Search

배경: There are limited data comparing the transmission rates and kinetics of viable virus shedding of the omicron variant to those of the delta variant. We compared these rates in hospitalized patients infected with delta and omicron variants. 방법: We prospectively enrolled adult patients with COVID-19 admitted to a tertiary care hospital in South Korea between September 2021 and May 2022. Secondary attack rates were calculated by epidemiologic investigation, and daily saliva samples were collected to evaluate viral shedding kinetics. Genomic and subgenomic SARS-CoV-2 RNA was measured by PCR, and virus culture was performed from daily saliva samples. 결과: A total of 88 patients with COVID-19 who agreed to daily sampling and were interviewed, were included. Of the 88 patients, 48 (59%) were infected with delta, and 34 (41%) with omicron ; a further five patients gave undetectable or inconclusive RNA PCR results and one was suspected of being co-infected with both variants. The baseline characteristics of the two groups were comparable except that fewer of the delta patients had been vaccinated, and the delta patients had more severe disease. The latter also had a higher secondary attack rate (31% [38/124]) vs. 7% [34/456], p<0.001 : Table 1). Multivariable analysis revealed that moderate-to-critical disease severity (HR 1.96), immunocompromised status (HR 2.17), fully- or 1st booster-vaccinated status (HR 0.49), and omicron infection (HR 0.44) were independently associated with prolonged viable virus shedding (Table 2). 결론: Patients with omicron infections had higher transmission rates but shorter periods of transmissible virus shedding than those with delta infections. [ABSTRACT FROM AUTHOR]

배경: Solid organ transplant recipients elicit decreased antibody responses mainly due to their weakened immune system. However, data are limited on antibody responses after the primary series of coronavirus disease 2019 (COVID-19) vaccines among recipients with solid organ transplant types. Thus, we compared the antibody responses after three COVID-19 vaccine doses between liver (LT) and kidney transplant (KT) recipients. 방법: We prospectively enrolled solid-organ transplant recipients who received three COVID-19 vaccine doses from June 2021 to February 2022 and measured S1-specific immunoglobulin G antibodies using an enzyme-linked immunosorbent assay. 결과: Seventy-six LT and 17 KT recipients were included in the final analysis. KT recipients showed consistently decreased antibody responses even after third dose vaccination (86.2% and 52.9%, P=0.008) and decreased antibody titer (423.0 [99.6–2057.0] vs. 19.7 IU/mL [6.9–339.4], P=0.006) than that of LT recipients. Mycophenolic acid was a significant risk factor for seropositive antibody response after the third dose vaccine in multivariable analysis (odds ratio 0.06, 95% confidence interval 0.00-0.39; P=0.02). 결론: We found a weaker antibody response despite the completion of the primary series of COVID-19 vaccines in KT recipients than that in LT recipients; mycophenolic acid use in KT recipients might be the main contributor to this observation. [ABSTRACT FROM AUTHOR]

The clinical benefit of adjuvant intravenous immunoglobulin (1VIG) therapy is controversial in immunocompromised patients with severe varicella. A twenty-one-year-old woman who had received a kidney transplant one year earlier presented with fever and generalized rash for 5 days. Initial immunoglobulin M (IgM) and IgG for varicella zoster virus (VZV) were negative; however, the patient was diagnosed with varicella with fulminant hepatitis because VZV-specific PCR from skin vesicles and blood was positive. The patient received intravenous acyclovir and 5-day IVIG. The decline of plasma viral load was steeper (beta coefficient -0.446) during IVIG therapy than after the therapy (beta coefficient -0.123) (P= 0.04), while VZV glycoprotein IgG titers and VZV-specific T cell responses were not detected during the 5-day IVIG therapy. The patient improved without any complications. This case provides an experimental evidence that adjuvant IVIG can significantly reduce viral load in immunocompromised patients with severe varicella. [ABSTRACT FROM AUTHOR]

배경: The B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a higher transmission rate and possibly higher airborne transmission risk than previous variants. Effectiveness of wearing N95 and surgical mask against transmission of the omicron variant has been uncertain. 방법: Patients with confirmed coronavirus disease 2019 in a Community Treatment Center in Seoul, South Korea between January and March 2022, when the omicron variant of SARS-CoV-2 was predominant, were enrolled. The patients read aloud a predefined manuscript for 10 minutes each while wearing (1) N95 mask, (2) surgical mask, and (3) no mask sequentially. SARS-CoV-2 viral loads in nasopharyngeal swabs and saliva, swabs from the outer and inner surfaces of the masks, petri dishes placed in 30-cm distance, and air sampling performed with 90-cm distance ahead of the patients were analyzed using real-time reverse transcription polymerase chain reaction. 결과: A total of 29 patients with mild symptomatic SARS-CoV-2 infection participated. The median age of the patients was 28 years, and 48% of the patients were men. The median interval between symptom onset and the experiment was 4 days. SARS-CoV-2 was detected only in the inner surfaces of N95 and surgical masks. However, contamination of the inner surface was higher in N95 mask (28%) than surgical mask (10%); that possibly indicate higher filtration effectiveness of N95 mask. Contamination of petri-dish seemed lower in N95 mask (3%) and surgical mask (3%), compared with no mask (17%). The virus was detected comparably in the air between N95 (7%), surgical (3%), and no mask (10%); that might be because of prior air contamination of the patient room. 결론: Our findings suggests that universal indoor masking both in infected and uninfected persons is important to prevent transmission of the omicron variant of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

배경 Immunity of healthcare workers to vaccine-preventable diseases is important to prevent hospital outbreak. We evaluated the sero-epidemiology of hepatitis A virus (HAV) infection and measles in sec- ondary hospitals workers in South Korea. 방법 Serum sample were collected from hospital workers in 28 secondary hospitals with 100-300 beds, lo- cated in Jeollanam-do South Korea in 2019. Chemiluminescent immunoassay was used for testing of im- munoglobulin G (IgG) antibodies to HAV and measles. 결과 Of total 2,573 hospital workers who were tested for HAV Ig G, 7% were physicians, 54% nurses, 19% nurse aides and 20% paramedical technicians. The overall HAV seropositivity rate was 43.3%. There were significant differences in HAV seropositivity between age groups (P < 0.001): 37.6% for < 25 years, 26.5% for 25-29 years, 25.2% for 30-34 years, 33.3% for 35-39 years, 61.5% for 40-44, and 88.8% for ≥45 years. Among those aged under <40 years old, seroprevalance was significantly lower in nurse aides (23.2%) and paramedical technicians (21.8%) compared to physicians (48.0%) and nurses (33.7%) (P < 0.001). Measles IgG test were performed in 2,068 hospital workers (6% physician, 53% nurse, 20% nurses’ aides and 21% paramedical technicians). The overall positivity of measles Ig G was 90.9%. The seropositivity for measles significantly increased with age (P < 0.001): 75.2% for < 25 years, 89.6% for 25-29 years, 98.1% for 30-34 years, 92.4% for 35-39 years, 97.4% for 40-44, and 97.7% for ≥45 years. There was no significant differences in measles immunity between occupations. 결론 Our findings suggest the need to augment appropriate vaccine programs for young hospital workers in South Korea. [ABSTRACT FROM AUTHOR]