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Vaccine effectiveness against hospitalization among adolescent and pediatric SARS-CoV-2 cases between May 2021 and January 2022 in Ontario, Canada: A retrospective cohort study
Vaccine effectiveness against hospitalization among adolescent and pediatric SARS-CoV-2 cases between May 2021 and January 2022 in Ontario, Canada: A retrospective cohort study
Background Vaccines against SARS-CoV-2 have been shown to reduce risk of infection as well as severe disease among those with breakthrough infection in adults. The latter effect is particularly important as immune evasion by Omicron variants appears to have made vaccines less effective at preventing infection. Therefore, we aimed to quantify the protection conferred by mRNA vaccination against hospitalization due to SARS-CoV-2 in adolescent and pediatric populations. Methods We retrospectively created a cohort of reported SARS-CoV-2 case records from Ontario’s Public Health Case and Contact Management Solution among those aged 4 to 17 linked to vaccination records from the COVaxON database on January 19, 2022. We used multivariable logistic regression to estimate the association between vaccination and hospitalization among SARS-CoV-2 cases prior to and during the emergence of Omicron. Results We included 62 hospitalized and 27,674 non-hospitalized SARS-CoV-2 cases, with disease onset from May 28, 2021 to December 4, 2021 (Pre-Omicron) and from December 23, 2021 to January 9, 2022 (Omicron). Among adolescents, two mRNA vaccine doses were associated with an 85% (aOR = 0.15; 95% CI: [0.04, 0.53]; p
·journals.plos.org·
Vaccine effectiveness against hospitalization among adolescent and pediatric SARS-CoV-2 cases between May 2021 and January 2022 in Ontario, Canada: A retrospective cohort study
Neurocognitive and psychiatric symptoms following infection with COVID-19: Evidence from laboratory and population studies
Neurocognitive and psychiatric symptoms following infection with COVID-19: Evidence from laboratory and population studies
The objective of the current investigation was to examine associations between symptomatic COVID-19 history, neurocognitive function, and psychiatric …
·sciencedirect.com·
Neurocognitive and psychiatric symptoms following infection with COVID-19: Evidence from laboratory and population studies
An Oral Galectin Inhibitor in COVID-19—A Phase II Randomized Controlled Trial
An Oral Galectin Inhibitor in COVID-19—A Phase II Randomized Controlled Trial
Background: SARS-CoV-2 vaccines play an important role in reducing disease severity, hospitalization, and death, although they failed to prevent the transmission of SARS-CoV-2 variants. Therefore, an effective inhibitor of galectin-3 (Gal-3) could be used to treat and prevent the transmission of COVID-19. ProLectin-M (PL-M), a Gal-3 antagonist, was shown to interact with Gal-3 and thereby prevent cellular entry of SARS-CoV-2 in previous studies. Aim: The present study aimed to further evaluate the therapeutic effect of PL-M tablets in 34 subjects with COVID-19. Methods: The efficacy of PL-M was evaluated in a randomized, double-blind, placebo-controlled clinical study in patients with mild to moderately severe COVID-19. Primary endpoints included changes in the absolute RT-PCR Ct values of the nucleocapsid and open reading frame (ORF) genes from baseline to days 3 and 7. The incidence of adverse events, changes in blood biochemistry, inflammatory biomarkers, and levels of antibodies against COVID-19 were also evaluated as part of the safety evaluation. Results: PL-M treatment significantly (p = 0.001) increased RT-PCR cycle counts for N and ORF genes on days 3 (Ct values 32.09 ± 2.39 and 30.69 ± 3.38, respectively) and 7 (Ct values 34.91 ± 0.39 and 34.85 ± 0.61, respectively) compared to a placebo treatment. On day 3, 14 subjects in the PL-M group had cycle counts for the N gene above the cut-off value of 29 (target cycle count 29), whereas on day 7, all subjects had cycle counts above the cut-off value. Ct values in placebo subjects were consistently less than 29, and no placebo subjects were RT-PCR-negative until day 7. Most of the symptoms disappeared completely after receiving PL-M treatment for 7 days in more patients compared to the placebo group. Conclusion: PL-M is safe and effective for clinical use in reducing viral loads and promoting rapid viral clearance in COVID-19 patients by inhibiting SARS-CoV-2 entry into cells through the inhibition of Gal-3.
