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| Open AccessImpact of antigen test target failure and testing strategies on the transmission of SARS-CoV-2 variants
Increasing reliance on antigen tests for SARS-CoV-2 screening may risk selection for variants not detected by these tests. Here, the authors identify a variant of this type circulating in Italy, estimate the potential impact of failure to detect the variant, and model testing strategies to mitigate the risk.
- Claudia Del Vecchio
- , Bethan Cracknell Daniels
- & Andrea Crisanti
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Article
| Open AccessClinical severity of SARS-CoV-2 Omicron BA.4 and BA.5 lineages compared to BA.1 and Delta in South Africa
South Africa experienced a resurgence in COVID-19 in 2022 driven by Omicron subvariants BA.4 and BA.5. Here, the authors investigate the severity of infections caused by these subvariants, and find no difference in the risk of severe outcomes when compared to Omicron BA.1, whilst all Omicron subvariants were less severe than Delta.
- Nicole Wolter
- , Waasila Jassat
- & Cheryl Cohen
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Article
| Open AccessHousehold transmission of SARS-CoV-2 Omicron variant of concern subvariants BA.1 and BA.2 in Denmark
In this study, the authors use household data from Denmark to investigate the transmissibility of the BA.1 and BA.2 Omicron SARS-CoV-2 subvariants. They find that the secondary attack rate was higher for BA.2, but that it had higher infectiousness only when cases were not vaccinated.
- Frederik Plesner Lyngse
- , Carsten Thure Kirkeby
- & Laust Hvas Mortensen
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| Open AccessIncreased household transmission and immune escape of the SARS-CoV-2 Omicron compared to Delta variants
In this study the authors investigate household transmission of SARS-CoV-2 in Norway. They find that the secondary attack rate was higher for Omicron than Delta, but that among three-dose vaccinated contacts the secondary attack rate was lower for both variants compared to contacts with two doses.
- Neda Jalali
- , Hilde K. Brustad
- & Birgitte Freiesleben de Blasio
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Article
| Open AccessEffect of booster vaccination against Delta and Omicron SARS-CoV-2 variants in Iceland
Iceland has used four different SARS-CoV-2 vaccines in various combinations. Here, the authors describe differences in the immune responses elicited by different initial/booster vaccine combinations, and then use population-level data to assess the effects of booster doses against Delta and Omicron infection.
- Gudmundur L. Norddahl
- , Pall Melsted
- & Kari Stefansson
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Article
| Open AccessUsing multiple sampling strategies to estimate SARS-CoV-2 epidemiological parameters from genomic sequencing data
SARS-CoV-2 genome sequencing data can be used to infer epidemiological parameters, but the impact of the strategy used to select samples on these estimates is rarely considered. Here, the authors produce estimates using different sampling strategies and compare results to those based on case reporting data.
- Rhys P. D. Inward
- , Kris V. Parag
- & Nuno R. Faria
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Article
| Open AccessHousehold transmission of the SARS-CoV-2 Omicron variant in Denmark
In this study, the authors compare the transmission dynamics of the Delta and Omicron SARS-CoV-2 variants using household data from Denmark. They find that Omicron has a higher secondary attack rate, and that the odds of infection with Omicron was higher than with Delta, particularly for vaccinated individuals.
- Frederik Plesner Lyngse
- , Laust Hvas Mortensen
- & Carsten Thure Kirkeby
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Article
| Open AccessTracking changes in SARS-CoV-2 transmission with a novel outpatient sentinel surveillance system in Chicago, USA
In this study, the authors develop a method for estimation of SARS-CoV-2 community transmission rates based on a sentinel population of people seeking outpatient testing with recent symptom onset. This method has fewer operational delays than methods based on hospital data, and may be subject to fewer biases.
- Reese Richardson
- , Emile Jorgensen
- & Jaline Gerardin
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Article
| Open AccessThe impact of repeated rapid test strategies on the effectiveness of at-home antiviral treatments for SARS-CoV-2
Antiviral treatments for SARS-CoV-2 infection are only beneficial when used early in infection, so early case detection is important. Here, the authors assess the frequency of testing needed to achieve population-level benefits and demonstrate the importance of high coverage and short delays from test to treatment.
- Tigist F. Menkir
- & Christl A. Donnelly
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Article
| Open AccessDerivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults
Frailty is associated with an increased risk for negative health outcomes in older populations, and being able to predict frailty could facilitate prevention measures. By performing an epigenome-wide screen, the authors derived a DNA methylation based measure for frailty which can predict both prevalence and longer-term incidence of frailty.
