6 research outputs found
Associated factors to serious infections in a large cohort of juvenile-onset systemic lupus erythematosus from Lupus Registry (RELESSER).
- Author
- Andreu J.L.
- Blanco R.
- Bohórquez C.
- Bonilla G.
- Boteanu A.
- Calvo-Alén J.
- del Campo V.
- Díez-Álvarez E.
- Expósito L.
- Fernández-Berrizbeitia O.
- Freire M.
- Galindo-Izquierdo M.
- Gantes M.
- Hernández-Cruz B.
- Horcada L.
- Juan Mas A.
- Lois Iglesias A.
- Lozano-Rivas N.
- López-Longo F.J.
- Montilla C.
- Moreno M.
- Mouriño-Rodríguez C.
- Muñoz-Fernández S.
- Narvaez J.
- Olivé-Marqués A.
- Ovalles J.
- Pecondón-Español Á.
- Pego-Reigosa J.M.
- Quevedo-Vila V.
- Raya E.
- Rubio-Muñoz P.
- Rúa-Figueroa Í.
- Salgado E.
- Salman-Monte T.C.
- Soler G.
- Tomero E.
- Torrente-Segarra V.
- Vela P.
- Velloso-Feijoo M.L.
- Vázquez-Rodríguez T.R.
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Objective: To assess the incidence of serious infection (SI) and associated factors in a large juvenile-onset systemic lupus erythematosus (jSLE) retrospective cohort. Methods: All patients in the Spanish Rheumatology Society Lupus Registry (RELESSER) who meet =4 ACR-97 SLE criteria and disease onset <18 years old (jSLE), were retrospectively investigated for SI (defined as either the need for hospitalization with antibacterial therapy for a potentially fatal infection or death caused by the infection). Standardized SI rate was calculated per 100 patient years. Patients with and without SI were compared. Bivariate and multivariate logistic and Cox regression models were built to calculate associated factors to SI and relative risks. Results: A total of 353 jSLE patients were included: 88.7% female, 14.3 years (± 2.9) of age at diagnosis, 16.0 years (± 9.3) of disease duration and 31.5 years (±10.5) at end of follow-up. A total of 104 (29.5%) patients suffered 205 SI (1, 55.8%; 2-5, 38.4%; and =6, 5.8%). Incidence rate was 3.7 (95%CI: 3.2–4.2) SI per 100 patient years. Respiratory location and bacterial infections were the most frequent. Higher number of SLE classification criteria, SLICC/ACR DI score and immunosuppressants use were associated to the presence of SI. Associated factors to shorter time to first infection were higher number of SLE criteria, splenectomy and immunosuppressants use. Conclusions: The risk of SI in jSLE patients is significant and higher than aSLE. It is associated to higher number of SLE criteria, damage accrual, some immunosuppressants and splenectomy
Differences in clinical manifestations and increased severity of systemic lupus erythematosus between two groups of Hispanics: European Caucasians versus Latin American mestizos (data from the RELESSER registry).