·mdpi.com·
An Oral Galectin Inhibitor in COVID-19—A Phase II Randomized Controlled Trial
Real time analysis of SARS-CoV-2 induced cytolysis reveals distinct variant-specific replication profiles
Real time analysis of SARS-CoV-2 induced cytolysis reveals distinct variant-specific replication profiles
The continuous evolution of new SARS-CoV-2 variants with enhanced immune evasion capacity suggests the entire population is and will continue to be potentially vulnerable to infection despite pre-existing immunity. The ability of each new variant to evade host humoral immunity is the focus of intense research across the globe. Each variant may also harbor unique replication capabilities relevant for disease and transmission. Here we demonstrate the utility of a new approach to assessing viral replication kinetics using Real Time Cell Analysis (RTCA). Virus induced cell death is measured in real time by the detection of electrical impedance through cell monolayers. Using this system, we quantified replication kinetics of five clinically important viral variants; USA WA1/2020 (an A1 ancestral lineage isolate), Delta, and Omicron subvariants BA.1, BA.4, and BA.5. We identified multiple kinetic measures that proved useful in variant replication comparisons including time (in hours) to the maximum rate of cell death at each log10 viral dilution and the slope at the maximum rate of cell death. We found that WA1/2020 and Delta were the most rapid but in distinct ways. While WA1/2020 induced cell death most rapidly after inoculation, Delta was slightly slower to reach cell death, it appeared to kill cells faster once cytotoxic effects began. Interestingly, BA.1, showed substantially reduced replication kinetics relative to all other variants. Together, these data show that real time analysis of cell death is a robust method to assess replicative capacity of any given SARS-CoV-2 variant rapidly and quantitatively, which may be useful in assessment of newly emerging variants. ### Competing Interest Statement The authors have declared no competing interest.
·biorxiv.org·
Real time analysis of SARS-CoV-2 induced cytolysis reveals distinct variant-specific replication profiles
The Effects of COVID-19 on the Placenta During Pregnancy
The Effects of COVID-19 on the Placenta During Pregnancy
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The virus primarily affects the lungs where it induces respiratory distress syndrome ranging from mild to acute, however, there is a growing body of evidence supporting its negative effects on other system organs that also carry the ACE2 receptor, such as the placenta. The majority of newborns delivered from SARS-CoV-2 positive mothers test negative following delivery, suggesting that there are protective mechanisms within the placenta. There appears to be a higher incidence of pregnancy-related complications in SARS-CoV-2 positive mothers, such as miscarriage, restricted fetal growth, or still-birth. In this review, we discuss the pathobiology of COVID-19 maternal infection and the potential adverse effects associated with viral infection, and the possibility of transplacental transmission.
·frontiersin.org·
The Effects of COVID-19 on the Placenta During Pregnancy
Immungedächtnis nach SARS-CoV-2: Eine COVID-Infektion schützt mindestens so gut wie die Impfung
Immungedächtnis nach SARS-CoV-2: Eine COVID-Infektion schützt mindestens so gut wie die Impfung
Immunität muss reifen, die Entwicklung eines abwehrbereiten Immungedächtnisses benötigt Zeit. Das kann auch bei einer SARS-CoV-2-Infektion gut gelingen, wie aus einer aktuellen Metaanalyse hervorgeht. Mit dem Stichtag 28. Februar 2023 waren in...