- Xiangwei Li
- , Thomas Delerue
- & Hermann Brenner
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Article
| Open AccessGenomic surveillance of SARS-CoV-2 Omicron variants on a university campus
This study presents results from a SARS-CoV-2 genomic surveillance study at a university campus in which ~2,000 samples were sequenced over five months. The authors document the replacement of Delta with Omicron as the dominant variant, and describe clinical characteristics and transmission dynamics.
- Ana A. Weil
- , Kyle G. Luiten
- & Helen Y. Chu
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Article
| Open AccessInterrupted-time-series analysis of the immediate impact of COVID-19 mitigation measures on preterm birth in China
The broader impacts of COVID-19 mitigation measures may include changes in the incidence of preterm birth. Here, the authors use data from ~11.7 million pregnancies in China and find evidence of a small decline in preterm birth rates immediately following the implementation of COVID-19 mitigation measures.
- Yanxia Xie
- , Yi Mu
- & Jun Zhu
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Article
| Open AccessReproducibility of real-world evidence studies using clinical practice data to inform regulatory and coverage decisions
Analyses of real-world evidence from digital clinical practice data provide important insights for healthcare decision makers. Here, authors test reproducibility of 150 peer-reviewed studies, reporting strong reproducibility, which could be further improved through more complete reporting in future original studies
- Shirley V. Wang
- , Sushama Kattinakere Sreedhara
- & Deborah Zarin
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Article
| Open AccessA prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity
Some patients experience long-lasting symptoms after coronavirus disease (COVID-19). Here the authors report the clinical and laboratory parameters in patients with post-COVID-19 syndrome from a prospective observational cohort study.
- Claudia Kedor
- , Helma Freitag
- & Carmen Scheibenbogen
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Comment
| Open AccessCall for a unified approach to Monkeypox infection in pregnancy: Lessons from the COVID-19 pandemic
In the current monkeypox outbreak, vaccination and treatment of pregnant women are recommended only if the benefits outweigh risks, but the extremely sparse data available limit evidence-based recommendations. We must facilitate a unified consensus approach to rapidly collect robust data. Two years into the COVID-19 pandemic, monkeypox has emerged as yet another challenge to the mother-fetus dyad, potentially placing both at risk, if exposed.
- Asma Khalil
- , Athina Samara
- & Shamez Ladhani
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Article
| Open AccessInvestigating disparity in access to Australian clinical genetic health services for Aboriginal and Torres Strait Islander people
Globally it is recognised that Indigenous populations should be able to access the benefits of genomics and precision medicine. Here, authors show that there are disparities in access to clinical genetic health services for Aboriginal and/or Torres Strait Islander people in Australia.
- Joanne Luke
- , Philippa Dalach
- & Margaret Kelaher
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Article
| Open AccessComparison of the 2021 COVID-19 roadmap projections against public health data in England
The ’Roadmap’ for relaxation of COVID-19 restrictions in England in 2021 was informed by mathematical modelling. Here, the authors perform a retrospective assessment of the accuracy of modelling predictions and identify the main sources of uncertainty that led to observed values deviating from projections.
- Matt J. Keeling
- , Louise Dyson
- & Samuel Moore
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Article
| Open AccessModelling the medium-term dynamics of SARS-CoV-2 transmission in England in the Omicron era
This mathematical modelling study projects the dynamics of SARS-CoV-2 in England until the end of 2022 assuming that the Omicron BA.2 sublineage remains dominant. They show that booster vaccination was highly effective in mitigating severe outcomes and that future dynamics will depend greatly on assumptions about waning immunity.
- Rosanna C. Barnard
- , Nicholas G. Davies
- & W. John Edmunds
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Article
| Open AccessSARS-CoV-2 antibodies and breakthrough infections in the Virus Watch cohort
Here the authors provide data from a sub-cohort of the Virus Watch study (19,556 adults) who completed at-home capillary blood sampling on a monthly basis and describe an association between anti-spike antibody levels and risk of SARS-CoV-2 infection.
- Robert W. Aldridge
- , Alexei Yavlinsky
- & Andrew Hayward
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Article
| Open AccessTrends in COVID-19 hospital outcomes in England before and after vaccine introduction, a cohort study
This study investigates trends in mortality and length of stay for people hospitalised with COVID-19 in England until September 2021. It shows that risks were higher for unvaccinated people and those with multiple comorbidities, and that busier hospitals had higher mortality rates at the start of the pandemic but this effect lessened over time.
- Peter D. Kirwan
- , Andre Charlett
- & Anne M. Presanis
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Article
| Open AccessSecond-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
Here, Simpson et al. analyze data from 3.6 million COVID-19 vaccine second doses (ChAdOx1 and BNT162b2) in Scotland for risk of thrombocytopenic, thromboembolic and hemorrhagic events. Borderline increased risks of immune thrombocytopenic purpura and cerebral venous sinus thrombosis were found for the ChAdOx1 vaccine. These events were rare and usually short-lived.
- Colin R. Simpson
- , Steven Kerr
- & Aziz Sheikh
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Article
| Open AccessRegional connectivity drove bidirectional transmission of SARS-CoV-2 in the Middle East during travel restrictions
The dynamics of SARS-CoV-2 transmission in the Middle East have been relatively under-studied. Here, the authors integrate genomic and travel data and show that introductions to the region were initially driven by intercontinental air travel, after which regional land travel became a more important driver.
- Edyth Parker
- , Catelyn Anderson
- & Issa Abu-Dayyeh
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Article
| Open AccessVaccine effectiveness of CoronaVac against COVID-19 among children in Brazil during the Omicron period
There is limited evidence of the effectiveness of the CoronaVac vaccine for children against the Omicron SARS-CoV-2 variant. Here, the authors use data from Brazil for children aged 6–11 years and estimate effectiveness of 40% against infection and 59% against severe disease at least two weeks after the second dose.
- Pilar T. V. Florentino
- , Flávia J. O. Alves
- & Enny S. Paixão
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Article
| Open AccessEmpirical evidence on the efficiency of backward contact tracing in COVID-19
Backward contact tracing aims to identify individuals who were infected by the same person as infected an index case, and has been shown to be effective in modelling studies of SARS-COV-2. Here, the authors present empirical data of the effectiveness of backward contact tracing from a program amongst university students in Belgium.
- Joren Raymenants
- , Caspar Geenen
- & Emmanuel Andre
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Article
| Open AccessProtection of COVID-19 vaccination and previous infection against Omicron BA.1, BA.2 and Delta SARS-CoV-2 infections
The protection of COVID-19 vaccines against emerging variants needs to be monitored. Here, the authors use community testing data from the Netherlands and find that protection against infection by Omicron subvariants BA.1 and 2 is low and that booster vaccines considerably but temporarily increase protection.
- Stijn P. Andeweg
- , Brechje de Gier
- & Mirjam J. Knol
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Article
| Open AccessSARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings
Air surveillance offers a potential means of monitoring airborne pathogens without the need for individual sampling. Here, the authors perform continuous air sampling in 15 community settings in the US for 29 weeks and demonstrate its feasibility for routine detection of SARS-CoV-2 and other respiratory pathogens.
- Mitchell D. Ramuta
- , Christina M. Newman
- & Shelby L. O’Connor
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Comment
| Open AccessScience in the time of COVID-19: Reflections on the UK Events Research Programme
We reflect on the extent to which the UK Events Research Programme adhered to four principles of design and evaluation in assessing risk of transmission from attending such mass events as football matches and festivals, and lessons learned.
- Theresa M. Marteau
- , Michael J. Parker
- & W. John Edmunds
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Article
| Open AccessProtection of Omicron sub-lineage infection against reinfection with another Omicron sub-lineage
The level of immunity induced by infection with different SARS-CoV-2 Omicron sub-lineages against infection with other sub-lineages is not known. Here, the authors use data from Qatar and show that infection with BA.1 induces strong protection against infection with BA.2, and vice versa, for several weeks.
- Hiam Chemaitelly
- , Houssein H. Ayoub
- & Laith J. Abu-Raddad
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Article
| Open AccessA suite of PCR-LwCas13a assays for detection and genotyping of Treponema pallidum in clinical samples
Clinical diagnosis of Treponema pallidum subspecies pallidum (TPA), the causative agent of syphilis, depends upon serological testing, which has reduced sensitivity for some stages of the disease. Accompanying methods to complement serological testing also have distinct limitations. In this work, authors develop an assay that combines PCR with CRISPR-LwCas13a, and demonstrate sensitivity and specificity on clinically confirmed syphilis samples.
- Wentao Chen
- , Hao Luo
- & Heping Zheng
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Article
| Open AccessSystematic evidence and gap map of research linking food security and nutrition to mental health
There is a broad range of research available on the relationship between food security and mental health. Here the authors carry out a systematic mapping of evidence on food security and nutrition related to mental health and identifies trends in themes, setting, and study design over the 20 year period studied.