- Author
- Alonso F
- Andreu J L
- Blanco R
- Bonilla G
- Boteanu A L
- Calvo Alén J
- Castellví I
- Díez-Álvarez E
- Erausquin C
- Fernández-Berrizbeitia O
- Fernández-Nebro A
- Freire M
- Galindo-Izquierdo M
- Gantes M
- Hernández Cruz B
- Hernández-Beriain J Á
- Horcada L
- Ibáñez-Barceló M
- López-Longo F J
- Marras C
- Martínez Taboada V
- Montilla C
- Moreno M
- Muñoz S
- Narváez J
- Olivé A
- Pecondón-Español Á
- Pego-Reigosa J M
- Pérez-Venegas J J
- Quevedo Vila V E
- Raya E
- RELESSER (Spanish Society of Rheumatology Systemic Lupus Erythematosus register) group
- Rodríguez-Gómez M
- Ruiz-Lucea E
- Ruán J Ibáñez
- Rúa-Figueroa Í
- Santos Soler G
- Sánchez-Atrio A
- Tomero E
- Uriarte E
- Vela P
- Vázquez T
- Publication venue
- 'SAGE Publications'
- Publication date
- 04/12/2019
- Field of study
Systemic lupus erythematosus (SLE) is regarded as a prototype autoimmune disease because it can serve as a means for studying differences between ethnic minorities and sex. Traditionally, all Hispanics have been bracketed within the same ethnic group, but there are differences between Hispanics from Spain and those from Latin America, not to mention other Spanish-speaking populations. This study aimed to determine the demographic and clinical characteristics, severity, activity, damage, mortality and co-morbidity of SLE in Hispanics belonging to the two ethnic groups resident in Spain, and to identify any differences. This was an observational, multi-centre, retrospective study. The demographic and clinical variables of patients with SLE from 45 rheumatology units were collected. The study was conducted in accordance with Good Clinical Practice guidelines. Hispanic patients from the registry were divided into two groups: Spaniards or European Caucasians (EC) and Latin American mestizos (LAM). Comparative univariate and multivariate statistical analyses were carried out. A total of 3490 SLE patients were included, 90% of whom were female; 3305 (92%) EC and 185 (5%) LAM. LAM patients experienced their first lupus symptoms four years earlier than EC patients and were diagnosed and included in the registry younger, and their SLE was of a shorter duration. The time in months from the first SLE symptoms to diagnosis was longer in EC patients, as were the follow-up periods. LAM patients exhibited higher prevalence rates of myositis, haemolytic anaemia and nephritis, but there were no differences in histological type or serositis. Anti-Sm, anti-Ro and anti-RNP antibodies were more frequently found in LAM patients. LAM patients also had higher levels of disease activity, severity and hospital admissions. However, there were no differences in damage index, mortality or co-morbidity index. In the multivariate analysis, after adjusting for confounders, in several models the odds ratio (95% confidence interval) for a Katz severity index >3 in LAM patients was 1.45 (1.038-2.026; p = 0.02). This difference did not extend to activity levels (i.e. SLEDAI >3; 0.98 (0.30-1.66)). SLE in Hispanic EC patients showed clinical differences compared to Hispanic LAM patients. The latter more frequently suffered nephritis and higher severity indices. This study shows that where lupus is concerned, not all Hispanics are equal