·aerzteblatt.de·
Immungedächtnis nach SARS-CoV-2: Eine COVID-Infektion schützt mindestens so gut wie die Impfung
Effectiveness of HEPA Filters at Removing Infectious SARS-CoV-2 from the Air - PubMed
Effectiveness of HEPA Filters at Removing Infectious SARS-CoV-2 from the Air - PubMed
Coronavirus disease 2019 (COVID-19) spreads by airborne transmission; therefore, the development and functional evaluation of air-cleaning technologies are essential for infection control. Air filtration using high-efficiency particulate air (HEPA) filters may be effective; however, no quantitative …
·pubmed.ncbi.nlm.nih.gov·
Effectiveness of HEPA Filters at Removing Infectious SARS-CoV-2 from the Air - PubMed
Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis
Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis
The COVID-19 pandemic represents one of the world’s most important challenges for global public healthcare. Various studies have found an association between severe vitamin D deficiency and COVID-19-related outcomes. Vitamin D plays a crucial role in immune function and inflammation. Recent data have suggested a protective role of vitamin D in COVID-19-related health outcomes. The purpose of this meta-analysis and trial sequential analysis (TSA) was to better explain the strength of the association between the protective role of vitamin D supplementation and the risk of mortality and admission to intensive care units (ICUs) in patients with COVID-19. Methods: We searched four databases on 20 September 2022. Two reviewers screened the randomized clinical trials (RCTs) and assessed the risk of bias, independently and in duplicate. The pre-specified outcomes of interest were mortality and ICU admission. Results: We identified 78 bibliographic citations. After the reviewers’ screening, only five RCTs were found to be suitable for our analysis. We performed meta-analyses and then TSAs. Vitamin D administration results in a decreased risk of death and ICU admission (standardized mean difference (95% CI): 0.49 (0.34–0.72) and 0.28 (0.20–0.39), respectively). The TSA of the protective role of vitamin D and ICU admission showed that, since the pooling of the studies reached a definite sample size, the positive association is conclusive. The TSA of the protective role of vitamin D in mortality risk showed that the z-curve was inside the alpha boundaries, indicating that the positive results need further studies. Discussion: The results of the meta-analyses and respective TSAs suggest a definitive association between the protective role of vitamin D and ICU hospitalization.
4. ConclusionsThe current evidence supports the benefits of vitamin D interventions in patients hospitalized with COVID-19 due to the protective effect provided by vitamin D against ICU admission and mortality. A meta-analysis per se does not allow us to state whether the results are truly positive or false-positive. In addition, the inclusion of studies with large effect sizes and significant heterogeneity separates us from the truth. For this reason, a TSA is mandatory to verify the reliability of meta-analysis results [92]. In conclusion, the positive results highlighted again and now validated by TSAs suggest that an indisputable association between vitamin D supplementation and the protective effect on ICU admission can be considered definitive evidence. On the contrary, further studies are needed to assess the utilization of vitamin D regarding the risk of death in patients hospitalized with COVID-19.
·ncbi.nlm.nih.gov·
Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis
Ergänzende Behandlung mit Curcumin, Quercetin und Vitamin D bei mildem/moderatem COVID-19 • DGP
Ergänzende Behandlung mit Curcumin, Quercetin und Vitamin D bei mildem/moderatem COVID-19 • DGP
Eine Pilotstudie untersuchte den Effekt einer ergänzenden Behandlung bei mildem bis moderatem COVID-19. Die Nahrungsergänzung beinhaltete Curcumin (aus Kurkuma), Quercetin (z.B. Blattgemüse und Brokkoli) und Vitamin D (Sonnenvitamin), die als entzündungshemmend und antiviral bekannt sind. Mit Hilfe der Ergänzungstherapie in der Frühphase der Erkrankung wurden Patienten schneller wieder negativ getestet. Akutsymptome klärten sich schneller als in der Kontrollgruppe. Blutwerte deuteten zudem darauf, dass die Nahrungsergänzung entzündlichen Prozessen bei COVID-19 entgegenwirkte.
