263. Yu Kato, Nathaniel I Bloom, etc., Memory B-Cell Development After Asymptomatic or Mild Symptomatic SARS-CoV-2 Infection, 2022.07.27, https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac319/6650397?searchresult=1 . We compared spike antibody titers, pseudovirus neutralizing antibody titers, and memory B-cell responses among SARS-CoV-2 PCR-positive Marine recruits who either reported asymptomatic or symptomatic infection. Thirty-six asymptomatic participants exhibited similar spike IgG titers, spike IgA titers, and pseudovirus neutralization titers compared to 30 symptomatic participants. Pseudovirus neutralization and spike IgG titers showed significant positive correlations with frequency of memory B cells. Among young adults, asymptomatic SARS-CoV-2 infection induced antibody and memory B-cell responses comparable to mild symptomatic infection.

262. Hans P Verkerke, Gregory L Damhorst, etc., Nucleocapsid Antigenemia Is a Marker of Acute SARS-CoV-2 Infection, 2022.07.25, https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac225/6649768?searchresult=1 . Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is essential for diagnosis, treatment, and infection control. Polymerase chain reaction (PCR) fails to distinguish acute from resolved infections, as RNA is frequently detected after infectiousness. We hypothesized that nucleocapsid in blood marks acute infection with the potential to enhance isolation and treatment strategies. In a retrospective serosurvey of inpatient and outpatient encounters, we categorized samples along an infection timeline using timing of SARS-CoV-2 testing and symptomatology. Among 1860 specimens from 1607 patients, the highest levels and frequency of antigenemia were observed in samples from acute SARS-CoV-2 infection. Antigenemia was higher in seronegative individuals and in those with severe disease. In our analysis, antigenemia exhibited 85.8% sensitivity and 98.6% specificity as a biomarker for acute coronavirus disease 2019 (COVID-19). Thus, antigenemia sensitively and specifically marks acute SARS-CoV-2 infection. Further study is warranted to determine whether antigenemia may aid individualized assessment of active COVID-19.

261. Priscila M S Castanha, Dylan J Tuttle, etc., Contribution of Coronavirus-Specific Immunoglobulin G Responses to Complement Overactivation in Patients with Severe Coronavirus Disease 2019, 2022.05.10, https://academic.oup.com/jid/article/226/5/766/6546404 . Excessive complement activation has been implicated in the pathogenesis of COVID-19, but the mechanisms leading to this response remain unclear. We measured plasma levels of key complement markers, SARS-CoV-2 RNA and antibodies against SARS-CoV-2 and seasonal human CCCs in hospitalized patients with COVID-19 of moderate (n = 18) and critical severity (n = 37) and in healthy controls (n = 10). These findings indicate that early, nonneutralizing IgG responses may play a key role in complement overactivation in severe COVID-19. Our work underscores the urgent need to develop therapeutic strategies to modify complement overactivation in patients with COVID-19.

260. Jennifer H Ku, Myron J Levin, etc., Risk of Severe Coronavirus Disease 2019 Disease in Individuals With Down Syndrome: A Matched Cohort Study From a Large, Integrated Health Care System, 2022.07.24, https://academic.oup.com/jid/article/226/5/757/6617571 . In a matched cohort study, we evaluated the risk of COVID-19 infection and severe COVID-19 disease in individuals with DS and their matched counterparts in a pre-COVID-19 vaccination period at Kaiser Permanente Southern California. Multivariable Cox proportion hazard regression was used to investigate associations between DS and risk of COVID-19 infection and severe COVID-19 disease. Although the risk of COVID-19 infection is lower, the risk of severe disease is higher in individuals with DS compared with their matched counterparts. Better infection monitoring, early treatment, and promotion of vaccine for COVID-19 are warranted for DS populations.