Differences in clinical manifestations and increased severity of systemic lupus erythematosus between two groups of Hispanics: European Caucasians versus Latin American mestizos (data from the RELESSER registry)
- Author
- A Fernández-Nebro
- A L Boteanu
- A Olivé
- A Sánchez-Atrio
- B Hernández Cruz
- C Erausquin
- C Marras
- C Montilla
- Calvo-Alén J
- E Díez-Álvarez
- E Raya
- E Ruiz-Lucea
- E Tomero
- E Uriarte
- F Alonso
- F J López-Longo
- G Bonilla
- G Santos Soler
- Hawker G
- I Castellví
- J Calvo Alén
- J Ibáñez Ruán
- J J Pérez-Venegas
- J M Pego-Reigosa
- J Narváez
- JL Andreu
- JÁ Hernández-Beriain
- L Horcada
- M Freire
- M Galindo-Izquierdo
- M Gantes
- M Ibáñez-Barceló
- M Moreno
- M Rodríguez-Gómez
- O Fernández-Berrizbeitia
- P Vela
- R Blanco
- S Muñoz
- Symmons DPM
- T Vázquez
- V E Quevedo Vila
- V Martínez Taboada
- Vina ER
- Á Pecondón-Español
- Í Rúa-Figueroa
- Publication venue
- 'SAGE Publications'
- Publication date
- Field of study
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- Publication venue
- 'Walter de Gruyter GmbH'
- Publication date
- 01/01/1943
- Field of study
Risk of COVID-19 after natural infection or vaccinationResearch in context
- Author
- A. Lina Rosengren
- Abram Burgher
- Adam B. Brosz
- Adam Rosen
- Adam Schwartz
- Adriana Sordo Duran
- Adrienna Marquez
- Adrienne E. Shapiro
- Aeiress Duhart
- Afsoon Roberts
- Albert Liu
- Alejandro Hoberman
- Alejandro Quintín Barrat Hernández
- Alex Greninger
- Alexander Clark
- Alfredo Gilberto Guerreros Benavides
- Alice McGarry
- Alicia Arrazcaeta
- Alisha Lutat
- Alison Bondell
- Alison Pellecchia
- Allie Oplinger
- Allison Green
- Allison O'Brien
- Alpa Patel
- Alyssa-Kay Peay
- Amanda Horn
- Amanda Lilienthal
- Amanda Occhino
- Amanda Philyaw
- Amaran Moodley
- Amber Grant
- Amber Stanford
- Amesika Nyaku
- Amie Shannon
- Amina Z. Haggag
- Amit Paliwal
- Amy Caldwell
- Amy Chamberlain
- Amy Dye
- Amy Falk
- Amy Kelley
- Amy Medina
- Amy Potts
- Amy Salzl
- Amy Sherman
- Amy Starr
- Amy Thompson
- Andrea Berry
- Andrea Clement
- Andrea Wendrow
- Andrea Zimmer
- Andres Bran
- Andres Camacho-Gonzalez
- Andrew Lauria
- Andrew McConnell
- Andrew McWilliams
- Anelgine C. Yoon
- Angela Lee
- Angela R. Branche
- Angelica Kottkamp
- Angella Webb
- Ann M. Milliken
- Ann R. Falsey
- Anna S. Lok
- Anna Wald
- Anne Marit de Groot
- Anne-Marie Rick
- Annette R. Bennett
- Annie Ciambruschini
- Annie Luetkemeyer
- Anthony Kim
- Anum Abbas
- Anyela Lara
- April Pixler
- Ariana C. Stanton
- Arthur L. Zemanek
- Asha Inniss
- Ashley Kennedy
- Ashley Perez
- Ashley Warden
- Asif Noor
- Atoya Adams
- Aurelio Cruz-Valdez
- Austin Chan
- Austin Swanson
- Ayanna Walters
- Ayoade Avworo
- Bailey Jordan
- Barbara Corral
- Barbara Rizzardi
- Barbara Rizzardi
- Barbara S. Taylor
- Barry S. Zingman
- Barton G. Williams
- Beatriz Grinsztejn
- Becky Martinez
- Ben Ladner
- Benjamin Eckhardt
- Benjamin J. Luft
- Bernard Grunstra
- Beth Safirstein
- Bethanie Wilkinson
- Beverly E. Sha
- Beverly Ewing
- Bindu Balani
- Blanca Gomez
- Bo Shopsin
- Boerries Brandenburg
- Brandie Taylor
- Brandon J. Essink
- Brandy Ball
- Breanz Watkins
- Brenda Dorcely
- Brendan Levy
- Brett Gray
- Brett Leav
- Brian D.W. Chow
- Brit Sovic
- Brittany Feijoo
- Brittany Stewart
- Bruce C. Gebhardt
- Bruce G. Rankin
- Bruce McClenathan
- Bruno Valenti
- Bryan Gordon
- C. Mary Healy
- Caitlin J. Guiney
- Caitlin Moran
- Candace Smith
- Candice Montros
