Covid19-Sources

IMPORTANCE Post-acute sequelae of SARS-CoV-2 infection (PASC) remains a major public health challenge. While previous studies have focused on characterizing PASC and identifying its subphenotypes in children and adolescents following an initial SARS-CoV-2 infection, the risks of PASC with Omicron-variant reinfections remain unclear. Using a real-world data approach, this study investigates the risks of PASC following reinfections during the Omicron phase in the pediatric population. OBJECTIVE To investigate the risks of PASC diagnosis and 24 PASC symptoms and conditions after reinfection of SARS-CoV-2 during Omicron period in the pediatric population. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the RECOVER consortium comprising 40 children's hospitals and health institutions in U.S. between January 2022 and October 2023. EXPOSURES A second SARS-CoV-2 infection, confirmed by a positive polymerase-chain-reaction (PCR) or antigen tests, or a diagnose of COVID-19, occurring at least 60 days after the initial infection, compared to the initial infection. MAIN OUTCOMES AND MEASURES PASC was identified using two approaches: (1) the ICD-10-CM diagnosis code U09.9 and (2) a symptom-based definition including 24 physician-identified symptoms and conditions. Absolute risks of incident PASC were reported, and relative risks (RRs) were calculated by comparing the second infection episode with the first infection episode groups using a modified Poisson regression model, adjusting for demographic, clinical, and healthcare utilization factors through exact matching and propensity scoring matching. RESULTS A total of 465,717 individuals under 21 years old (mean [SD] age 8.17 [6.58] years; 52% male) were included. Compared to the first infection, a second infection was associated with significantly increased risk of an overall PASC diagnosis (RR, 2.08; 95% confidence interval [CI], 1.68-2.59), and with many specific conditions including: myocarditis (RR, 3.60; 95% CI, 1.46-8.86); changes in taste and smell (RR, 2.83; 95% CI, 1.41-5.67); thrombophlebitis and thromboembolism (RR, 2.28; 95% CI, 1.71-3.04); heart disease (RR, 1.96; 95% CI, 1.69 to 2.28); acute kidney injury (RR, 1.90; 95% CI, 1.38 to 2.61); fluid and electrolyte (RR, 1.89; 95% CI, 1.62 to 2.20); generalized pain (RR, 1.70; 95% CI, 1.48 to 1.95); arrhythmias (RR, 1.59; 95% CI, 1.45-1.74); abnormal liver enzyme (RR, 1.56; 95% CI, 1.24 to 1.96); fatigue and malaise (RR, 1.50; 95% CI, 1.38 to 1.64); musculoskeletal pain (RR, 1.45; 95% CI, 1.37 to 1.54); abdominal pain (RR, 1.42; 95% CI, 1.34 to 1.50); postural orthostatic tachycardia syndromes (POTS)/dysautonomia (RR, 1.35; 95% CI, 1.20 to 1.51); cognitive functions (RR, 1.32; 95% CI, 1.15 to 1.50); and respiratory signs and symptoms (RR, 1.29; 95% CI, 1.25 to 1.33). The risks were consistent across various organ systems, including cardiovascular, respiratory, gastrointestinal, neurological, and musculoskeletal systems. CONCLUSIONS AND RELEVANCE Children and adolescents face significantly higher risk of various PASC outcomes after reinfection with SARS-CoV-2. These findings suggest a cumulative risk of PASC and highlight the urgent need for targeted prevention strategies to reduce reinfections, which includes an increased emphasis on initial or re-vaccination of children. ### Competing Interest Statement Dr. Jhaveri is a consultant for AstraZeneca, Seqirus, Gilead, Sanofi; receives an editorial stipend from the Pediatric Infectious Diseases Society; research support from GSK; and royalties from Up To Date/Wolters Kluwer. All other co-authors have no conflicts of interest to report. ### Funding Statement This research was funded by the National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program of research. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethnics committee/IRB of University of Pennsylvania waived ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request.