·deutschesgesundheitsportal.de·
Ergänzende Behandlung mit Curcumin, Quercetin und Vitamin D bei mildem/moderatem COVID-19 • DGP
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study
Myocarditis and pericarditis are potential post-acute cardiac sequelae of COVID-19 infection, arising from adaptive immune responses. We aimed to study the incidence of post-acute COVID-19 myocarditis and pericarditis. Retrospective cohort study of 196,992 adults after COVID-19 infection in Clalit Health Services members in Israel between March 2020 and January 2021. Inpatient myocarditis and pericarditis diagnoses were retrieved from day 10 after positive PCR. Follow-up was censored on 28 February 2021, with minimum observation of 18 days. The control cohort of 590,976 adults with at least one negative PCR and no positive PCR were age- and sex-matched. Since the Israeli vaccination program was initiated on 20 December 2020, the time-period matching of the control cohort was calculated backward from 15 December 2020. Nine post-COVID-19 patients developed myocarditis (0.0046%), and eleven patients were diagnosed with pericarditis (0.0056%). In the control cohort, 27 patients had myocarditis (0.0046%) and 52 had pericarditis (0.0088%). Age (adjusted hazard ratio [aHR] 0.96, 95% confidence interval [CI]; 0.93 to 1.00) and male sex (aHR 4.42; 95% CI, 1.64 to 11.96) were associated with myocarditis. Male sex (aHR 1.93; 95% CI 1.09 to 3.41) and peripheral vascular disease (aHR 4.20; 95% CI 1.50 to 11.72) were associated with pericarditis. Post COVID-19 infection was not associated with either myocarditis (aHR 1.08; 95% CI 0.45 to 2.56) or pericarditis (aHR 0.53; 95% CI 0.25 to 1.13). We did not observe an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from COVID-19 infection.
·mdpi.com·
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study
The potential impacts of obesity on COVID-19
The potential impacts of obesity on COVID-19
Obese patients are at increased risk of exacerbations from viral respiratory infections. During the H1N1 pandemic, obesity was associated with an increased risk of influenza-associated intensive care unit (ICU) admission and death, longer duration of mechanical ventilation, and longer duration of ICU and hospital length of stay compared with the non-obese. These observations have raised a concern about the correlation between obesity and the current COVID-19 pandemic. In this review, we have outlined the potential impacts of obesity on respiratory physiology and the function of both innate and adaptive immune responses. Also, it has been clearly illustrated that obese patients are potentially more vulnerable to COVID-19 and more contagious than lean patients. The comorbidities associated with obesity were found to be correlated with a severe clinical course of COVID-19 and increased mortality and high BMI has been shown to be correlated with hospitalisation, the need for mechanical ventilation and non-survival. The review also sheds light on the challenges that obese patients pose for healthcare providers inside and outside ICUs.
·rcpjournals.org·
The potential impacts of obesity on COVID-19
Defining post-acute COVID-19 syndrome (PACS) by an epigenetic biosignature in peripheral blood mononuclear cells - Clinical Epigenetics
Defining post-acute COVID-19 syndrome (PACS) by an epigenetic biosignature in peripheral blood mononuclear cells - Clinical Epigenetics
Post-acute COVID-19 syndrome (PACS) has been defined as symptoms persisting after clearance of a COVID-19 infection. We have previously demonstrated that alterations in DNA methylation (DNAm) status persist in individuals who recovered from a COVID-19 infection, but it is currently unknown if PACS is associated with epigenetic changes. We compared DNAm patterns in patients with PACS with those in controls and in healthy COVID-19 convalescents and found a unique DNAm signature in PACS patients. This signature unravelled modified pathways that regulate angiotensin II and muscarinic receptor signalling and protein–protein interaction networks that have bearings on vesicle formation and mitochondrial function.
