Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy

Background: Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non -vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. Methods: Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non -vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson's Chi-square and Mann -Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. Results: Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non -vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039-0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582-1.703, p = 0.987). Conclusions: This study provides real -world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first -booster uptake rates

The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p < 0.001) and be vaccinated (37% vs. 12.7%, p < 0.001). We evaluated the contribution of immune suppression to hospitalization during the various stages of the epidemic and investigated whether immune suppression contributed to severe outcomes and death, also considering the vaccination status of the patients. The proportion of immune suppressed patients among all hospitalizations (initially stable at <20%) started to increase around December 2021, and remained high (30–50%). This change coincided with an increase in the proportions of older patients and patients with co-morbidities and with a decrease in the proportion of patients with severe outcomes. Vaccinated patients showed a lower proportion of severe outcomes; among non-vaccinated patients, severe outcomes were more common in immune suppressed individuals. Immune suppression was a significant predictor of severe outcomes, after adjusting for age, sex, co-morbidities, period of hospitalization, and vaccination status (OR: 1.64; 95% CI: 1.23–2.19), while vaccination was a protective factor (OR: 0.31; 95% IC: 0.20–0.47). However, after November 2021, differences in disease outcomes between vaccinated and non-vaccinated groups (for both immune suppressed and immune competent subjects) disappeared. Since December 2021, the spread of the less virulent Omicron variant and an overall higher level of induced and/or natural immunity likely contributed to the observed shift in hospitalized patient characteristics. Nonetheless, vaccination against SARS-CoV-2, likely in combination with naturally acquired immunity, effectively reduced severe outcomes in both immune competent (73.9% vs. 48.2%, p < 0.001) and immune suppressed (66.4% vs. 35.2%, p < 0.001) patients, confirming previous observations about the value of the vaccine in preventing serious disease

Plastics in sea surface waters around the Antarctic Peninsula

Although marine plastic pollution has been the focus of several studies, there are still many gaps in our understanding of the concentrations, characteristics and impacts of plastics in the oceans. This study aimed to quantify and characterize plastic debris in oceanic surface waters of the Antarctic Peninsula. Sampling was done through surface trawls, and mean debris concentration was estimated at 1,794 items.km−2 with an average weight of 27.8 g.km−2. No statistical difference was found between the amount of mesoplastics (46%) and microplastics (54%). We found hard and flexible fragments, spheres and lines, in nine colors, composed mostly of polyurethane, polyamide, and polyethylene. An oceanographic dispersal model showed that, for at least seven years, sampled plastics likely did not originate from latitudes lower than 58°S. Analysis of epiplastic community diversity revealed bacteria, microalgae, and invertebrate groups adhered to debris. Paint fragments were present at all sampling stations and were approximately 30 times more abundant than plastics. Although paint particles were not included in plastic concentration estimates, we highlight that they could have similar impacts as marine plastics. We call for urgent action to avoid and mitigate plastic and paint fragment inputs to the Southern Ocean

Many-to-many mixed stock analysis estimates for Brazilian populations.

<p>(a) shows feeding ground-centric estimates, and (b) rookery-centric estimates. MSA outputs for all other areas are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088746#pone.0088746.s001" target="_blank">Figures S1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0088746#pone.0088746.s002" target="_blank">S2</a>. BS =  Bahia/Sergipe, PI =  Pipa, PP =  Principe, BB =  Barbados, GU =  Guadeloupe, AB =  Antigua & Barbuda, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, CR =  Costa Rica, NI =  Nicaragua, CU =  Cuba, MX =  Mexico, SP =  São Pedro and São Paulo, CE =  Ceará coast, BA =  Bahia coast, AP =  Abrolhos Park, SB =  South Brazil, NR =  Noronha/Rocas, PP =  Principe, CV =  Cape Verde, TC =  Turks & Caicos, BH =  Bahamas, FL =  Florida, CY =  Cayman Islands, TX =  Texas, FL =  Florida, UN =  Unknown.</p

Natal origins for <i>E. imbricata</i> in Brazilian waters as estimated by drifters.

<p>SPSP =  São Pedro and São Paulo Archipelago; NR/CE =  Noronha/Ceará; BA/AP/SB =  Bahia, Abrolhos, South Brazil.</p

Pairwise <i>F</i>-st (above diagonal) and φ-st (below diagonal) values between feeding populations in the Atlantic.

<p>Bold indicates lack of significant difference (p>0.05). SP =  São Pedro and São Paulo, CE =  Ceará coast, BA =  Bahia coast, AP =  Abrolhos Park, SB =  South Brazil, NR =  Noronha/Rocas, PP =  Principe, CV =  Cape Verde, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, TC =  Turks & Caicos, BH =  Bahamas, FL =  Florida, CY =  Cayman Islands, MX =  Mexico, TX =  Texas, FL =  Florida.</p

Correlation between genetic and drifter profiles for Brazilian feeding grounds.

<p>Genetic profiles are based on log-transformed data of origins from genetic/population size (MSA – x axis) and drifter/population size (y axis) information profiles.</p

Main haplotype frequencies of genetically described populations in the Atlantic.

<p>*study areas described in this work. Rookeries: BS =  Bahia/Sergipe, PI =  Pipa, PP =  Principe, BB =  Barbados, GU =  Guadeloupe, AB =  Antigua & Barbuda, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, CR =  Costa Rica, NI =  Nicaragua, CU =  Cuba, MX =  Mexico. Feeding grounds: SP =  São Pedro and São Paulo, NR =  Noronha/Rocas, CE =  Ceará coast, BA =  Bahia coast, AP =  Abrolhos Park, SB =  South Brazil, PP =  Principe, CV =  Cape Verde, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, TC =  Turks & Caicos, BH =  Bahamas, FL =  Florida, CY =  Cayman Islands, MX =  Mexico, TX =  Texas.</p

Haplotype frequencies (740 bp) for Brazilian feeding grounds.

<p>Shorter (360 bp) haplotype equivalent is given when available.</p><p>SPSP =  São Pedro and São Paulo, South Brazil  =  Arvoredo Reserve/Cassino Beach.</p

Locations of genetically described hawksbill populations in the Atlantic.

<p>Red triangles  =  rookeries, black squares  =  feeding grounds, *study areas described in this work. Rookeries: BS =  Bahia/Sergipe, PI =  Pipa, PP =  Principe, BB =  Barbados, GU =  Guadeloupe, AB =  Antigua & Barbuda, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, CR =  Costa Rica, NI =  Nicaragua, CU =  Cuba, MX =  Mexico. Feeding grounds: SP =  São Pedro and São Paulo, NR =  Noronha/Rocas, CE =  Ceará coast, BA =  Bahia coast, AP =  Abrolhos Park, SB =  South Brazil, PP =  Principe, CV =  Cape Verde, UV =  U.S. Virgin Islands, PR =  Puerto Rico, DR =  Dominican Republic, TC =  Turks & Caicos, BH =  Bahamas, FL =  Florida, CU =  Cuba, CY =  Cayman Islands, MX =  Mexico, TX =  Texas.</p