关键词： SARS-CoV-2 variant   COVID-19   AZD1222   ChAdOx1 nCov-19   Vaccine efficacy  

摘要： COVID-19 vaccine efficacy (VE) has been observed to vary against antigenically distinct SARS-CoV-2 variants of concern (VoC). Here we report the final analysis of VE and safety from COV005: a phase 1b/2, multicenter, double-blind, randomized, placebo-controlled study of primary series AZD1222 (ChAdOx1 nCoV-19) vaccination in South African adults aged 18-65 years. South Africa's first, second, and third waves of SARS-CoV-2 infections were respectively driven by the ancestral SARS-CoV-2 virus (wild type, WT), and SARS-CoV-2 Beta and Delta VoCs. VE against asymptomatic and symptomatic infection was 90.6% for WT, 6.7% for Beta and 77.1% for Delta. No cases of severe COVID-19 were documented ahead of unblinding. Safety was consistent with the interim analysis, with no new safety concerns identified. Notably, South Africa's Delta wave occurred >= 9 months after primary series vaccination, suggesting that primary series AZD1222 vaccination offers a good durability of protection, potentially due to an anamnestic response. (C) 2023 Published by Elsevier Ltd.

关键词： 新型冠状病毒   Omicron变异株   BA.5.2亚型   全基因组测序  

摘要： 目的研究引起2022年浙江省台州市2起本土疫情的新型冠状病毒（SARS-CoV-2）Omicron变异株BA.5.2亚型的分子特征，为新型冠状病毒感染（COVID-19）疫情的预防与控制提供实验室支持。方法对2起本土疫情的首例感染者及密切接触者的9份确认阳性样本进行三代全基因组测序，测得序列进行在线基因分型、核苷酸和氨基酸变异位点分析，并与其他亚型比较同源性。结果与参考株Wuhan-Hu-1（NC＿045512.2）相比，引起10月15日疫情的BA.5.2亚型毒株有75个核苷酸变异位点和53个氨基酸变异位点，引起11月15日疫情的BA.5.2亚型毒株有80个核苷酸变异位点和58个氨基酸变异位点，通过与国家基因组科学数据中心（NGDC）的SARS-CoV-2数据库序列比对，未发现基因组同源的病毒序列。结论 利用单分子三代测序技术可快速开展本土或外地输入感染者的SARS-CoV-2的全基因组序列监测，对预防与控制COVID-19疫情暴发与流行病学溯源调查具有重要意义。

关键词： ChAdOx1 nCoV19 vaccination   Dose 2   Thrombosis with thrombocytopenia   syndrome   Vaccine-induced immune thrombotic   thrombocytopenia   VITT  

摘要： Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but established complication of 1st dose ChAdOx1 nCoV19 vaccination (AZD1222), however this complication after dose 2 remains controversial. Objectives: To describe the clinicopathological features of confirmed cases of VITT post dose 2 AZD1222 vaccination in Australia, and to compare this cohort to confirmed cases of VITT post 1st dose. Methods: Sequential cases of clinically suspected VITT (thrombocytopenia, D-Dimer > 5x upper limit nor-mal and thrombosis) within 4-42 days of dose 2 AZD1222 referred to Australia's centralised testing cen-tre underwent platelet activation confirmatory testing in keeping with the national diagnostic algorithm. Final classification was assigned after adjudication by an expert advisory committee. Descriptive statis-tics were performed on this cohort and comparative analyses carried out on confirmed cases of VITT after 1st and 2nd dose AZD1222. Results: Of 62 patients referred, 15 demonstrated presence of antibody mediated platelet activation con-sistent with VITT after dose 2 AZD1222. Four were immunoassay positive. Median time to presentation was 13 days (range 1-53) platelet count 116x10<^>9/L (range 63-139) and D-dimer elevation 14.5xULN (IQR 11, 26). Two fatalities occurred. In each, the dosing interval was less than 30 days. In comparison to 1st dose, dose 2 cases were more likely to be male (OR 4.6, 95% CI 1.3-15.8, p = 0.03), present with higher platelet counts (p = 0.05), lower D-Dimer (p = 01) and less likely to have unusual site thromboses (OR 0.14, 95% CI 0.04-0.28, p = 0.02). Conclusions: VITT is a complication of dose 2 AZD1222 vaccination. Whilst clinicopathological features are less severe, fatalities occurred in patients with concomitant factors. Crown Copyright (c) 2023 Published by Elsevier Ltd. All rights reserved.

