Severe acute respiratory syndrome coronavirus 2 antibody prevalence in adult patients with short bowel syndrome—A German multicenter cross‐sectional study

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Abstract

Background

Not all patients suffer from a severe course of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, demanding a definition of groups at risk. Short bowel syndrome (SBS) has been assumed to be a risk factor, because of the complexity of disease, the need for interdisciplinary care, and frequent contact with caretakers. We aimed to establish data on the course of infection and prevalence of SARS‐CoV‐2 seropositivity in SBS patients in Germany.

Methods

From January 2021 until January 2022 a total of 119 patients from three different tertiary care centers with SBS were included. All patients received an antibody test against the nucleocapsid (N) antigen and were asked to fill out a questionnaire, which included frequency of contact with medical personnel, risk behavior and worries.

Results

Sixty‐seven percent of SBS patients received parenteral nutrition with a median of 6 days per week. The seroprevalence of SARS‐CoV‐2 antibodies was 7.6% ( n = 9). Seven patients with positive antibodies had coronavirus disease 2019 (COVID‐19) with a mild course. None of the patients were hospitalized or needed further treatment. There was no difference in willingness to take risks in SARS‐CoV‐2 antibody–positive and –negative patients ( P = 0.61). Patients were predominantly worried about the economy (61%) and transmitting COVID‐19 (52%), less frequent (26%) about receiving insufficient medical treatment.

Conclusion

These are the first clinical results concerning SARS‐CoV‐2 seropositivity and COVID‐19 disease in patients with SBS. The seropositivity is comparable to national data, which we attribute to increased risk awareness and avoidance. Further studies are warranted to investigate effects of COVID‐19 infection in SBS patients.

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Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study

Tommy Nyberg, Neil M Ferguson, Sophie Nash … (2022)

Background The omicron variant (B.1.1.529) of SARS-CoV-2 has demonstrated partial vaccine escape and high transmissibility, with early studies indicating lower severity of infection than that of the delta variant (B.1.617.2). We aimed to better characterise omicron severity relative to delta by assessing the relative risk of hospital attendance, hospital admission, or death in a large national cohort. Methods Individual-level data on laboratory-confirmed COVID-19 cases resident in England between Nov 29, 2021, and Jan 9, 2022, were linked to routine datasets on vaccination status, hospital attendance and admission, and mortality. The relative risk of hospital attendance or admission within 14 days, or death within 28 days after confirmed infection, was estimated using proportional hazards regression. Analyses were stratified by test date, 10-year age band, ethnicity, residential region, and vaccination status, and were further adjusted for sex, index of multiple deprivation decile, evidence of a previous infection, and year of age within each age band. A secondary analysis estimated variant-specific and vaccine-specific vaccine effectiveness and the intrinsic relative severity of omicron infection compared with delta (ie, the relative risk in unvaccinated cases). Findings The adjusted hazard ratio (HR) of hospital attendance (not necessarily resulting in admission) with omicron compared with delta was 0·56 (95% CI 0·54–0·58); for hospital admission and death, HR estimates were 0·41 (0·39–0·43) and 0·31 (0·26–0·37), respectively. Omicron versus delta HR estimates varied with age for all endpoints examined. The adjusted HR for hospital admission was 1·10 (0·85–1·42) in those younger than 10 years, decreasing to 0·25 (0·21–0·30) in 60–69-year-olds, and then increasing to 0·47 (0·40–0·56) in those aged at least 80 years. For both variants, past infection gave some protection against death both in vaccinated (HR 0·47 [0·32–0·68]) and unvaccinated (0·18 [0·06–0·57]) cases. In vaccinated cases, past infection offered no additional protection against hospital admission beyond that provided by vaccination (HR 0·96 [0·88–1·04]); however, for unvaccinated cases, past infection gave moderate protection (HR 0·55 [0·48–0·63]). Omicron versus delta HR estimates were lower for hospital admission (0·30 [0·28–0·32]) in unvaccinated cases than the corresponding HR estimated for all cases in the primary analysis. Booster vaccination with an mRNA vaccine was highly protective against hospitalisation and death in omicron cases (HR for hospital admission 8–11 weeks post-booster vs unvaccinated: 0·22 [0·20–0·24]), with the protection afforded after a booster not being affected by the vaccine used for doses 1 and 2. Interpretation The risk of severe outcomes following SARS-CoV-2 infection is substantially lower for omicron than for delta, with higher reductions for more severe endpoints and significant variation with age. Underlying the observed risks is a larger reduction in intrinsic severity (in unvaccinated individuals) counterbalanced by a reduction in vaccine effectiveness. Documented previous SARS-CoV-2 infection offered some protection against hospitalisation and high protection against death in unvaccinated individuals, but only offered additional protection in vaccinated individuals for the death endpoint. Booster vaccination with mRNA vaccines maintains over 70% protection against hospitalisation and death in breakthrough confirmed omicron infections. Funding Medical Research Council, UK Research and Innovation, Department of Health and Social Care, National Institute for Health Research, Community Jameel, and Engineering and Physical Sciences Research Council.

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Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers

Sheila Lumley, Denise O’Donnell, Nicole Stoesser … (2020)

Abstract Background The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. Methods We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. Results A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike–seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike–seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P=0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status. Conclusions The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.)