·clinicalepigeneticsjournal.biomedcentral.com·
Defining post-acute COVID-19 syndrome (PACS) by an epigenetic biosignature in peripheral blood mononuclear cells - Clinical Epigenetics
Forecasting the trajectory of the COVID-19 pandemic into 2023 under plausible variant and intervention scenarios: a global modelling study
Forecasting the trajectory of the COVID-19 pandemic into 2023 under plausible variant and intervention scenarios: a global modelling study
Background The recent Omicron-related waves of the COVID-19 pandemic have resulted in unprecedented levels of population transmission due to the variant’s high level of infectiousness across most of the world. China, the last large country to end its “zero-COVID” policies, is currently facing its own massive Omicron-related wave, and the final impact of that wave remains uncertain. We have seen repeatedly that the epidemiological characteristics of new variants can have profound impacts on global health outcomes. While the characteristics of these new variants are difficult to predict ahead of their emergence, considering the impact of potential future scenarios is of central importance for prudent planning and policy making. This paper samples across a range of potential variant-level characteristics to provide global forecasts of infections, hospitalisations, and deaths in the face of ongoing Omicron-related transmission and waning levels of past immunity and evaluates a range of interventions that may diminish the impact of future waves. Methods We created a susceptible-exposed-infectious dynamic model that accounts for vaccine uptake and effectiveness, antiviral administration, the emergence of new variants, and waning protection from both infection- and vaccine-derived immunity. Using this model, we first estimated past infections, hospitalisations, and deaths by variant, location, and day. We used these findings to more fully understand the global progression of the COVID-19 pandemic through December 12, 2022. Second, we forecasted these same outcome measures under five potential variant emergence scenarios. Third, we evaluated three different interventions in isolation and in concert within each potential variant scenario, to assess the impact of available intervention strategies through June 30, 2023. Findings We estimated that from November 15, 2021, through December 12, 2022, there were 8.60 billion (95% uncertainty interval [UI] 6.37–11.7) SARS-CoV-2 infections, 13.1 million (10.6–16.5) hospitalisations, and 3.04 million (2.65–3.55) deaths, the majority of which were attributable to Omicron variants (98.5% [97.4–99.1] of infections, 82.6% [76.7–86.3] of hospitalisations, and 72.4% [66.4–76.0] of deaths). Compared to the pre-Omicron pandemic period from January 1, 2020, to November 15, 2021, we estimated that there were more than twice as many infections (214% [163–286]) globally from November 15, 2021, to December 12, 2022, but only 20.6% (19.8–21.4) of the estimated deaths. The massive Omicron waves and high vaccination rates in many high-income countries have together contributed to high levels of immunity against SARS-CoV-2 infection, leaving only 97.3% (96.3–98.2) of the global population with no protection as of December 1, 2022. Concurrently, however, China, where only 17.6% [5.28–34.8] of the population have ever experienced infection due to its zero-COVID policy, requires special attention over the next few months, as all our future scenarios predict substantial increases in transmission, hospitalisation, and death in China in now that zero-COVID policies have been relaxed. Under the future scenario we consider most plausible (a scenario with another new Omicron-like variant emerging and reference levels of the drivers of transmission), we estimated there will be an additional 5.19 billion (3.11–7.78) infections, 13.6 million (8.50–21.8) hospitalisations, and 2.74 million (1.40–5.68) deaths between December 12, 2022, and June 30, 2023, with the Western Pacific region projected to sustain the highest rates of additional deaths, driven primarily by the uncontained outbreak in China. By comparison, a baseline scenario in which no new variant emerges results in 3.54 billion (2.24–5.43) infections, 6.26 million (4.11–9.65) hospitalisations, and 1.58 million (0.829–3.95) deaths in the same forecast period. The ability for a new variant to break through past infection- and vaccine-derived immunity greatly influences future outcomes: we estimate a new variant with the high severity of Delta, but correspondingly moderate immunity breakthrough rates will have difficulty overtaking current variants and will result in similar outcomes to the Omicron-like variant scenario with 3.64 billion (2.26–5.83) new infections, 7.87 million (4.81–13.0) new hospitalisations, and 2.87 million (1.03–5.56) new deaths. Finally, if we consider a variant that combines the high infectiousness and breakthrough rates of Omicron with the high severity of Delta, we again estimate 5.19 billion (3.11–7.78) new infections, but due to the presumed increase in severe outcomes, we estimate 30.2 million (13.4–51.2) new hospitalisations and 15.9 million (4.31–35.9) deaths over the forecasted period. The impacts of interventions vary by variant characteristics and region of the world, with increased mask usage and reimplementation of some mandates having massive impact in some regions while having less impact in others. Finally, assuming variant spread was as rapid as observed for Omicron, we find almost no impact of a rapidly developed and deployed variant-targeted