- Carina A. Rodriguez
- Carl Fichtenbaum
- Carl P. Griffin
- Carlos A. Fierro
- Carlos del Rio
- Carlos Lopez
- Carlos Malvestutto
- Carmel B. Dyer
- Carmen A. Paez
- Carmen Amador
- Carmen D. Zorrilla
- Carmen Medina
- Carol Ann Linebarger
- Carol Kauffman
- Carol L. Mitchell
- Carolene Stephenson
- Caroline Greene
- Carolyn Scatamacchia
- Carolyn Tran
- Carrie Johnston
- Carrie Sopher
- Catherine A. Bunce
- Catherine Mary Healy
- Catherine Q. Gular
- Cathy Laflan
- Cecilia McKeown-Bragas
- Celia Gonzalez
- Celia Maxwell
- Charles Harper
- Charles M. Fogarty
- Charlotte-Paige Rolle
- Charnell Cromer
- Chelsea Miles
- Chelsie Nutsch
- Chelsie Nutsch
- Chen S. Tan
- Chenchen Yu
- Cheryl Nuss
- Cheryl Young
- Chimeremma Nnadi
- Chinar Desai
- Christian Tomaszewski
- Christina A. Rostad
- Christina Bacher
- Christina Kennelly
- Christine Akamine
- Christine B. Turley
- Christine Hull
- Christine Wilson
- Christopher Carpenter
- Christopher Dedon
- Christopher Galloway
- Christopher Matich
- Christy Schmeck
- Christy Sweet
- Clarence B. Creech II
- Clarisse Baudelaire
- Claudia De La Matta Rodriguez
- Claudia Espinosa
- Claudio Nuñez Lagos
- Clint C. Guillory
- Clint Wilson
- Codi M. Anthony
- Colleen F. Kelley
- Colleen Jacobsen
- Connie Moya
- Cora Sonnier
- Corey G. Anderson
- Corey M. Chen
- Cornell Calinescu
- Corrina Pavetto
- Cortney Burch
- Cory J. Huffine
- Craig Dietz
- Cristina Cicogna
- Crystal Rowell
- Cynthia Becher Strout
- Cynthia Brown
- Cynthia Bueno
- Cynthia L. Gay
- Cynthia L. Monaco
- Cynthia Montano-Pereira
- Cyrus Hoseyni
- Dakotah C. Lane
- Dalia Tovar
- Daniel Duncanson
- Daniel Hoft
- Daniel Kaul
- Daniel S. Graciaa
- Daniel T. Lawler
- Daniela Pineda Méndez
- Danielle Raley
- Danny Sugimoto
- Danyel Johnson
- Darlene Bartilucci
- David B. Musante
- David Beckmann
- David Browder
- David Dellaero
- David Fitz-Patrick
- David Halpert
- David I. Bernstein
- David J. Diemert
- David J. Ensz
- David Kline
- David L. Fried
- David Metzger
- David Pampe
- David Pitrak
- David R. Andes
- David Rosenberg
- David Tatelbaum
- David Wohl
- Dawn Furey
- Dawn Robison
- Dean Follmann
- Dean M. Boswell
- Deanna Cooper
- Debora Dunbar
- Deborah A. Theodore
- Deborah Murray
- Debra B. Schroeck
- Delia Bullock
- Denis Tarakjian
- Denise Casey
- Denise Roadman
- Denise Sample
- Denisse Alejandra González Estrada
- Derek Lewis
- Derek M. Smith
- Destiny S. Heinzig-Cartwright
- Diana Badillo
- Diana F. Florescu
- Diana Vegas
- Dianca Sierra
- Diane H. Johnson
- Dilek Ince
- Dima Dandachi
- Dirk Heerwegh
- Dolores Rijos
- Donald M. Brandon
- Donald Quinn
- Donna Percy
- Doris Franco-Vitteri
- Douglas S. Denham
- E. Javier Pretell Alva
- Edgar Garcia
- Edith Swann
- Eduardo Gabriel Vázquez Saldaña
- Edward C. Jones-López
- Edward E. Walsh
- Edward Ellerbeck
- Edward M. Tavel Jr.
- Elham Ghadishah
- Elie Gharib
- Elisa Swieboda
- Elissa Malkin
- Elizabeth Barranco-Santana
- Elizabeth Bennett
- Elizabeth Bruce
- Elizabeth Danford
- Elizabeth Duke
- Elizabeth E. Robison
- Elizabeth Everette
- Elizabeth Formentini
- Elizabeth Hammershaimb
- Elizabeth Parker
- Elizabeth Secord
- Ellie Carmody
- Elliot DeHaan
- Elwaleed Elnagar
- Emily Degan
- Emily Oppenheim
- Emma Bainbridge
- Emmanuel B. Walter
- Eneyda Giuvanela Llerena Zegarra
- Enrique Ocaña
- Eric A. Meyerowitz
- Eric Bravo
- Eric McGrath
- Eric Miller