Nosocomial infections are costly, and airborne transmission is increasingly recognized as important for spread. Air cleaning units (ACUs) may reduce transmission, but little research has focused on their effectiveness on open wards. Aim To assess whether ACUs reduce nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), or other, infections on older adult inpatient wards. Methods This was a quasi-experimental before-and-after study on two intervention–control ward pairs in a UK teaching hospital. Infections were identified using routinely collected electronic health record data during 1 year of ACU implementation and the preceding year (‘core study period’). Extended analyses included 6 months of additional data from one ward pair following ACU removal. Hazard ratios (HRs) were estimated through Cox regression controlling for age, sex, ward and background infection risk. The time that the ACUs were switched on was also recorded for Intervention Ward 2. Findings ACUs were initially feasible, but compliance reduced towards the end of the study (average operation in first vs second half of ACU time on Intervention Ward 2: 77% vs 53%). In total, 8171 admissions for 48 h (6112 patients, median age 85 years) were included. Overall, the incidence of ward-acquired SARS-CoV-2 was 3.8%. ACU implementation was associated with a non-significant trend of lower hazard for SARS-CoV-2 infection [HR core study period 0.90, 95% confidence interval (CI) 0.53–1.52; HR extended study period 0.78, 95% CI 0.53–1.14]. Only 1.5% of admissions resulted in other notable ward-acquired infections. Conclusion ACUs may reduce SARS-CoV-2 infection to a clinically meaningfully degree. Larger studies could reduce uncertainty, perhaps using a crossover design, and factors influencing acceptability to staff and patients should be explored further.

Eine retrospektive Analyse von Daten der neurologischen Notfallambulanz des Universitätsklinikums Essen zeigt einen signifikanten Anstieg der Patientenzahlen nach der ersten Medienberichterstattung über Sinusvenenthrombosen als möglicher Folge der COVID-19-Impfung im Jahr 2021. Die Ergebnisse legen nahe, dass ein medieninduzierter Nocebo-Effekte dabei eine bedeutende Rolle spielte.​

There are many reasons to doubt the conclusions of that viral “post-vaccination syndrome” study.

imageimageInnate immune memory enables enhanced responses to antigens through long-lasting epigenetic changes triggered by initial exposure. SARS-CoV-2 mRNA vaccination induces innate immune memory by establishing persistent H3K27ac epigenetic ...

There are limited approaches to monitor virus spread in vivo. Here, the authors report PET/CT-based in vivo imaging to track SARS-CoV-2 biodistribution in a COVID-19 non-human primate model using a radiolabeled human antibody revealing persistent detection in the lung and brain 3 months after infection.

Metabolic activity is the basic life activity of organisms and the fundamental for maintaining body functions. With the improvement of living standards, the incidence of metabolic disorder is also increasing. At present, most of the clinical treatment strategies and meta-analysis for metabolic disorder uncover that combined medicines with berberine ameliorate several metabolic disorders. However, evidence to disclose the therapeutic effect of berberine treatment alone and the possible factors affecting the efficacy is limited. Therefore, we have formulated strict inclusion criteria and selected more reliable data for meta-analysis through more refined screening strategies to provide evidence and guidance for clinical decision-making and understand the effect of berberine treatment alone and the factors affecting its efficacy. Methods and results: Using meta-analysis of “Cochrane Handbook for Systematic Reviews of Interventions” as guidelines, we searched PubMed, GeenMedical, Cochrane library, and china national knowledge infrastructure (CNKI) for trials reporting clinical treatment data of berberine. Another 417 trials were included through other sources to increase confidence in results. Among the 1,660 related documents retrieved from the four databases, 18 eligible documents were selected for analysis. Given the differences in trial design and measurement units, we used the standardized mean difference (SMD) method to eliminate the differences and then summarize the data for analysis. The main factors are triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), homeostasis model assessment-insulin resistance (HOMA-IR), and fasting plasma glucose (FPG). Random-effect model analysis was performed: TG (SMD: 0.94; 95%CI: 0.49,1.38; p = 0.00), TC (SMD: 1.06; 95%CI: 0.64, 1.48; p = 0.00), LDL (SMD: 1.77; 95%CI: 1.11,2.44; p = 0.00), HDL (SMD: −1.59; 95%CI: −2.32, −0.85; p = 0.00), HOMA-IR (SMD: 1.25; 95%CI: 0.25,2.24; p = 0.01), and FPG (SMD: 0.65; 95%CI: 0.28,1.03; p = 0.00). This study aimed to conduct a systematic review and meta-analysis of the literature to evaluate the therapeutic effect of berberine singly on metabolic diseases. Conclusion: Berberine can improve obesity and hyperlipidemia by reducing TG, TC, and LDL and increasing HDL; reduce insulin resistance to improve type Ⅱ diabetes; and prevent diabetic encephalopathy.