- Thalia M. Sparling
- , Megan Deeney
- & Suneetha Kadiyala
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Article
| Open AccessDynamics of a national Omicron SARS-CoV-2 epidemic during January 2022 in England
The REACT-1 study measures the community prevalence of SARS-CoV-2 in England through repeated cross-sectional surveys. Here, the authors present data from REACT-1 that document the increase in infection prevalence, particularly among children, associated with the Omicron variant in January 2022.
- Paul Elliott
- , Oliver Eales
- & Christl A. Donnelly
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Article
| Open AccessEffectiveness of REGEN-COV antibody combination in preventing severe COVID-19 outcomes
REGEN-COV is a SARS-CoV-2 combined monoclonal antibody treatment which has been shown to be effective in randomised controlled trials. Here, the authors assess its real-world effectiveness using data from Israel during the Delta wave and find that it reduced the risk of hospitalisation, severe disease and death.
- Samah Hayek
- , Yatir Ben-shlomo
- & Alon Peretz
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Article
| Open AccessLevels of SARS-CoV-2 antibodies among fully vaccinated individuals with Delta or Omicron variant breakthrough infections
The SARS-CoV-2 Omicron variant is associated with high rates of vaccine breakthrough infections, but the immunological basis for this is not well characterised. Here, the authors show that increased anti-Spike IgG antibody levels are associated with a reduced risk of infection with the Delta variant, but not with Omicron.
- Nina Breinholt Stærke
- , Joanne Reekie
- & Ole Schmeltz Søgaard
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Article
| Open AccessDynamics of competing SARS-CoV-2 variants during the Omicron epidemic in England
This study presents data from the REACT-1 SARS-CoV-2 community sampling study in England from November 2021 to March 2022. They show that the Omicron variant peaked in January with a prevalence of ~7% and that the BA.2 sublineage had a 1.5x higher reproduction number compared to other Omicron sublineages.
- Oliver Eales
- , Leonardo de Oliveira Martins
- & Marc Chadeau-Hyam
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Article
| Open AccessAn analysis of 45 large-scale wastewater sites in England to estimate SARS-CoV-2 community prevalence
Wastewater surveillance could provide a means of monitoring SARS-CoV-2 prevalence that does not rely on testing individuals. Here, the authors report results from England’s national wastewater surveillance program, use it to estimate prevalence, and compare estimates with those from population-based prevalence surveys.
- Mario Morvan
- , Anna Lo Jacomo
- & Leon Danon
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Article
| Open AccessA nationwide questionnaire study of post-acute symptoms and health problems after SARS-CoV-2 infection in Denmark
The health impacts associated with SARS-CoV-2 infection are still not well understood. Here, the authors report findings from a survey of ~150,000 people in Denmark, and identify elevated risks associated with testing positive for SARS-CoV-2 for a range of acute and post-acute symptoms and new diagnoses.
- Anna Irene Vedel Sørensen
- , Lampros Spiliopoulos
- & Anders Hviid
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Article
| Open AccessDuration of protection of CoronaVac plus heterologous BNT162b2 booster in the Omicron period in Brazil
Primary CoronaVac vaccination followed by a BNT162b2 booster dose confers protection against some SARS-CoV-2 variants but its effectiveness against Omicron is unknown. Here, the authors show that this combination confers a high level of protection against severe outcomes for up to 120 days, with evidence of waning for those aged 80 or older.
- Thiago Cerqueira-Silva
- , Vinicius de Araujo Oliveira
- & Manoel Barral-Netto
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Article
| Open AccessPost-recovery COVID-19 and incident heart failure in the National COVID Cohort Collaborative (N3C) study
The relationship between post-recovery COVID-19 and incident heart failure has not been investigated at scale. Here, the authors use electronic health records for ~600,000 patients in the US and find a higher rate of post-discharge incident heart failure in those hospitalised with COVID-19 than without.
- Husam M. Salah
- , Marat Fudim
- & Melissa C. Caughey
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Article
| Open AccessGenomic epidemiology of Delta SARS-CoV-2 during transition from elimination to suppression in Aotearoa New Zealand
Aotearoa New Zealand pursued a COVID-19 elimination strategy until October 2021 when it moved to a suppression strategy. In this genomic surveillance study, the authors describe spread of the virus during the transition between these strategies, with evidence of substantial undetected community transmission.
