Cellular Immunity of SARS-CoV-2 in the Borriana COVID-19 Cohort: A Nested Case-Control Study.

Our goal was to determine the cellular immune response (CIR) in a sample of the Borriana COVID-19 cohort (Spain) to identify associated factors and their relationship with infection, reinfection and sequelae. We conducted a nested case-control study using a randomly selected sample of 225 individuals aged 18 and older, including 36 individuals naïve to the SARS-CoV-2 infection and 189 infected patients. We employed flow-cytometry-based immunoassays for intracellular cytokine staining, using Wuhan and BA.2 antigens, and chemiluminescence microparticle immunoassay to detect SARS-CoV-2 antibodies. Logistic regression models were applied. A total of 215 (95.6%) participants exhibited T-cell response (TCR) to at least one antigen. Positive responses of CD4+ and CD8+ T cells were 89.8% and 85.3%, respectively. No difference in CIR was found between naïve and infected patients. Patients who experienced sequelae exhibited a higher CIR than those without. A positive correlation was observed between TCR and anti-spike IgG levels. Factors positively associated with the TCR included blood group A, number of SARS-CoV-2 vaccine doses received, and anti-N IgM; factors inversely related were the time elapsed since the last vaccine dose or infection, and blood group B. These findings contribute valuable insights into the nuanced immune landscape shaped by SARS-CoV-2 infection and vaccination.

[Impact of the pandemic on various infectious diseases with different epidemiological patterns of seasonality, transmission and age]. / Impacto de la pandemia en varias enfermedades infecciosas con patrones epidemiológicos distintos de estacionalidad, transmisión y edad.

OBJECTIVE: The COVID-19 pandemic has had a strong impact on other infectious diseases. The aim of this paper was to analyze the epidemiological changes that occurred during the pandemic in eight infectious diseases with different epidemiological patterns: influenza, respiratory syncytial virus, rotavirus, pneumococcus, Campylobacter, non-typhoid Salmonella, gonorrhea and herpes zoster. METHODS: From the Microbiological Surveillance Network, the time series of cases was traced from January 2017 to March 2023. Three periods were distinguished: reference, pandemic and beginning of the post-pandemic. The distribution by age and sex in these periods was analyzed. Incidence rates and rate ratios (RR) were calculated. These RRs and their 95% confidence intervals were estimated overall and by year of age in children under five years of age. RESULTS: Statistically significant differences were found in the impact that the pandemic had on each of these diseases. Some, after a period of epidemic silence, have revealed an intense post-pandemic rebound. The post-pandemic global RT increased for influenza (2.4), RSV (1.9) and gonorrhea (3.1); rotavirus recovered its pre-pandemic level (1.07); and pneumococcus (0.84), Campylobacter (0.83) and Salmonella (0.60) decreased. In children under 5 years of age, the patterns were specific and heterogeneous for each disease. CONCLUSIONS: The impact of the pandemic is very different in these diseases. Pediatric and respiratory-transmitted seasonal viral infections are the ones that are most affected, but with different patterns of recovery to normality. Gastrointestinal bacterial infections suffer fewer variations, except for rotavirus. Gonorrhea do not interrupt its increasing trend seen in the pre-pandemic. Shingles show a slight post-pandemic increase. Several diseases with different epidemiological patterns have been studied for a sufficient period to observe how the acute phase of the pandemic emerges.

OBJECTIVE: La pandemia de la COVID-19 ha tenido un fuerte impacto sobre otras enfermedades infecciosas. El objetivo de este trabajo fue analizar los cambios epidemiológicos acaecidos durante la pandemia en ocho enfermedades infecciosas con patrones epidemiológicos distintos: la gripe; virus respiratorio sincitial; rotavirus; neumococo; Campylobacter; Salmonella no tifoidea; gonococia; herpes zóster. METHODS: A partir de la Red de Vigilancia Microbiológica, se trazó la serie temporal de casos desde enero de 2017 a marzo de 2023. Se distinguieron tres periodos: prepandemia (referencia), pandemia e inicio de la pospandemia. Se analizó la distribución por edad y sexo en esos periodos. Se calcularon las tasas de incidencia y las razones de tasas (RT). Se estimaron esas RT globales y sus intervalos de confianza al 95% por cada año de edad en menores de cinco años. RESULTS: Se encontraron diferencias estadísticamente significativas en el impacto que la pandemia tuvo en cada una de esas enfermedades. Algunas, tras un periodo de silencio epidémico, revelaron un repunte intenso pospandémico. Incrementaron la RT global postpandémica la gripe (2,4), VRS (1,9) y gonococia (3,1); recuperó su nivel prepandémico el rotavirus (1,07); y disminuyeron el neumococo (0,84), Campylobacter (0,83) y Salmonella (0,60). En menores de cinco años, los patrones fueron específicos y heterogéneos para cada enfermedad. CONCLUSIONS: El impacto de la pandemia es muy diferente en estas enfermedades. Las infecciones víricas estacionales pediátricas y de transmisión respiratoria son las que más se ven afectadas, pero con patrones de recuperación de la normalidad distintos. Las infecciones bacterianas gastrointestinales sufren menos variaciones, salvo el rotavirus. La gonococia no interrumpe su tendencia al aumento avistada ya en la prepandemia. El herpes zóster muestra un ligero incremento pospandémico. Se han estudiado varias enfermedades con distinto patrón epidemiológico durante un periodo suficiente para observar cómo se produce la salida de la fase aguda de la pandemia.

Impacto de la pandemia en varias enfermedades infecciosas con patrones epidemiológicos distintos de estacionalidad, transmisión y edad / mpact of the pandemic on various infectious diseases with different epidemiological patterns of seasonality, transmission and age

Fundamentos: la pandemia de la covid-19 ha tenido un fuerte impacto sobre otras enfermedades infecciosas. El objetivo de este trabajo fue analizar los cambios epidemiológicos acaecidos durante la pandemia en ocho enfermedades infecciosas con patrones epidemiológicos distintos: la gripe; virus respiratorio sincitial; rotavirus; neumococo; campylobacter; salmonella no tifoidea; gonococia; herpes zóster.métodos: a partir de la red de vigilancia microbiológica, se trazó la serie temporal de casos desde enero de 2017 a marzo de 2023. Se distinguieron tres periodos: prepandemia (referencia), pandemia e inicio de la pospandemia. Se analizó la distribución por edad y sexo en esos periodos. Se calcularon las tasas de incidencia y las razones de tasas (rt). Se estimaron esas rt globales y sus intervalos de confianza al 95% por cada año de edad en menores de cinco años. Resultados: se encontraron diferencias estadísticamente significativas en el impacto que la pandemia tuvo en cada una de esas enfermedades. Algunas, tras un periodo de silencio epidémico, revelaron un repunte intenso pospandémico. Incrementaron la rt global postpandémica la gripe (2,4), vrs (1,9) y gonococia (3,1); recuperó su nivel prepandémico el rotavirus (1,07); y disminuyeron el neumococo (0,84), campylobacter (0,83) y salmonella (0,60). En menores de cinco años, los patrones fueron específicos y hete-rogéneos para cada enfermedad.conclusiones: el impacto de la pandemia es muy diferente en estas enfermedades. Las infecciones víricas estacionales pediá-tricas y de transmisión respiratoria son las que más se ven afectadas, pero con patrones de recuperación de la normalidad distintos. Las infecciones bacterianas gastrointestinales sufren menos variaciones, salvo el rotavirus. La gonococia no interrumpe su tendencia al aumento avistada ya en la prepandemia. El herpes zóster muestra un ligero incremento pospandémico. Se han estudiado varias enfermedades con distinto patrón epidemiológico durante un periodo suficiente para observar cómo se produce la salida de la fase aguda de la pandemia.(AU)

Background: the covid-19 pandemic has had a strong impact on other infectious diseases. The aim of this paper was to analyze the epidemiological changes that occurred during the pandemic in eight infectious diseases with different epidemiological patterns: influenza, respiratory syncytial virus, rotavirus, pneumococcus, campylobacter, non-typhoid salmonella, gonorrhea and herpes zoster.methods: from the microbiological surveillance network, the time series of cases was traced from january 2017 to march 2023. Three periods were distinguished: reference, pandemic and beginning of the post-pandemic. The distribution by age and sex in these periods was analyzed. Incidence rates and rate ratios (rr) were calculated. These rrs and their 95% confidence intervals were estimated overall and by year of age in children under five years of age. Results: statistically significant differences were found in the impact that the pandemic had on each of these diseases. Some, after a period of epidemic silence, have revealed an intense post-pandemic rebound. The post-pandemic global rt increased for influenza (2.4), rsv (1.9) and gonorrhea (3.1); rotavirus recovered its pre-pandemic level (1.07); and pneumococcus (0.84), campylobacter (0.83) and salmonella (0.60) decreased. In children under 5 years of age, the patterns were specific and heterogeneous for each disease.conclusions: the impact of the pandemic is very different in these diseases. Pediatric and respiratory-transmitted seasonal viral infections are the ones that are most affected, but with different patterns of recovery to normality. Gastrointestinal bacterial infections suffer fewer variations, except for rotavirus. Gonorrhea do not interrupt its increasing trend seen in the pre-pandemic. Shingles show a slight post-pandemic increase. Several diseases with different epidemiological patterns have been studied for a sufficient period to observe how the acute phase of the pandemic emerges.(AU)

ABO Blood Groups and Incidence of COVID-19 in the Mass Gathering Events in Borriana (Spain), March 2020: A Retrospective Cohort Study.

Our objective was to estimate the incidence of COVID-19 and the ABO blood Groups in the mass-gathering events (MGEs) during the Falles Festival in Borriana (Spain) from 6-10 March 2020. We conducted a population-based retrospective cohort study and measured anti-SARS-CoV-2 antibodies and the ABO of participants. We performed laboratory COVID-19 tests and obtained the ABO in 775 subjects (72.8% of the original exposed cohort): O-group (45.2%), A-group (43.1%), B-group (8.5%) and AB-group (3.4%). Adjusted for confounding factors, including COVID-19 exposure during the MGEs, attack rates of COVID-19 for each ABO group were 55.4%, 59.6%, 60.2%, and 63.7%. The adjusted relative risks were for O-group 0.93 (95% Confidence Interval [CI] 0.83-1.04), for A-group 1.06 (95% CI 0.94-1.18), for B-group 1.04 (95%CI 0.88-1.24), and for AB-group 1.11 (95% CI 0.81-1.51) with no significant differences. Conclusions: Our results suggest no effect of ABO on COVID-19 incidence. We observed weak but not significant protection of the O-group and not a significantly greater infection risk for the remaining groups compared with the O-group. More studies are needed to resolve the controversies regarding the association between ABO and COVID-19.

Incidence, Hospitalization, Mortality and Risk Factors of COVID-19 in Long-Term Care Residential Homes for Patients with Chronic Mental Illness.

Long-term care residential homes (LTCRH) for patients with chronic mental illness have suffered the enormous impact of COVID-19. This study aimed to estimate incidence, hospitalization, mortality, and risk factors of COVID-19 to prevent future epidemics. From March 2020 to January 2021 and before vaccination anti-SARS-CoV-2 begins, cumulate incidence rate (CIR), hospitalization rate (HR), mortality rate (MR), and risk factors of COVID-19 in the 11 LTCRH of two Health Departments of Castellon (Spain) were studied by epidemiological surveillance and an ecological design. Laboratory tests confirmed COVID-19 cases, and multilevel Poisson regression models were employed. All LTCRH participated and comprised 346 residents and 482 staff. Residents had a mean age of 47 years, 40% women, and suffered 75 cases of COVID-19 (CIR = 21.7%), five hospitalizations (HR = 1.4%), and two deaths (MR = 0.6%) with 2.5% fatality-case. Staff suffered 74 cases of the disease (CIR = 15.4%), one hospitalization (HR = 0.2%), and no deaths were reported. Risk factors associated with COVID-19 incidence in residents were private ownership, severe disability, residents be younger, CIR in municipalities where LTCRH was located, CIR in staff, and older age of the facilities. Conclusion: COVID-19 incidence could be prevented by improving infection control in residents and staff and modernizing facilities with increased public ownership.

Incidence, Mortality, and Risk Factors of COVID-19 in Nursing Homes.

During the period from March 2020 to January 2021, we performed an analysis of incidence, mortality, and risk factors of COVID-19 in nursing homes (NHs) in two health departments (HDs) of Castellon (Spain) 2021 through epidemiological surveillance and an ecological design. Laboratory-confirmed COVID-19 cases, cumulative incidence rate (CIR), and mortality rate (MR) of 27 NHs were collected. Information of residents, staff, and facilities was obtained by questionnaire. Multilevel Poisson regression models were applied. All NHs in the HDs participated with 2229 residents (median: 83 years old, 67.3% women) and 1666 staff. Among residents, 815 cases (CIR: 34.8 per 100) and 202 deaths (MR: 8.7 per 100, case fatality 21.0%) were reported and, among staff, 296 cases (CIR: 19.2 per 100) without deaths. Residents' CIR and MR increased with staff CIR, age of the building, residents/staff ratios, occupancy rate, and crowding index; CIR increased with private NH ownership, large NH size, large urban area, and the percentage of women residents; and MR was associated with residents' severe disabilities. In conclusion, several risk factors of COVID-19 incidence and mortality can be prevented by improving infection and quality controls, ameliorating residents/staff ratios, improving structural facilities, and increasing NH public ownership to avoid new outbreaks.

[Seroepidemiology of Coxiella burnetii infection among blood donors in Albacete]. / Seroepidemiología de la infección por Coxiella burnetii en donantes de sangre en Albacete.

INTRODUCTION: The objectives of this study were to determine the prevalence of antibodies to Coxiella burnetii among blood donors and to examine the epidemiological characteristics of C. burnetii infection in Albacete, Spain. METHODS: A total of 863 serum samples were collected from blood donors aged 18-65 years. Donor samples were stratified by age, sex, and residence (rural or urban). IgG and IgM titers to the C. burnetii phase II antigen were determined by an indirect immunofluorescence assay. RESULTS: The prevalence of anti-phase II IgG was 23.1%, and three (0.3%) donors had positive IgM titers. Men were more frequently seropositive than women (29% vs. 18%; OR: 1.85; 95% CI: 1.34-2.56), and this difference was not related to differential occupational exposure to animals. Pet ownership had no impact on seroprevalence. In contrast, occupations involving contact with domestic ungulates were associated with a higher seroprevalence (OR: 2.39; 95% CI: 1.04-5.48). Nevertheless, 90% of seropositive donors reported no contact with farm animals. CONCLUSION: Our results show that C. burnetii infection is highly endemic in Albacete and that most infections are not linked to specific occupational exposure in this area. The high prevalence of antibodies to C. burnetii among blood donors indicates the advisability of studies to determine the risk of transfusion-transmitted Q fever in endemic areas.

Seroepidemiología de la infección por Coxiella burnetii en donantes de sangre en Albacete / No disponible

Introducción. Los objetivos de este estudio fueron determinar la prevalencia de anticuerpos frente a Coxiella burnetii en donantes de sangre y estudiar las características epidemiológicas de la infección por C. burnetii en Albacete. Métodos. Se tomaron 863 muestras de suero de donantes de sangre con edades entre 18 y 65 años. Las muestras se estratificaron por edad, sexo y residencia (rural o urbana). Se determinaron los títulos de IgG e IgM frente al antígeno de fase II de C. burnetii mediante inmunofluorescencia indirecta. Resultados. La prevalencia de IgG anti-fase II fue del 23,1% y 3 donantes (0,3%) tenían títulos positivos de IgM. Los varones fueron más frecuentemente seropositivos que las mujeres (29% frente a 18%; odds ratio [OR]: 1,85; intervalo de confianza del 95% [IC 95%]: 1,34-2,56), y esta diferencia no estaba relacionada con una exposición ocupacional diferencial a animales. Tener una mascota no tuvo efecto sobre la seroprevalencia. Por el contrario, las ocupaciones que implican contacto con ungulados domésticos se asociaron con una seroprevalencia incrementada (OR: 2,39; IC 95%: 1,04-5,48). Sin embargo, el 90% de los donantes seropositivos no tenían contacto con animales de granja. Conclusión. Nuestros resultados muestran que la infección por C. burnetii es altamente endémica en Albacete y que la mayoría de las infecciones no están ligadas a una exposición ocupacional específica. La alta prevalencia de anticuerpos frente a C. burnetii en donantes de sangre indica la conveniencia de realizar estudios para determinar el riesgo de fiebre Q transmitida por transfusión en áreas endémicas (AU)

Introduction. The objectives of this study were to determine the prevalence of antibodies to Coxiella burnetii among blood donors and to examine the epidemiological characteristics of C. burnetii infection in Albacete, Spain. Methods. A total of 863 serum samples were collected from blood donors aged 18-65 years. Donor samples were stratified by age, sex, and residence (rural or urban). IgG and IgM titers to the C. burnetii phase II antigen were determined by an indirect immunofluorescence assay. Results. The prevalence of anti-phase II IgG was 23.1%, and three (0.3%) donors had positive IgM titers. Men were more frequently seropositive than women (29% vs. 18%; OR: 1.85; 95% CI: 1.34-2.56), and this difference was not related to differential occupational exposure to animals. Pet ownership had no impact on seroprevalence. In contrast, occupations involving contact with domestic ungulates were associated with a higher seroprevalence (OR: 2.39; 95% CI: 1.04-5.48). Nevertheless, 90% of seropositive donors reported no contact with farm animals. Conclusion. Our results show that C. burnetii infection is highly endemic in Albacete and that most infections are not linked to specific occupational exposure in this area. The high prevalence of antibodies to C. burnetii among blood donors indicates the advisability of studies to determine the risk of transfusion-transmitted Q fever in endemic areas (AU)

[Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain]. / Estudio clínico-epidemiológico de las rickettsiosis del grupo de las fiebres exantemáticas en Albacete.

INTRODUCTION: The aim of this study was to describe the clinical and epidemiological features of spotted fever group rickettsiosis acquired in the province of Albacete, Spain. METHODS: We retrospectively reviewed the clinical records of patients with a diagnosis of spotted fever group rickettsiosis and positive serologic results between 1997 and 2003. Criteria for inclusion were as follows: 1) seroconversion in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of 160 dollars with two or three of the following symptoms: fever, eschar, or rash. RESULTS: There were 41 cases in the study period. Mean age was 58 years (range: 14-84). Thirty-seven (90%) patients were 40 or more years old (RR: 10,1; 95% CI: 4,3-24,0). Twenty-five (63%) patients were of rural origin (RR: 3,5; 95% CI: 1,8-6,5). Thirty-six (88%) patients had regular or recent contact with the rural milieu or with animals. Forty patients had fever and 38 (93%) had one or two eschars. There were 32 cases of Mediterranean spotted fever, 2 cases with symptoms consistent with DEBONEL/TIBOLA, and 7 atypical cases with eschar and no rash. CONCLUSION: Spotted fever group rickettsiosis was mainly found in adults in contact with the rural milieu or with animals. Age over 40 years old and residence in a rural area were risk factors. Mediterranean spotted fever was the most common syndrome.

Estudio clínico-epidemiológico de las rickettsiosis del grupo de las fiebres exantemáticas en Albacete / Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain

INTRODUCCIÓN. El objetivo de este trabajo es describir las características clínicas y epidemiológicas de las rickettsiosis del grupo de las fiebres exantemáticas adquiridas en la provincia de Albacete. MÉTODOS. Se revisaron retrospectivamente las historias clínicas de los pacientes que tuvieron un diagnóstico de rickettsiosis del grupo de las fiebres exantemáticas con serología positiva entre 1997 y 2003. Los criterios de inclusión fueron los siguientes: 1) seroconversión en inmunoglobulina G (IgG) frente a Rickettsia conorii por inmunofluorescencia indirecta (IFI) o 2) un título igual o superior a 160 con 2 o 3 de los siguientes síntomas: fiebre, mancha negra, exantema. RESULTADOS. Hubo 41 casos en el período de estudio. La edad media fue 58 años (intervalo: 14-84). Treinta y siete (90%)pacientes tenían 40 o más años de edad (riesgo relativo [RR]:10,1; intervalo de confianza del 95 % [IC 95%]: 4,3-24,0).Veinticinco (63%) pacientes eran de procedencia rural (RR:3,5; IC 95%: 1,8-6,5). Treinta y seis (88%) pacientes habían tenido contacto habitual o reciente con el medio rural o con animales. Cuarenta pacientes tuvieron fiebre y 38 (93%)presentaron una o dos escaras. Hubo 32 casos de fiebre botonosa mediterránea, 2 casos compatibles con DEBONEL/TIBOLA y 7 casos atípicos con escara y sin exantema. CONCLUSIÓN. Las rickettsiosis del grupo de las fiebres exantemáticas se diagnosticaron principalmente en adultos en contacto con el medio rural o con animales. La edad superior a 40 años y la residencia en el medio rural fueron factores de riesgo. La fiebre botonosa mediterránea fue el síndrome más frecuente (AU)

INTRODUCTION. The aim of this study was to describe the clinical and epidemiological features of spotted fever group rickettsiosis acquired in the province of Albacete, Spain. METHODS. We retrospectively reviewed the clinical records of patients with a diagnosis of spotted fever group rickettsiosis and positive serologic results between 1997 and 2003. Criteria for inclusion were as follows: 1) serocon version in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of >= 160 with two or three of the following symptoms: fever, eschar, or rash. RESULTS. There were 41 cases in the study period. Mean age was 58 years (range: 14-84). Thirty-seven (90%) patients were 40 or more years old (RR: 10,1; 95% CI: 4,3-24,0).Twenty-five (63%) patients were of rural origin (RR: 3,5;95% CI: 1,8-6,5). Thirty-six (88%) patients had regular or recent contact with the rural milieu or with animals. Forty patients had fever and 38 (93%) had one or two eschars. There were 32 cases of Mediterranean spotted fever, 2 cases with symptoms consistent with DEBONEL/TIBOLA, and 7 atypical cases with eschar and no rash. CONCLUSION. Spotted fever group rickettsiosis was mainly found in adults in contact with the rural milieu or with animals. Age over 40 years old and residence in a rural area were risk factors. Mediterranean spotted fever wasthe most common síndrome (AU)