- Erica Herc
- Erica Johnson
- Erica Osmundsen
- Erica Sanchez
- Erika A. Cutz
- Erika Mendoza
- Erin A. Goecker
- Erin Cooksey
- Erin Coston
- Ernesto Delgado
- Esther L. Harmon
- Esther S. Huffine
- Evan C. Ewers
- Evan J. Anderson
- Evelyn Hall
- Evelyn Lomasney
- Evelyn Quevedo
- Fan Yang
- Farah Irani
- Farhan Siddiqui
- Fernanda Morales
- Fernando L. Merino
- Filip Dubovsky
- Flora Castellino
- Florence Momplaisir
- Florida Aristy
- Frances Downing
- Frank James
- Frank S. Eder
- Frank Struyf
- Fred E. Newton
- Frederick Raiser III
- Fredric Santiago
- Gail Broder
- Gary Albert
- Gary Headden
- Gary Horwith
- Gary Luckasen
- Gary Simon
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- Troy Holdeman
- Tyler D. Bold
- Uriel R. Felsen
- Valentine M. Ebuh
- Valeria D. Cantos
- Valerie K. Arnold
- Vanessa Abad
- Vanessa Raabe
- Veronica G. Fragoso
- Veronica Garcia-Fragoso
- Veronica Procasky
- Veronica Viar
- Vicki E. Miller
- Vickie Leathers
- Victoria Andriulis
- Victoria Engler
- Victoria Mosteller
- Victoria R. Anderson
- Vida Veronica Ruiz Herrera
- Vincent Huynh
- Vincent Mirkil
- Vivek Rajasekhar
- Viviana Gonzalez
- Vladimir Berthaud
- Walter Patton
- Wanda Ramon
- Waseem Chughtai
- Wayne L. Harper
- Wayne Woo
- Wendell Lewis
- Wendell Lewis III
- Wendy A. Keitel
- Wesley Campbell
- Wesley Van Ever
- Westly Keating
- Whitney West
- Will Hernandez
- William B. Davis
- William B. Smith
- William H. Jones
- William Jennings
- William Kirby
- William P. Silver
- William R. Hartman
- William S. Davis Jr.
- William Schnitz
- William Seger
- Winniberg Stephany Alvarez León
- Winston Cavert
- Xiaomi Tong
- Yaa D. Oppong
- Yi H. Wu
- Ying Huang
- Yogesh K. Paliwal
- Youyi Fong
- Yunda Huang
- Yunda Huang
- Yvonne Davis
- Zachary Bittner
- Zainab Rizvi
- Zindy Yazmín Zárate Hinojosa
- Zudi-Mwak Takizala
- Publication venue
- Elsevier
- Publication date
- 01/10/2023
- Field of study
Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health
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Risk of COVID-19 after natural infection or vaccinationResearch in context
- Author
- Abad Vanessa
- Abate Getahun
- Abbas Anum
- Ackerman Jamie
- Ackerman Ronald
- Ackermann Jeremy
- Adams Atoya
- Adams Mark S.
- Adams Michael R.
- Adelglass Jeffrey
- Afework Sarah
- Ahmad Nina
- Akamine Christine
- Ake Julie A.
- Al-Ibrahim Mohamed S.
- Albert Gary
- Alcaide Maria L.
- Alderson Nathan
- Aleman Lily
- Alemán José O.
- Allaw Mohammed
- Alva E. Javier Pretell
- Alvarado Hilario
- Amador Carmen
- Andersen James
- Anderson Corey G.
- Anderson Evan J.
- Anderson Victoria R.
- Andes David R.
- Andrasik Michele P.
- Andree Stephanie
- Andrews Jeb
- Andriesen Jessica G.
- Andriulis Victoria
- Ansel Jessica L.
- Anthony Codi M.
- Antwi Mohammed
- Arduino Roberto C.
- Aristy Florida
- Arnold Valerie K.
- Arrazcaeta Alicia
- Atmar Robert L.
- Avworo Ayoade
- Bacher Christina
- Baden Lindsey R.
- Badillo Diana
- Bainbridge Emma
- Baka Michele
- Baker Sherrie
- Balani Bindu
- Ball Brandy
- Bances Karla Beatriz Tafur
- Baron Mira
- Barranco-Santana Elizabeth
- Bartilucci Darlene
- Bashour Jennifer
- Batteiger Teresa A.
- Baudelaire Clarisse
- Bazan Jose A.
- Becerra Maria G.
- Becker Teresa
- Beckmann David
- Bedimo Roger J.
- Belhorn Linda R.
- Benavides Alfredo Gilberto Guerreros
- Beninati Genevieve
- Benitez Jorge A.