- Lauren Jelley
- , Jordan Douglas
- & Jemma L. Geoghegan
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Article
| Open AccessEffectiveness and protection duration of Covid-19 vaccines and previous infection against any SARS-CoV-2 infection in young adults
Here the authors estimate effectiveness of three COVID-19 vaccines in university students and find that 2-dose mRNA vaccines offer strong protection against general SARS-CoV-2 infection caused by delta, but protection substantially declines over 6 months. While previous infection protects against reinfection, vaccination substantially increases protection.
- Lior Rennert
- , Zichen Ma
- & Delphine Dean
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Article
| Open AccessThe effect of COVID certificates on vaccine uptake, health outcomes, and the economy
Many countries introduced COVID certificates that were required to access public venues. Here, the authors analyse data from France, Germany, and Italy, and estimate that these policies led to increased vaccine uptake of 6-13 percentage points with subsequent beneficial impacts on health and economic outcomes.
- Miquel Oliu-Barton
- , Bary S. R. Pradelski
- & Guntram B. Wolff
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Article
| Open AccessPopulation genomics of ancient and modern Trichuris trichiura
The whipworm Trichuris trichiura is a soil-transmitted helminth that causes the neglected tropical disease trichuriasis in humans. Here, the authors produce whole genome sequences of modern and ancient samples from humans and non-human primates to characterise the genomic diversity and evolution of this pathogen.
- Stephen R. Doyle
- , Martin Jensen Søe
- & Christian Moliin Outzen Kapel
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Article
| Open AccessInferring the epidemiological benefit of indoor vector control interventions against malaria from mosquito data
Estimating the effectiveness of malaria vector control interventions has typically relied on resource-intensive cluster randomised trials. Here, the authors estimate changes in malaria prevalence using entomological data from experimental hut trials, which may provide an alternative route to approval of interventions in some situations.
- Ellie Sherrard-Smith
- , Corine Ngufor
- & Thomas S. Churcher
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Article
| Open AccessEffect of vaccination on household transmission of SARS-CoV-2 Delta variant of concern
COVID-19 vaccines may reduce the susceptibility of an individual to infection and/or the infectiousness of breakthrough infections. Here, the authors use data from Denmark and estimate that vaccine effectiveness was 61% for susceptibility and 31% for infectiousness during a period of Delta variant dominance.
- Frederik Plesner Lyngse
- , Kåre Mølbak
- & Carsten Thure Kirkeby
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Article
| Open AccessSARS-CoV-2 antibody trajectories after a single COVID-19 vaccination with and without prior infection
The impact of prior infection on the immune response to COVID-19 vaccination has not been fully characterised. Here, the authors use data from ~100,000 adults in the UK and find that a single vaccine dose in those with prior infection produces a comparable or stronger response to two doses in those without infection.
- Jia Wei
- , Philippa C. Matthews
- & Chris Cunningham
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Article
| Open AccessLong COVID burden and risk factors in 10 UK longitudinal studies and electronic health records
Current understanding of Long COVID is limited, in part, due to lack of evidence from population-representative studies. Here, the authors analyse data from ten UK population-based studies and electronic health records, and find wide variation in the frequency of Long COVID between studies but some consistent risk factors.
- Ellen J. Thompson
- , Dylan M. Williams
- & Claire J. Steves
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Article
| Open AccessCOVID-19 disease severity in US Veterans infected during Omicron and Delta variant predominant periods
Infection with the SARS-CoV-2 Omicron variant appears to cause milder disease in the general population than infection with Delta. Here the authors use data from the US Department of Veterans Affairs and demonstrate that this also applies to infection in an at-risk population of older age and with more co-morbidities.
- Florian B. Mayr
- , Victor B. Talisa
- & Adeel A. Butt
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Article
| Open AccessAge and sex-specific risks of myocarditis and pericarditis following Covid-19 messenger RNA vaccines
There have been reports of myocarditis and pericarditis following mRNA COVID-9 vaccination. Here, the authors use nationwide data from France and find increased risks of these outcomes in the first week following vaccination, for both the first and second dose, and present age- and sex-specific rates.
- Stéphane Le Vu
- , Marion Bertrand
- & Mahmoud Zureik
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Article
| Open AccessContribution of low population immunity to the severe Omicron BA.2 outbreak in Hong Kong
Hong Kong experienced a severe wave of SARS-CoV-2 in early 2022. Here, the authors use genomic and serosurveillance data and show that this wave was dominated by the Omicron BA.2 sublineage, and that low protective immunity, particularly in older age groups, contributed to its severity.
- Lin-Lei Chen
- , Syed Muhammad Umer Abdullah
- & Kelvin Kai-Wang To