booster. Interpretation As infection-derived and vaccine-conferred protection wanes, we expect infections to rise, but as most of the world’s population has some level of immunity to SARS-CoV-2 as of December 12, 2022, all but the most pessimistic forecasts in this analysis do not predict a massive global surge by June 30, 2023. Paradoxically, China, due to its lower levels of population immunity and effective vaccination will likely experience substantial numbers of infections and deaths that, due to its large population size, will adversely affect the global toll. This could be substantially mitigated by existing intervention options including masking, vaccination, health-care preparedness, and effective antiviral compounds for those at most at risk of poor outcomes. While still resulting in morbidity and mortality, this endemic transmission provides protection from less transmissible variants and particularly protects against sub-lineages of the more severe pre-Omicron variants. In the scenarios where a new variant does emerge and spread globally, however, the speed of this spread may be too fast to rely on even the most quickly developed mRNA vaccines to provide protection soon enough. Existing vaccines and boosters have played an important role in increasing immunity worldwide, but the continued contribution of mask usage (both past and future) in the prevention of infection and death cannot be understated. The characteristics of future COVID-19 variants are inherently difficult to predict, and our forecasts do show considerable differences in outcomes as a function of these variant properties. Given the uncertainty surrounding what type of variant will next emerge, the world would be wise to remain vigilant in 2023 as we move to the next phase of the COVID-19 pandemic. Funding Bill & Melinda Gates Foundation, J. Stanton, T. Gillespie, and J. and E. Nordstrom. Evidence before this study Since the beginning of the COVID-19 pandemic, there have been a plethora of COVID-19 models developed; most were designed to focus on a specific location (or small set of locations) and a short time horizon (usually less than a month). A number of modelling consortiums were created to develop ensemble predictions across models of this sort (e.g., the COVID-19 Forecast Hub [maintained by the Reich Lab of the University of Massachusetts Amherst in collaboration with USA CDC (Centers for Disease Control)] or the European COVID-19 Forecast Hub [created by a multitude of infectious disease modelling teams and coordinated by ECDC (European Centre for Disease Prevention and Control)]), and the final results typically predicted four weeks, and at most, six weeks forward. The models combined for these ensembles ran the spectrum from transmission dynamic models that incorporated complex mixing patterns between individuals, to machine learning models that were agnostic of the fact that the input and output were associated with infectious diseases. Moreover, most of these models were designed to predict the most likely outcome as opposed to evaluate potential future scenarios. A small subset of these models were created with this sort of flexibility, though they have primarily been applied to limited global regions (e.g., USA CDC scenarios) and they typically do not evaluate multiple potential scenarios three to six months into the future. The Institute for Health Metrics and Evaluation (IHME) COVID-19 model has been generating and publishing forecasts of SARS-CoV-2 infections and COVID-19 deaths globally with four-month time horizons and making these available at mostly weekly intervals on its website since March 26, 2020 (). The cadence has now slowed to monthly updates as in many parts of the world, data needed to support the modelling of COVID-19 have reduced and/or ceased to be collected as the attention of policy makers and funders is drawn elsewhere. Several epidemiological scenarios have been evaluated in these online estimates, but the outcomes have not been formally compared across these scenarios globally into 2023. This article is also the first full formal documentation of the IHME-SEI model incorporating foundation work on infection–fatality ratio, more robust cumulative infection calculations, as well as more recently developed work that allows for waning immunity. Added value of this study To our knowledge, this study is the first to forecast multiple future COVID-19 scenarios of variant emergence against a background of high rates of past SARS-CoV-2 exposure globally, nationally, and for a set of subnational locations, six months into the future. It is also one of the first to forecast the impact of China relaxing its zero-COVID policy. The scenarios considered were selected to represent a range of realistic potential futures and are directly comparable by region, country...
·medrxiv.org·
Forecasting the trajectory of the COVID-19 pandemic into 2023 under plausible variant and intervention scenarios: a global modelling study
Multiomic characterisation of the long-term sequelae of SARS survivors: a clinical observational study
Multiomic characterisation of the long-term sequelae of SARS survivors: a clinical observational study
Although health outcomes continued to improve, our study suggested that SARS survivors still suffered from physical fatigue, osteoporosis, and necrosis of the femoral head 18 years after discharge, possibly related to plasma metabolic disorders and immunological alterations.
·thelancet.com·
Multiomic characterisation of the long-term sequelae of SARS survivors: a clinical observational study