Abstract. SARS-CoV2, severe acute respiratory syndrome coronavirus 2, is frequently associated with neurological manifestations. Despite the presence of mi

epigenetischen Veränderungen führten zu einem verstärkten „Ablesen“ von entzündungsfordernden Genen, was wiederum zur Produktion von Botenstoffen führte, die zahlreiche Immunzellen aktivieren können und somit deren Fähigkeit zur Bekämpfung von Infektionen verstärken. „Da es sich

Head outlines the key themes shaping life and health conversations

Stephenson, Pinto Pereira et al. investigate the proportion of children and young people with Post Covid-19 condition 24-months post-infection. Only 7.2% meet the definition consistently at 3-, 6-, 12- and 24-months post-infection, highlighting the importance of longitudinal studies.

This retrospective cohort study found that patients kidney disease who received nirmatrelvir/ritonavir for COVID-19 were less likely to be hospitalized wit

Cohen et al. report a patient-led case series of 13 individuals with Long COVID who initiated extended courses of Paxlovid outside of, or within the context of, an acute SARS-CoV-2 infection. Long courses of nirmatrelvir/ritonavir have meaningful benefits for some people with Long COVID but not all.

After surviving Coronavirus Disease 2019 (COVID-19), some people develop symptoms known as post-acute sequelae of COVID-19 (PASC). PASC is an emerging phenomenon yet to be fully understood, and identifying risk factors has been challenging. This study investigated the association between the number of COVID-19 episodes and the incidence of PASC among essential workers. Methods We analyzed data from 2511 essential workers, mainly first responders, with confirmed polymerase chain reaction, antibody, or antigen-positive test results for SARS-CoV-2 infection from March 2020 to February 2024. Data were collected through in-person questionnaires and surveys sent via text and email, internal medical records, follow-up calls, and external medical records. Participants who reported continuation or the development of new symptoms three months after the initial SARS-CoV-2 infection, with symptoms lasting for at least two months, were categorized as having PASC, while those without any COVID-19 or whose symptoms resolved were classified as non-PASC. PASC was common in this cohort so we used a Poisson regression model to compute multivariable-adjusted Relative Risk (RR) for the association between risk of PASC and SARS-CoV-2 re-infection, severity, and vaccination status at first infection. Findings A total of 475 (prevalence = 18.9%, [95% confidence interval] = [17.4–20.5]) PASC patients were identified. The mean (standard deviation (SD)) age of participants who experienced PASC (54.8 (7.2) years) was similar to those who did not (54.2 (7.4) years). There were 403 (16.1% [14.6–17.5]) participants who experienced multiple instances of COVID-19. After adjusting for relevant demographic, lifestyle, and clinical variables, we found a significant association between the risk of experiencing PASC and multiple SARS-COV-2 infections (RR = 1.41 [1.14–1.74]), severe COVID-19 (RR = 3.17 [2.41–4.16]), and being unvaccinated at first infection (RR = 3.29 [2.46–4.41]).