259. Dimitra Panteli, Christoph Reichebner, etc., Health care patterns and policies in 18 European countries during the first wave of the COVID-19 pandemic: an observational study, 2022.05.27, https://academic.oup.com/eurpub/article/32/4/557/6594116 . COVID-19 pandemic has developed into an unprecedented global challenge. Differences between countries in testing strategies, hospitalization protocols as well as ensuring and managing ICU capacities can illustrate initial responses to a major health system shock, and steer future preparedness activities. This study enables a general understanding of how the early evolution of the pandemic influenced and was influenced by country responses and clearly demonstrates the immense potential for cross-country learning.

258. J Mwai, J Mutai, L Kaduka, etc., Association between sociodemographic characteristics and knowledge and practice of COVID-19 measures among households in Mombasa and Kilifi County, Kenya, 2022.07.28, https://academic.oup.com/inthealth/advance-article/doi/10.1093/inthealth/ihac049/6651286?searchresult=1 . The sociodemographic characteristics of populations play a key role in behavioural aspects as far as prevention and control of COVID-19 are concerned. There is a need for partnerships between the MoH and county governments to put in place a multisectoral community approach to advance feasible behavioural interventions among targeted populations towards combating the spread of COVID-19.

257. Jaime C Auton, Daniel Sturman, Individual differences and compliance intentions with COVID-19 restrictions: insights from a lockdown in Melbourne (Australia), 2022.07.18, https://academic.oup.com/heapro/article/37/3/daac089/6651170?searchresult=1 . It was found that greater levels of organization predicted greater intentions to comply with the COVID-19 restrictions, while higher socio-economic status, sociability and anxiety predicted lower compliance intentions. Further, individuals previously diagnosed with COVID-19 reported lower intentions to comply with the COVID-19 restrictions. The strongest predictor of compliance intentions, however, was a greater knowledge of the current restrictions. These findings highlight that public health orders around COVID-19 restrictions should be presented in a clear and uncomplicated manner and should target specific groups to increase compliance.

256. Char Leung, Li Su, etc., Better healthcare can reduce the risk of COVID-19 in-hospital post-partum maternal death: evidence from Brazil, 2022.08.10, https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyac157/6659906?searchresult=1 . COVID-19 in post-partum women is commonly overlooked. The present study assessed whether puerperium is an independent risk factor of COVID-19 related in-hospital maternal death and whether fatality is preventable in the Brazilian context. We demonstrated that puerperium was associated with an increased odds of COVID-19-related in-hospital mortality. Only part of the risk can be reduced by quality healthcare such as non-profit private hospitals, those that have an obstetric centre or those located in urban areas.

255. Florence Débarre, Emmanuel Lecoeur, etc., The French Covid-19 vaccination policy did not solve vaccination inequities: a nationwide study on 64.5 million people, 2022.09.14, https://academic.oup.com/eurpub/advance-article/doi/10.1093/eurpub/ckac125/6697909?searchresult=1 . This study aims to obtain further insights on the socio-economic, political and geographic factor associated with vaccination rates, and to evaluate the effect of the French domestic sanitary pass, by using nationwide, exhaustive datasets. By emphasizing a differentiated use of COVID-19 vaccination according to a socio-economic gradient, the study confirms the strong impact of social inequalities on COVID-19. Previous research found that the most deprived areas have been disproportionately infected and hospitalized during the pandemic. The study further show that poorer districts are also the least vaccinated and, hence, the most still at risk, despite the widely celebrated domestic sanitary pass. There is an urgent need to define new vaccination policies that truly address social inequities.

254. Donato Greco, What Does the Monkeypox Outbreak Tell Us about Global Health Governance? Critical Remarks on the New WHO Declaration of Public Health Emergency of International Concern, 2022.08.10, https://www.ejiltalk.org/what-does-the-monkeypox-outbreak-tell-us-about-global-health-governance-critical-remarks-on-the-new-who-declaration-of-public-health-emergency-of-international-concern/ . On 23 July 2022, the Director-General of the World Health Organisation (“WHO”) declared that the outbreak of monkeypox constitutes a public health emergency of international concern (“PHEIC”). The present post is aimed at highlighting some critical issues related not only to the PHEIC declaration but, more generally, to global health governance. The post shows that not a few shortcomings affect the governance of international health emergencies.

Beijing Interest Group on Global Health and Global Governance
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