Immunological response against SARS-CoV-2 following full-dose administration of Comirnaty® COVID-19 vaccine in nursing home residents

6 páginas, 2 figuras, 3 tablas. Se puede acceder al texto completo de este artículo desde PubMedCentral: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490129 . Los datos de investigación utilizados en el mismo, se encuentran disponibles en: https://doi.org/10.1016/j.cmi.2021.09.031.Objectives: The current study was aimed at examining SARS-CoV-2 immune responses following two doses of Comirnaty® COVID-19 vaccine among elderly people in nursing homes. Methods: A prospective cohort study in a representative sample from nursing homes in Valencia (n = 881; males: 271, females 610; median age, 86 years) recruited residents using a random one-stage cluster sampling approach. A lateral flow immunochromatography device (LFIC) (OnSite COVID-19 IgG/IgM Rapid Test; CTK BIOTECH, Poway, CA, USA) was used as the front-line test for detecting SARS-CoV-2-Spike (S)-specific antibodies in whole blood obtained using a fingerstick. Residents returning negative LFIC results underwent venipuncture and testing for presence of SARS-CoV-2-S-reactive antibodies and T cells using the Roche Elecsys® Anti-SARS-CoV-2 S (Roche Diagnostics, Pleasanton, CA, USA), the LIAISON® SARS-CoV-2 TrimericS IgG assay (Diasorin S.p.A, Saluggia, Italy) and by flow cytometry, respectively. Results: The SARS-CoV-2-S antibody detection rate in nursing home residents was 99.6% (283/284) and 98.3% (587/597) for SARS-CoV-2 recovered and naïve residents, respectively, within a median of 99 days (range 17-125 days) after full vaccination. Three out of five residents lacking SARS-CoV-2-S antibodies had detectable S-reactive CD8+ and/or CD4+ T cells. In addition, 50/50 and 40/50 participants with detectable SARS-CoV-2 antibodies also had SARS-CoV-2-S-reactive interferon-γ-producing CD4+ and CD8+ T cells, respectively. Discussion: The Comirnaty® COVID-19 vaccine is highly immunogenic in nursing home residents. Keywords: Comirnaty®COVID-19 vaccine; Nursing home residents; SARS-CoV-2; SARS-CoV-2-S antibodies.Ignacio Torres (Río Hortega Contract; CM20/00090), Eliseo Albert (Juan Rodes Contract; JR20/00011) and Estela Gimenez (Juan Rod es Contract, JR18/00053) hold contracts funded by the Health Institute Carlos III (co-financed by the European Regional Development Fund, ERDF/FEDER).Peer reviewe

La crítica de la razón epidemiológica en el estudio de la Seguridad del Paciente

La interacción entre los diferentes modelos de causalidad y los métodos para su análisis han variado a lo largo de la historia hasta llegar al método hipotético-deductivo y los criterios de causalidad aceptados en el denominado método científico. La preocupación por los eventos adversos responde a los diferentes abordajes teóricos, siendo la realización de estudios epidemiológicos una de las herramientas más recurrida. Sin embargo, la metodología comúnmente utilizada para el fenómeno de los eventos adversos en su conjunto ha sido variable y no refleja los criterios de causalidad establecidos. OBJETIVO: Valorar cómo se han establecido las relaciones causales en los estudios epidemiológicos sobre eventos adversos globales en hospitales. METODOLOGÍA: Análisis crítico de las publicaciones sobre eventos adversos globales de los proyectos referentes para un país o región, publicados de forma previa al marco conceptual en seguridad del paciente de la Organización Mundial de la Salud. RESULTADOS: Se describen las implicaciones tanto en la frecuencia como en las relaciones causales del modo en el que han sido tratados cada uno de los criterios de causalidad y se proponen medidas correctivas para el diseño, formularios, entrenamiento o análisis en vistas a la realización de estudios epidemiológicos en Seguridad del Paciente

Nomenclatura, Clasificación y Percepciones Locales Acerca de los Hongos en dos Comunidades de la Selva Lacandona, Chiapas, México

Mediante un estudio etnomicográfico se describen las formas de nombrar, clasificar y percibir a los hongos en la comunidad de Playón de la Gloria y Lacanjá-Chansayab, en la Selva Lacandona. Se registraron 13 tipos de hongos que son reconocidos en la primera comunidad y 41 tipos en la segunda, que corresponden a 16 y 52 especies taxonómicas, respectivamente. Los nombres asignados, en su mayoría corresponden a alusiones morfológicas. Ambas comunidades nombran y clasifican especies en función de su significación culturaL Además, existenpercepciones similares con respecto a los hongos, independientemente de su condición etno-histórica, sin embargo una diferencia trascendental es la percepción con respecto a su importancia y a su papel en la sucesión vegetal de la selva

Nursing workload predictors in Catalonia (Spain): a home care cohort study Variables predictoras de las cargas de trabajo de enfermería en Cataluña: seguimiento de una cohorte de atención domiciliaria