Background. Understanding the interference patterns of respiratory viruses could be important for shedding light on potential strategies to combat these human infectious agents. Objective. To investigate the possible interactions between adenovirus type 2 (AdV2), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A/H1N1 pandemic (H1N1pdm09) using the A549 cell line. Methods. Single infections, co-infections, and superinfections (at 3 and 24 h after the first virus infection) were performed by varying the multiplicity of infection (MOI). Virus replication kinetics and the mRNA expression of IFN-α, IL-1α and IL-6 were assessed by real-time qPCR. Results. Co-infection experiments showed different growth dynamics, depending on the presence of the specific virus and time. AdV2 replication remained stable or possibly enhanced in the presence of co-infection with each of the two H1N1pdm09 and SARS-CoV-2 viruses used. In contrast, SARS-CoV-2 replication was facilitated by H1N1pdm09 but hindered by AdV2, indicating possible different interactions. Finally, H1N1pdm09 replication exhibited variably effectiveness in the presence of AdV2 and SARS-CoV-2. Superinfection experiments showed that the replication of all viruses was affected by time and MOI. The mRNA expression of IFN-α, IL-1α and IL-6 showed divergent results depending on the virus used and the time of infection. Conclusions. Further investigation of co-infection or superinfection may be helpful in understanding the potential relationship involved in the outcome of viral respiratory infection in the human population.

Mukherjee et al. report that vaccination prior to SARS-CoV-2 infection does not affect the neurological manifestations of Long COVID. Minor symptom differe

DMZ – WISSENSCHAFT ¦ S. Koller ¦ Eine US-amerikanische Studie untersucht erstmals umfassend die Wirksamkeit des COVID-19-Impfstoffs BNT162b2 (Pfizer-BioNTech) bei der Prävention von Long COVID in der pädiatrischen Bevölkerung. Dabei beleuchtet sie sowohl die direkte Schutzwirkung der Impfung als auch deren indirekte Effekte durch die Verhinderung von SARS-CoV-2-Infektionen. Die Ergebnisse liefern wertvolle Einblicke für den öffentlichen Gesundheitssektor. Long COVID bei Kindern und Jugendlichen Long COVID, auch bekannt als Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), umfasst anhaltende oder neu auftretende Symptome nach einer COVID-19-Infektion. Bei Kindern und Jugendlichen zeigt sich Long COVID oft in unterschiedlichen klinischen Merkmalen und mit einer geringeren Häufigkeit im Vergleich zu Erwachsenen. Zu den betroffenen Organsystemen gehören das Herz-Kreislauf-System, das Nervensystem, der Stoffwechsel und die Nieren. Trotz der etablierten Wirksamkeit von COVID-19-Impfstoffen gegen symptomatische und schwere Verläufe bleibt die Frage offen, wie gut eine Impfung vor Long COVID schützt – insbesondere bei jungen Menschen. Die vorliegende Studie schließt diese Wissenslücke und liefert erstmals differenzierte Ergebnisse zu dieser Fragestellung. Methodik der Studie Die Untersuchung nutzte elektronische Gesundheitsdaten (EHR) aus einem nationalen Netzwerk von Kinderkrankenhäusern in den USA. Dabei wurden Daten aus den Perioden der Delta- und Omikron-Varianten analysiert. Die Forscher:innen setzten eine kausale Mediationsanalyse ein, um sowohl die Gesamtwirksamkeit des Impfstoffs auf die Long-COVID-Risiken als auch die direkten und indirekten Effekte der Impfung zu bewerten. Diese Methode ermöglicht es, den Einfluss der Impfung zu quantifizieren, ohne durch mögliche Verzerrungen aufgrund von Infektionsstatus-Bedingungen belastet zu sein. Zudem wurden Computeralgorithmen genutzt, um Long COVID anhand spezifischer Symptome und Krankheitscluster zu definieren. Die Datenbasis umfasste pädiatrische Populationen aus unterschiedlichen Versorgungseinrichtungen, wodurch eine breite repräsentative Stichprobe sichergestellt wurde. Zentrale Ergebnisse Die Studie fand heraus, dass die BNT162b2-Impfung während der Delta-Periode einen hohen Schutz vor Long COVID bot, während die Wirksamkeit in der Omikron-Periode moderater ausfiel. Dieser Rückgang ist auf die höhere Übertragbarkeit und geringere Schwere der Omikron-Varianten sowie die allgemein niedrigere Impfeffektivität zurückzuführen. Die Analyse ergab, dass der Hauptvorteil der Impfung in der Verhinderung von Infektionen liegt. Infektionen nach einer Impfung hatten ein ähnliches Risiko für Long COVID wie Infektionen bei Ungeimpften. Die direkte Schutzwirkung der Impfung gegen die Entwicklung von Long COVID über die Infektionsverhinderung hinaus war dagegen begrenzt. Bedeutung für den öffentlichen Gesundheitssektor Die Ergebnisse unterstreichen die Notwendigkeit, SARS-CoV-2-Infektionen durch Impfprogramme weiterhin zu minimieren. Besonders die pädiatrische Bevölkerung profitiert von einer Impfung nicht nur durch den Schutz vor akuten Infektionen, sondern auch durch die Reduzierung des Risikos für langfristige gesundheitliche Folgen. Zudem liefert die Studie wichtige Erkenntnisse für die weitere Forschung. Sie zeigt, dass bisherige Studien, die den Infektionsstatus als Basis für die Bewertung der Impfwirkung auf Long COVID nutzten, möglicherweise Verzerrungen aufwiesen. Die hier angewandte Mediationsanalyse bietet einen präziseren Ansatz. Fazit Die BNT162b2-Impfung bietet signifikanten Schutz vor Long COVID bei Kindern und Jugendlichen, vor allem durch die Verhinderung von SARS-CoV-2-Infektionen. Diese Ergebnisse betonen die Bedeutung von Impfstrategien als zentrale Maßnahme zur Eindämmung der Pandemie und ihrer Langzeitfolgen. Die Studie stellt einen wichtigen Meilenstein dar, indem sie neue Erkenntnisse für eine gezielte Prävention von Long COVID in der jungen Bevölkerung liefert. Weitere Forschungen sind notwendig, um die Auswirkungen von Impfungen gegen neue Virusvarianten und langfristige Effekte weiterhin zu bewerten. > Zur Studie

ownload PDF Cite Set Alert Get Rights Reprints Previous article Next article Our recent study using data from more than 20 million participants has shown that COVID-19 vaccines consistently prevent long COVID symptoms in adults, with meta-analytic calibrated subdistribution hazard ratio (sHRs) of 0·54 (95% CI 0·44–0·67) in CPRD GOLD, 0·48 (0·34–0·68) in CPRD AURUM, 0·71 (0·55–0·91) in SIDIAP, and 0·59 (0·40–0·87) in CORIVA.1 In addition, when considering post-COVID thromboembolic and cardiovascular complications as outcomes of interest, recently published data have shown that vaccination with any COVID-19 first vaccine dose (ChAdOx1, BNT162b2, and mRNA-1273) is associated with reduced risk of post-acute heart failure (0·45 [0·38–0·53] 0–30 days after SARS-CoV-2 infection; 0·61 [0·51–0·73] 91–180 days after SARS-CoV-2 infection), venous thromboembolism (sHR 0·22 [95% CI 0·17–0·29] 0–30 days after SARS-CoV-2 infection; 0·53 [0·40–0·70] 91–180 days after SARS-CoV-2 infection), and arterial thrombosis (0·53 [0·44–0·63] 0–30 days after SARS-CoV-2 infection; 0·72 [0·58–0·88] 91–180 days after SARS-CoV-2 infection).2 With the use of the Observational Medical Outcomes Partnership (OMOP) common data model (CDM), all our analyses were conducted across three European countries (Estonia, Spain, and the UK) without transferring patient data, using federated analyses similar to those used by the European Medicines Agency-funded Data Analysis and Real World Interrogation Network.

Scientific Reports - Long-COVID in children and adolescents: a systematic review and meta-analyses

The psychological trauma following COVID-19 has been lengthy and fraught for some children and their families. The specific problems encountered by ch…

medRxiv - The Preprint Server for Health Sciences

The COVID-19 pandemic has prompted a quest to understand why certain individuals remain uninfected or asymptomatic despite repetitive exposure to SARS-CoV-2. Here, we focused on six exposed females residing with their symptomatic and reinfected SARS-CoV-2 PCR-positive COVID-19 partners. Peripheral blood mononuclear cell samples from couples were analysed for poly (I:C)-induced mRNA expression of type I/III interferons and interferon-stimulated genes (ISGs). Remarkably, we found a significant upregulation of the ISG interferon-inducible protein with tetrapeptide repeats 3 (IFIT3) gene exclusively in exposed uninfected or asymptomatic females, suggesting a potential role in protective immunity against symptomatic COVID-19.

Links between the complement and coagulation systems could lead to Long Covid therapies

Patients with post-COVID condition (PCC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience symptoms potentially associated with small fiber neuropathy (SFN). Methods A sample of 90 participants, comprising 30 PCC patients, 30 ME/CFS patients, and 30 healthy controls (HC), matched by sex and age, was assessed. Neuropathic, autonomic, and fatigue symptoms were measured with TaskForce Monitor, the Sudoscan, heat and cold evoked potentials, In Vivo Corneal Confocal Microscopy (IVCCM), and specialized questionaries. Results PCC and ME/CFS patients demonstrated significantly higher levels of autonomic symptoms (H = 39.89, p  0.001), neuropathic symptoms (H = 48.94, p  0.001), and fatigue (H = 49.29, p  0.001) compared to HC. Quantitative sensory testing revealed significant differences in heat detection thresholds between PCC patients and HC (F = 4.82; p  0.01). Regarding corneal small fiber tortuosity, there were statistically significant differences between patients and HC (F = 6.80; p  0.01), indicating pathological responses in patients. Small fiber tortuosity in IVCCM was identified as the main discriminator between patients and HC (AUC = 0.720; p  0.01). Conclusion PCC and ME/CFS patients demonstrated sensory SFN, as evidenced by impaired heat detection and increased tortuosity of small fibers in the central corneal subbasal plexus. The findings underscore the importance of a multimodal approach to comprehensively detect and characterize SFN. This study provides valuable scientific insights into the neuropathic manifestations associated with these conditions.

Medical News: Since the emergence of SARS-CoV-2 in late 2019, scientists have been trying to unravel the secrets behind its ability to cause disease. While some people experience only mild symptoms, others suffer from severe complications such as pneumonia, acute respiratory distress syndrome (ARDS), and even death. What makes the virus so dangerous in some cases? A team of researchers, led by Yi ...

Post-COVID-19 syndrome, referred to as “long COVID,” is characterized by persistent symptoms that develop during or after SRAS-CoV-2 infection lasting…

Inflammatory bowel disease (IBD) treatments and pregnancy can independently modulate immune responses, but the combined effects on SARS-CoV-2 vaccine-induced immunity are poorly understood. This study explores the efficacy of SARS-CoV-2 vaccination and placental antibody transfer among pregnant women with IBD on biologic therapies. This observational study included pregnant women with and without IBD from the PIANO and PREVENT-COVID studies and their neonates. We assessed anti-SARS-CoV-2 neutralizing antibody titers (NT50) in maternal and cord blood post-vaccination using a pseudotype neutralization assay and calculated placental transfer ratios. A total of 32 pregnant women participated, and 27 were exposed to a biologic medication during pregnancy. Neutralizing antibody titers were similar between biologic-treated and non-treated groups, and biologic-exposed women demonstrated robust placental transfer of neutralizing antibodies. Corticosteroid use during pregnancy was significantly associated with reduced placental transfer efficiency, although this effect was not significant in a sensitivity analysis excluding patients treated with immunomodulators. Vaccination timing and previous SARS-CoV-2 infection impacted maternal and cord antibody levels, with higher titers observed in those vaccinated before pregnancy or infected during pregnancy. Overall, our findings suggest that pregnant women with IBD on biologic therapies mount effective SARS-CoV-2 neutralizing antibody responses similar to their non-biologic-exposed counterparts, with efficient placental transfer. These findings support the safety and efficacy of SARS-CoV-2 vaccination in this population, although further research with larger cohorts is needed to explore the long-term protective effects of transferred antibodies in neonates. Corticosteroid use, immunomodulator use, and vaccination timing may influence antibody dynamics, underscoring the need for tailored clinical management in this vulnerable population.