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Global Percentage of Asymptomatic SARS-CoV-2 Infections Among the Tested Population and Individuals With Confirmed COVID-19 Diagnosis : A Systematic Review and Meta-analysis

Qiuyue Ma, Jue Liu, Qiao Liu … (2021)

Question What is the percentage of asymptomatic individuals with positive test results for SARS-CoV-2 among tested individuals and those with confirmed COVID-19 diagnosis? Findings In this systematic review and meta-analysis of 95 unique studies with 29 776 306 individuals undergoing testing, the pooled percentage of asymptomatic infections was 0.25% among the tested population and 40.50% among the population with confirmed COVID-19. Meaning The high percentage of asymptomatic infections from this study highlights the potential transmission risk of asymptomatic infections in communities. This systematic review and meta-analysis evaluated the percentage of asymptomatic COVID-19 infections among individuals undergoing testing and those with confirmed infections. Importance Asymptomatic infections are potential sources of transmission for COVID-19. Objective To evaluate the percentage of asymptomatic infections among individuals undergoing testing (tested population) and those with confirmed COVID-19 (confirmed population). Data Sources PubMed, EMBASE, and ScienceDirect were searched on February 4, 2021. Study Selection Cross-sectional studies, cohort studies, case series studies, and case series on transmission reporting the number of asymptomatic infections among the tested and confirmed COVID-19 populations that were published in Chinese or English were included. Data Extraction and Synthesis This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Random-effects models were used to estimate the pooled percentage and its 95% CI. Three researchers performed the data extraction independently. Main Outcomes and Measures The percentage of asymptomatic infections among the tested and confirmed populations. Results Ninety-five unique eligible studies were included, covering 29 776 306 individuals undergoing testing. The pooled percentage of asymptomatic infections among the tested population was 0.25% (95% CI, 0.23%-0.27%), which was higher in nursing home residents or staff (4.52% [95% CI, 4.15%-4.89%]), air or cruise travelers (2.02% [95% CI, 1.66%-2.38%]), and pregnant women (2.34% [95% CI, 1.89%-2.78%]). The pooled percentage of asymptomatic infections among the confirmed population was 40.50% (95% CI, 33.50%-47.50%), which was higher in pregnant women (54.11% [95% CI, 39.16%-69.05%]), air or cruise travelers (52.91% [95% CI, 36.08%-69.73%]), and nursing home residents or staff (47.53% [95% CI, 36.36%-58.70%]). Conclusions and Relevance In this meta-analysis of the percentage of asymptomatic SARS-CoV-2 infections among populations tested for and with confirmed COVID-19, the pooled percentage of asymptomatic infections was 0.25% among the tested population and 40.50% among the confirmed population. The high percentage of asymptomatic infections highlights the potential transmission risk of asymptomatic infections in communities.

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Author and article information

Contributors

Elisabeth Blüthner:

ORCID: http://orcid.org/0000-0002-7008-8795

elisabeth.bluethner@charite.de

Journal

Journal ID (nlm-ta): JPEN J Parenter Enteral Nutr

Journal ID (iso-abbrev): JPEN J Parenter Enteral Nutr

Journal ID (doi): 10.1002/(ISSN)1941-2444

Journal ID (publisher-id): JPEN

Title: JPEN. Journal of Parenteral and Enteral Nutrition

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0148-6071

ISSN (Electronic): 1941-2444

Publication date (Electronic): 27 June 2022

Publication date PMC-release: 27 June 2022

Electronic Location Identifier: 10.1002/jpen.2410

Affiliations

[ ¹ ] Department of Hepatology and Gastroenterology, Charité—Universitätsmedizin Berlin Campus Charité Mitte and Campus Virchow‐Klinikum Berlin Germany

[ ² ] BIH Charité Clinician Scientist Program Berlin Institute of Health (BIH) Berlin Germany

[ ³ ] Department of Internal Medicine and Gastroenterology Asklepios Clinic St. Georg Hamburg Germany

[ ⁴ ] Medical Clinic 1 University Hospital Frankfurt Frankfurt am Main Germany

[ ⁵ ] Department of Surgery Campus Charité Mitte, Campus Virchow‐Klinikum Charité—Universitätsmedizin Berlin Berlin Germany

Author notes

[*] [* ] Correspondence Elisabeth Blüthner, MD, Department of Hepatology and Gastroenterology, Charité—Universitätsmedizin Berlin, Charitéplatz 1, Berlin 10117, Germany.

Email: elisabeth.bluethner@ 123456charite.de

Author information

Elisabeth Blüthner http://orcid.org/0000-0002-7008-8795

Simon Moosburner http://orcid.org/0000-0003-1879-4788

Article

Publisher ID: JPEN2410

DOI: 10.1002/jpen.2410

PMC ID: 9347527

PubMed ID: 35616296

SO-VID: 7df29e2b-e62a-42fa-b193-10f3df039867

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date revision received : 27 April 2022

Date received : 21 March 2022

Date accepted : 23 May 2022

Page count

Figures: 2, Tables: 1, Pages: 8, Words: 3604

Funding

Funded by: Charité—Universitätsmedizin Berlin

Funded by: Berlin Institute of Health

Custom metadata

source-schema-version-number 2.0

edited-state corrected-proof

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:03.08.2022

ScienceOpen disciplines: Nutrition & Dietetics

Keywords: covid‐19,n protein,risk behavior,sars‐cov‐2,seroprevalence,short bowel syndrome (sbs)

Data availability: