome from specific covariates and NuPDQ, PREPS, and NuPCI scores.Results: 42.8% of the sample reported significant levels of anxiety, while 10.3% was positive on depression screening and 13.1% on OCD screening. No significant difference was found in the prevalence of high anxiety, depression, or OCD screening scores compared with the first pandemic wave. Controlling for covariates, we found that GAD-7 and PHQ-2 scores were predicted by pregnancy-specific stress; positive OCD screening was not. The model of high anxiety was improved by adding pandemic-related stress as a predictor (in particular, feeling unprepared for delivery and postpartum). Finally, coping strategies (avoidance, spiritual coping, and planning-preparation) significantly improved prediction of all three psychopathological outcomes.Conclusions: The present study suggests the importance of pregnancy-related stress, COVID-19 pandemic stress, and of coping strategies in counteracting or contributing to psychiatric symptomatology during the current pandemic.

Omicron threatens fourth pandemic wave in Mexico

Headline MEXICO: Omicron threatens fourth pandemic wave

Defining Antibody Seroprevalence and Duration of Humoral Responses to SARS-CoV-2 Infection and/or Vaccination in a Greek Community

Background: In this work we aimed to evaluate antibody-response longevity to SARS-CoV-2 infection and/or vaccination in one of the Greek communities that was worst hit by the pandemic, Deskati, five months after a previous serosurveillance and nine months after the pandemic wave initiation (October 2020). Methods: The SARS-CoV-2 IgG II Quant method (Architect, Abbott, IL, USA) was used for antibody testing. Results: A total of 69 subjects, who previously tested positive or negative for COVID-19 antibodies, participated in the study. We found that 48% of participants turned positive due to vaccination and 27% of participants were both previously infected and vaccinated. All previously infected participants retained antibodies to the virus, irrespective of their vaccination status. The antibody titers were significantly higher in previously infected participants that had been vaccinated than those who were unvaccinated and in those that had been previously hospitalized for COVID-19 than those with mild disease. Conclusions: Antibody responses to SARS-CoV-2 infection were maintained nine months after the pandemic. Vaccination alone had generated an immune response in almost half of the population. Higher antibody titers were found in the case of vaccination in previously infected subjects and especially in those with severe disease leading to hospitalization