关键词： MERS-CoV   SARS-CoV-2   2019-nCoV   Self-harm   Prevalence   Systematic review  

摘要： BackgroundCOVID-19 and its transmission mitigation measures have caused widespread mental health problems. Previous studies have suggested that psychological, economic, behavioral, and psychosocial problems associated with the COVID-19 pandemic may lead to a rise in self-harm. However, little is known about the prevalence of self-harm worldwide during COVID-19. Therefore, a quantitative synthesis is needed to reach an overall conclusion regarding the prevalence of self-harm during the *** using permutations of COVID-19, self-harm or relevant search terms, we searched the following electronic databases from November 2019 to January 2022: Web of Science, PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang Database and systematically reviewed the evidence according to MOOSE guidelines. We employed Cochran's chi-squared test (Cochran's Q), I(2)test and subgroup analysis to assess and address the heterogeneity. Sensitivity analysis was conducted by eliminating each included study individually and then combining the *** studies that met the inclusion and exclusion criteria were identified, with sample sizes ranging from 228 to 49,227. The methodological quality of the included studies was mostly at the medium level. By using a random effect model, the pooled prevalence of self-harm was 15.8% (95% CI 13.3-18.3). Based on subgroup analysis, the following characteristics of the included studies were more likely to have a higher prevalence of self-harm: studies conducted in Asia or prior to July 2020, cross-sectional studies, samples recruited in hospitals or schools, adolescents, females, the purpose of self-harm (NSSI), mental symptoms and restriction *** provided the first meta-analytic estimated prevalence of self-harm based on a large sample from different countries and populations. The prevalence of self-harm during COVID-19 was not enc

关键词： COVID-19   SARS-CoV-2   Heterologous vaccination   Immunogenicity   Meta-analysis  

摘要： Introduction: Here, we systematically assessed the safety and immunogenicity of the heterologous ChAd/ BNT vaccination *** and methods: We evaluated the immunogenicity by the geometric mean titers ratio (GMTR) of the neutralizing antibody and anti-spike IgG. The safety of heterologous ChAd/BNT vaccination was evaluated using the pooled risk ratios (RRs) calculated by the random-effects model about the adverse events. Our study was registered with PROSPERO, ***: Eleven studies were included in the analyses. Compared to the homologous ChAd/ChAd vaccination, the heterologous ChAd/BNT vaccination showed significantly higher immunogenicity in terms of the neutralizing antibody and GMTR of anti-spike IgG, but at the same time displayed higher incidence of total adverse reactions, especially for the local adverse reactions. Moreover, heterologous ChAd/BNT vaccination showed similar immunogenicity to the homologous BNT/BNT vaccination (GMTR of neutralizing antibody and anti-spike IgG) and similar ***: Heterologous ChAd/BNT vaccination showed robust immunogenicity and tolerable safety. (c) 2023 Elsevier Ltd. All rights reserved.

关键词： 新型冠状病毒肺炎   医务人员   社会支持   睡眠质量  

摘要： 目的:了解新冠肺炎防控常态化期间医务人员的睡眠质量和社会支持水平,探讨两者之间的关系。方法:2021年1-6月,招募参加某三级综合医院健康体检的医务人员3163名,采用匹兹堡睡眠质量指数(PSQI)、社会支持评定量表(SSRS)、病人健康问卷-2(PHQ-2)、广泛性焦虑障碍量表-2(GAD-2)分别调查睡眠、社会支持、抑郁和焦虑状况。根据SSRS得分可分为低水平社会支持(≤22分)、中等水平社会支持(23~44分)和高水平社会支持(>44分)。结果:27.8%的医务人员睡眠质量差(PSQI得分>5分);90.7%的医务人员的社会支持水平为中等水平,仅有6.3%为高水平。中、高水平的社会支持与睡眠质量负向关联(OR=0.58、0.49)。结论:在新冠肺炎防控常态化期间,医务人员的睡眠质量与社会支持水平关系密切。

关键词： 新型冠状病毒   新型冠状病毒感染   特异性受体结合结构域   抗体   中和活性   流行病学  

摘要： 目的分析感染新型冠状病毒(SARS-CoV-2)的医护工作人员特异性受体结合结构域(RBD)中和抗体变化,了解高风险人群免疫应答,为后续健康随访提供依据。方法随机选取2022年12月1日-2022年12月25日某综合医院385例感染SARS-CoV-2在岗医护工作人员,收集流行病学史和临床症状信息,检测末梢血SARS-CoV-2特异性抗体[S-IgM、S-IgG和RBD中和抗体(荧光免疫层析法)]表达水平,JPR模型分析表达趋势。结果JPR模型分析显示,S-IgM、S-IgG和RBD中和抗体分别在出现症状后4天、6天和6天上升趋势明显,S-IgM在出现症状后8天开始下降。广义线性混合模型多因素分析显示,性别和发热症状均与RBD中和抗体关联性弱;随着年龄增加,RBD中和抗体表达下降;接种疫苗会增加RBD中和抗体表达。结论SARS-CoV-2特异性抗体S-IgM、S-IgG和RBD中和抗体在出现典型症状后4~6天升高趋势明显,RBD中和抗体维持时间长。此外,随年龄增加,RBD中和抗体水平呈下降趋势。

关键词： 新型冠状病毒感染   育龄期妇女   扶正驱邪   疏风清热   固守肺卫   三因制宜   人参花   桑叶   尤昭玲  

摘要： 育龄期妇女新型冠状病毒感染的临床表现、转归与预后不同于常人,故其治疗的特殊性在于既要消除新型冠状病毒感染后的临床症状,又要防治月经不调、胎动不安等。全国名中医尤昭玲教授在充分注重女性特殊生理病理特点的基础上,创制适宜处在月经期、备孕期、妊娠期、产后等湖南省长沙市育龄期妇女新型冠状病毒感染的居家治疗方剂。该方具有扶正驱邪、疏风清热的功效。其组方特点:一是扶正清热、利咽化痰,攻补兼施;二是有的放矢,固守肺卫,散清结合;三是既病防变,安抚肝胃;四是因人、因时、因地制宜,照顾育龄期女性的特殊性;五是药入三焦,联防联守。此外,寒温药并用,使寒而不遏,温而不燥。

关键词： 新型冠状病毒   奥密克戎变异株   临床特点   药学监护  

摘要： 目的:分析赣南地区新型冠状病毒奥密克戎变异株(SARS-CoV-2 Omicron)感染患者的临床特点与药学监护情况,为该类患者的救治提供参考。方法:选取2022年9月—10月赣州市第五人民医院收治的240例SARS-CoV-2 Omicron感染患者作为研究对象,采集患者的年龄、性别、疫苗接种、药物使用、用药干预、药物不良反应等信息,分析患者的流行病学特点。结果:240例SARS-CoV-2 Omicron感染患者的年龄主要集中在18~60岁(156例,占65.00%),临床分型主要为轻型(205例,占85.42%)和无症状(24例,占10.00%);240例患者中有228例接种过疫苗(接种率为95.00%),其中完全全程接种的有162例;用药情况分析显示,240例患者全部使用了抗病毒药物,其中使用最多的是阿兹夫定片(192例,占85.71%),其用药疗程为(13.55±2.87)d;而使用抗菌药物的仅有62例,使用率为25.83%;使用中成药的有240例(使用率为100.00%),其中使用最多的为连花清瘟颗粒(231例,占96.25%)和肺力咳合剂(127例,占52.92%);针对240例患者,临床药师累计审核医嘱9676条,其中不合理医嘱有24条(不合理率为0.25%),对此临床药师均提出了用药建议,而采纳的有21条(采纳率为87.50%);用药期间,有5例报告药物不良反应,但均不严重。结论:此次赣南地区SARS-CoV-2 Omicron感染主要表现为无症状和轻型,在临床药师的支持协助下,患者住院期间用药情况较为合理,且药物不良反应发生较少。

关键词： 冠状病毒感染   病毒性感染   心前区疼痛   神经损害   多系统损害   中草药防治   黏膜屏障   轻症患者  

摘要： 新型冠状病毒(新冠病毒)从上呼吸道侵入造成呼吸道损害和炎症反应,通常易引起重视。各类病毒性感染,常常因病毒突破皮肤黏膜屏障进入血循环而演变为系统性感染,新冠病毒感染也不例外,重症住院患者出现包括心血管在内的多系统损害亦十分常见。笔者注意到2022年冬季新型冠状病毒感染疫情(新冠疫情)暴发流行中,许多轻症患者感染后出现不同程度的活动时心慌、气促或出现胸闷、心前区疼痛等症状.