A nanoengineered immunosensor uses machine learning to detect multiple biomarkers for rapid prediction of acute thrombosis.

Importance Existing systematic literature reviews (SLRs) on COVID-19 vaccine effectiveness (VE) against post-COVID-19 conditions (PCC) document high heterogeneity across studies, but have not compared VE across design features known to impact PCC burden or VE against other COVID-19 endpoints. Objective This SLR summarizes the evidence across studies among predominately adults that report an adjusted measure of association for the relationship between vaccination and PCC, by timing of vaccination relative to infection or PCC-onset and across different study characteristics. Evidence review A comprehensive search strategy was developed within the OVID platform across EMBASE, MEDLINE® and Evidence-Based Medicine reviews, and supplemented with WHO COVID library and Google Scholar® searches, to collate evidence on vaccination and PCC published or posted as pre-prints between January 1st, 2020 and July 18th, 2023. JBI Critical Appraisal Checklists were used to assess each study’s risk of bias. Findings This review included 97 studies and synthesized results from 56 studies with low risk of bias that reported adjusted measures for the association between vaccination and PCC. Overall, 77% of pre-infection adjusted VE (aVE) estimates (vs. unvaccinated) were statistically significant (range: 7%–95%), 80% of estimates reflecting a mix of those vaccinated before and after infection were statistically significant (range: 62%–73%), one of five estimates reflecting vaccination after PCC onset was statistically significant (aVE=41%), 43% of post-infection vaccination estimates were statistically significant (two were protective [range: 28%–40%] and one was not [aVE=-47%]), and 46% of estimates not specifying vaccination timing were statistically significant (23 were protective [range: 29%–75%] and one was not [aVE=-132%]). Statistically significant pre-infection aVE estimates were slightly higher for mRNA (range: 14%–84%) than non-mRNA vaccines (range: 16%–38%) and aVE ranges during (4 studies; range: 10%–70%) and before Omicron predominance (10 studies; range: 7%–50%) overlapped. Pre-infection vaccination was protective regardless of vaccine type, number of doses received, PCC definition, predominant variant, and severity of acute infections included. Conclusions and Relevance Collectively our findings suggest that COVID-19 vaccination received prior to SARS-CoV-2 infection reduces the subsequent risk of developing PCC regardless of the predominant variant circulating. Question Do measures of COVID-19 vaccine effectiveness against post-COVID-19 conditions (PCC) vary by timing of vaccine relative to SARS-CoV-2 infection or PCC onset, vaccine type and number of doses received, PCC definition, predominant SARS-CoV-2 variant, and disease severity? Findings COVID-19 vaccination before SARS-CoV-2 infection appeared to reduce the risk of PCC (vs. unvaccinated). Compared with other COVID-19 vaccine types, mRNA vaccines seemed to offer greater protection, and a dose response was observed for mRNA vaccines. Meaning Despite heterogeneity across included studies, pre-infection vaccination reduced the risk of ≥1 PCC, regardless of SARS-CoV-2 variant, proportion of sample hospitalized, and PCC definition. ### Competing Interest Statement Nadine Al Akoury, Moe H Kyaw, Abby E Rudolph, Julia Spinardi, and Hammam Haridy are employees of Pfizer Inc. and may hold stock or stock options. Kristen Markus, Isabelle Whittle, and Olivia Wright are employees of Adelphi Values PROVE. Adelphi Values PROVE received funding from the study sponsor for the conduct of the review. This manuscript nor one with substantially similar content has been published or is being considered for publication elsewhere from these authors. ### Funding Statement This study was funded by Pfizer Inc. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data supporting the findings of this study are available within the paper and its Supplementary Information.