- Bennett Annette R.
- Bennett Elizabeth
- Beresnev Tatiana
- Berman Megan
- Bermudez Maria I.
- Bernard Marcia
- Bernstein David I.
- Berry Andrea
- Berry Jennifer
- Berthaud Vladimir
- Bialobok Kristin
- Billings Joanne L.
- Bittner Zachary
- Blevins Jeanne
- Blumenthal Jill
- Boas Rebecca
- Bocchini Joseph
- Bold Tyler D.
- Bondell Alison
- Bondy Paul
- Borger Judith
- Borgetti Scott
- Boscia Joseph
- Boswell Dean M.
- Bourgeois Tana
- Bowers Maggie
- Bradley Paul S.
- Brady Judith
- Brakema Riemke
- Bran Andres
- Branche Angela R.
- Brandenburg Boerries
- Brandon Donald M.
- Bravo Eric
- Briskin Toby
- Broder Gail
- Brosz Adam B.
- Browder David
- Browder Lesley
- Brown Cynthia
- Brown Jeremy
- Brownlee Robert
- Bruce Elizabeth
- Bueno Cynthia
- Bullock Delia
- Bunce Catherine A.
- Burch Cortney
- Burgett Michelle L.
- Burgher Abram
- Butcher Michael B.
- Buynak Robert J.
- Bäcker Martín
- Cade LaShondra
- Calderon Rafael
- Calderone Richard
- Caldwell Amy
- Calinescu Cornell
- Call Robert S.
- Callis Jim
- Camacho-Gonzalez Andres
- Campbell Thomas B.
- Campbell Wesley
- Cancilla Michael
- Cannon Kevin D.
- Cantos Valeria D.
- Carmody Ellie
- Carpenter Christopher
- Carr Melissa
- Carrascal Monica B.
- Carsons Steven E.
- Carvajal Marianela
- Casey Denise
- Caso Jorge
- Castellino Flora
- Castellon Marvin
- Castro Mario
- Catan Hannah
- Cavert Winston
- Chacón Jorge A.
- Chadwick Mesha M.
- Chamberlain Amy
- Chan Austin
- Chang Jennifer
- Chebib Mouna G.
- Chen Corey M.
- Cheng Margaret
- Cho Iksung
- Choquette Karin
- Chouteau R. Michelle
- Chow Brian D.W.
- Choza Laura Julia Camacho
- Chrisley Lisa
- Christensen Shane G.
- Chu Hanh
- Chu Laurence
- Chughtai Waseem
- Chung Michael
- Ciambruschini Annie
- Cicogna Cristina
- Clarence B. Creech I I
- Clark Alexander
- Clark Jesse L.
- Claybrook Phillip
- Clement Andrea
- Clement Lauren
- Clemons Steve
- Cohen Lisa
- Cohen Stuart H.
- Coleman Jacob
- Colindres Roberto A. Viau
- Connor Joseph P.
- Conway James H.
- Cooksey Erin
- Coombs Robert W.
- Cooney Maureen
- Cooper Deanna
- Coplan Paul
- Corey Lawrence
- Cornelison Raymond
- Corral Barbara
- Coslet Jordan
- Coston Erin
- Cotugno Michael J.
- Cramer Paul
- Cromer Charnell
- Cross Marshall A.
- Cruz-Valdez Aurelio
- Curlin Marcel
- Curry LaKondria
- Custers Jerome
- Cutz Erika A.
- DallaPiazza Michelle
- Dandachi Dima
- Danford Elizabeth
- Dang Lyly
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- Davis Joseph D.
- Davis Matthew G.
- Davis William B.
- Davis Yvonne
- Davit Rajesh K.
- de Groot Anne Marit
- De La Cruz Luis I.
- De La Matta Rodriguez Claudia
- De Proost Ian
- Dedon Christopher
- Dedon Jon F.
- Deese Teresa
- Degan Emily
- DeHaan Elliot
- del Rio Carlos
- Delgado Ernesto
- Delgado Michael
- Delgado Mike
- Dellaero David
- Denham Douglas S.
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- Zorrilla Carmen D.
- Áñez Germán
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/10/2023
- Field of study
Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health