Objective: To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program. Methods: A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits. Results: Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR=1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR=1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR=4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR=1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR=0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home. Conclusions: Workload can be predicted by patients' clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.<br>Objetivo: Identificar las características basales de los pacientes crónicos y su entorno que predicen la carga de trabajo de enfermería durante el año siguiente a su inclusión en un programa de atención domiciliaria (ATDOM). Métodos: Estudio longitudinal realizado en 72 equipos de atención primaria de salud en Cataluña. Seguimiento durante un año de 1068 pacientes de ATDOM mayores de 64 años de edad. Variables recogidas: nivel de salud y situación social (test de Charlson, Barthel, Pfeiffer, Braden y Gijón); sobrecarga del cuidador (Test de Zarit); ingresos hospitalarios y visitas a urgencias; estado subjetivo de salud (SF-12); visitas de los profesionales de salud. Resultados: Los pacientes recibieron 7,2 (DE: 10,4) visitas anuales de su enfermera habitual. Observamos que tienen más riesgo de recibir visitas de enfermería los pacientes varones (IRR=1,42, IC95%: 1,20-1,67), con dependencia para las actividades de la vida diaria (IRR=1,65, IC95%: 1,29-2,13), afectados por úlceras por decúbito (IRR=4,03, IC95%: 2,27-7,14) y que precisaron servicios de atención de urgencia a domicilio (IRR=1,65, IC95%: 1,31-2,07). Por otro lado, los pacientes con deterioro cognitivo importante tienen menos probabilidad de recibir visitas de su enfermera (IRR=0,78, IC95%: 0,63-0,98). Conclusiones: Las características clínicas de los pacientes permiten predecir la carga de trabajo de enfermería. Esta relación positiva de la carga de trabajo con las variables relacionadas con la gravedad de la enfermedad y la relación negativa con el deterioro cognitivo muestra que la enfermería domiciliaria en Cataluña está básicamente orientada a la demanda

Influenza Vaccine Effectiveness in Preventing Influenza A(H3N2)-Related Hospitalizations in Adults Targeted for Vaccination by Type of Vaccine: A Hospital-Based Test-Negative Study, 2011–2012 A(H3N2) Predominant Influenza Season, Valencia, Spain

<div><p>Background</p><p>Most evidence of the effectiveness of influenza vaccines comes from studies conducted in primary care, but less is known about their effectiveness in preventing serious complications. Here, we examined the influenza vaccine effectiveness (IVE) against hospitalization with PCR-confirmed influenza in the predominant A(H3N2) 2011–2012 influenza season.</p><p>Methods</p><p>A hospital-based, test-negative study was conducted in nine hospitals in Valencia, Spain. All emergency admissions with a predefined subset of symptoms were eligible. We enrolled consenting adults age 18 and over, targeted for influenza vaccination because of comorbidity, with symptoms of influenza-like-illness within seven days of admission. We estimated IVE as (1-adjusted vaccination odds ratio)*100 after accounting for major confounders, calendar time and recruitment hospital.</p><p>Results</p><p>The subjects included 544 positive for influenza A(H3N2) and 1,370 negative for influenza admissions. Age was an IVE modifying factor. Regardless of vaccine administration, IVE was 72% (38 to 88%) in subjects aged under 65 and 21% (−5% to 40%) in subjects aged 65 and over. By type of vaccine, the IVE of classical intramuscular split-influenza vaccine, used in subjects 18 to 64, was 68% (12% to 88%). The IVE for intradermal and virosomal influenza vaccines, used in subjects aged 65 and over, was 39% (11% to 58%) and 16% (−39% to 49%), respectively.</p><p>Conclusions</p><p>The split-influenza vaccine was effective in preventing influenza-associated hospitalizations in adults aged under 65. The intradermal vaccine was moderately effective in those aged 65 and over.</p></div

Vaccination according to PCR result.

<p>PCR real-time reverse transcription-polymerase chain reaction. CI Confidence Interval. LR Likelihood ratio.</p>a<p>Any vaccination ever recorded in the Vaccine Information System.</p>b.<p>A patient was considered immunized with the 2011–2012 influenza seasonal vaccine if the vaccine was recorded in the Vaccine Information System as administered more than 14 days before the date of the ILI onset or if the patients reported vaccination more than two weeks before symptoms onset.</p>c<p>Data from 1,086 (288 positive and 798 negative) patients vaccinated 15 or more days before onset of symptoms according to the information in the Vaccine Information System out of 1,169 classified as immunized because of information retrieved from the Vaccine Information System or by patient's recall of vaccination two weeks before symptoms onset.</p><p>Vaccination according to PCR result.</p

Influenza vaccines recorded as administered by type of vaccine, age group, and PCR result.

<p>PCR real-time reverse transcription-polymerase chain reaction.</p>a.<p>Recorded vaccinations in the Vaccine Information System only (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0112294#pone-0112294-t004" target="_blank">Table 4</a> for the percentage of patients included in the Vaccine Information System). The percentages reported over all participants included in the Vaccine Information System and with any vaccination ever recorded in the Vaccine Information System.</p>b.<p>Encompassing epidemiological weeks 52 to 12, with influenza related admissions identified in> = 65 years subjects. This was the age group targeted to receive this type of vaccine.</p>c.<p>Encompassing epidemiological weeks 4 to 10, with influenza related admissions identified in <65 years old subjects. This was the age group targeted to receive this type of vaccine.</p><p>Influenza vaccines recorded as administered by type of vaccine, age group, and PCR result.</p

Sensitivity analysis of adjusted influenza vaccine effectiveness.

<p>Adjusted influenza vaccine effectiveness (IVE) assessed for all ages, <65 and> = 65, and by: a) vaccination ascertainment method: Vaccine Information System (VIS), as reported by the patient (recall) and both combined; b) days to swab: seven or less, four or less. Reference category for all analyses includes all patients irrespective of time elapsed to swab and vaccination according to VIS or recall. OR: adjusted odds ratio. OR adjusted as reported in footnotes in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0112294#pone-0112294-t006" target="_blank">Table 6</a>.</p