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Article ; Online: Prioritizing interventions for preventing COVID-19 outbreaks in military basic training.

España, Guido / Perkins, T Alex / Pollett, Simon D / Smith, Morgan E / Moore, Sean M / Kwon, Paul O / Hall, Tara L / Beagle, Milford H / Murray, Clinton K / Hakre, Shilpa / Peel, Sheila A / Modjarrad, Kayvon / Scott, Paul T

PLoS computational biology

2022 Volume 18, Issue 10, Page(s) e1010489

Abstract: Like other congregate living settings, military basic training has been subject to outbreaks of COVID-19. We sought to identify improved strategies for preventing outbreaks in this setting using an agent-based model of a hypothetical cohort of trainees ... ...

Abstract	Like other congregate living settings, military basic training has been subject to outbreaks of COVID-19. We sought to identify improved strategies for preventing outbreaks in this setting using an agent-based model of a hypothetical cohort of trainees on a U.S. Army post. Our analysis revealed unique aspects of basic training that require customized approaches to outbreak prevention, which draws attention to the possibility that customized approaches may be necessary in other settings, too. In particular, we showed that introductions by trainers and support staff may be a major vulnerability, given that those individuals remain at risk of community exposure throughout the training period. We also found that increased testing of trainees upon arrival could actually increase the risk of outbreaks, given the potential for false-positive test results to lead to susceptible individuals becoming infected in group isolation and seeding outbreaks in training units upon release. Until an effective transmission-blocking vaccine is adopted at high coverage by individuals involved with basic training, need will persist for non-pharmaceutical interventions to prevent outbreaks in military basic training. Ongoing uncertainties about virus variants and breakthrough infections necessitate continued vigilance in this setting, even as vaccination coverage increases.
MeSH term(s)	Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; Military Personnel ; Disease Outbreaks/prevention & control ; Cohort Studies
Language	English
Publishing date	2022-10-07
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2193340-6
ISSN	1553-7358 ; 1553-734X
ISSN (online)	1553-7358
ISSN	1553-734X
DOI	10.1371/journal.pcbi.1010489
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Article ; Online: SARS-CoV-2 infection is associated with self-reported post-acute neuropsychological symptoms within six months of follow-up.

Andronescu, Liana R / Richard, Stephanie A / Scher, Ann I / Lindholm, David A / Mende, Katrin / Ganesan, Anuradha / Huprikar, Nikhil / Lalani, Tahaniyat / Smith, Alfred / Mody, Rupal M / Jones, Milissa U / Bazan, Samantha E / Colombo, Rhonda E / Colombo, Christopher J / Ewers, Evan / Larson, Derek T / Maves, Ryan C / Berjohn, Catherine M / Maldonado, Carlos J /

English, Caroline / Sanchez Edwards, Margaret / Rozman, Julia S / Rusiecki, Jennifer / Byrne, Celia / Simons, Mark P / Tribble, David / Burgess, Timothy H / Pollett, Simon D / Agan, Brian K

PloS one

2024 Volume 19, Issue 4, Page(s) e0297481

Abstract: Background: Chronic neuropsychological sequelae following SARS-CoV-2 infection, including depression, anxiety, fatigue, and general cognitive difficulties, are a major public health concern. Given the potential impact of long-term neuropsychological ... ...

Abstract	Background: Chronic neuropsychological sequelae following SARS-CoV-2 infection, including depression, anxiety, fatigue, and general cognitive difficulties, are a major public health concern. Given the potential impact of long-term neuropsychological impairment, it is important to characterize the frequency and predictors of this post-infection phenotype. Methods: The Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential (EPICC) study is a longitudinal study assessing the impact of SARS-CoV-2 infection in U.S. Military Healthcare System (MHS) beneficiaries, i.e. those eligible for care in the MHS including active duty servicemembers, dependents, and retirees. Four broad areas of neuropsychological symptoms were assessed cross-sectionally among subjects 1-6 months post-infection/enrollment, including: depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), fatigue (PROMIS® Fatigue 7a), and cognitive function (PROMIS® Cognitive Function 8a and PROMIS® Cognitive Function abilities 8a). Multivariable Poisson regression models compared participants with and without SARS-CoV-2 infection history on these measures, adjusting for sex, ethnicity, active-duty status, age, and months post-first positive or enrollment of questionnaire completion (MPFP/E); models for fatigue and cognitive function were also adjusted for depression and anxiety scores. Results: The study population included 2383 participants who completed all five instruments within six MPFP/E, of whom 687 (28.8%) had at least one positive SARS-CoV-2 test. Compared to those who had never tested positive for SARS-CoV-2, the positive group was more likely to meet instrument-based criteria for depression (15.4% vs 10.3%, p<0.001), fatigue (20.1% vs 8.0%, p<0.001), impaired cognitive function (15.7% vs 8.6%, p<0.001), and impaired cognitive function abilities (24.3% vs 16.3%, p<0.001). In multivariable models, SARS-CoV-2 positive participants, assessed at an average of 2.7 months after infection, had increased risk of moderate to severe depression (RR: 1.44, 95% CI 1.12-1.84), fatigue (RR: 2.07, 95% CI 1.62-2.65), impaired cognitive function (RR: 1.64, 95% CI 1.27-2.11), and impaired cognitive function abilities (RR: 1.41, 95% CI 1.15-1.71); MPFP/E was not significant. Conclusions: Participants with a history of SARS-CoV-2 infection were up to twice as likely to report cognitive impairment and fatigue as the group without prior SARS-CoV-2 infection. These findings underscore the continued importance of preventing SARS-CoV-2 infection and while time since infection/enrollment was not significant through 6 months of follow-up, this highlights the need for additional research into the long-term impacts of COVID-19 to mitigate and reverse these neuropsychological outcomes.
MeSH term(s)	Humans ; Self Report ; COVID-19/complications ; COVID-19/epidemiology ; SARS-CoV-2 ; Follow-Up Studies ; Longitudinal Studies ; Fatigue/epidemiology ; Fatigue/etiology ; Anxiety Disorders
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0297481
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Article ; Online: Metagenomic analysis reveals Culex mosquito virome diversity and Japanese encephalitis genotype V in the Republic of Korea.

Sanborn, Mark A / Wuertz, Kathryn McGuckin / Kim, Heung-Chul / Yang, Yu / Li, Tao / Pollett, Simon D / Jarman, Richard G / Berry, Irina Maljkovic / Klein, Terry A / Hang, Jun

Molecular ecology

2021 Volume 30, Issue 21, Page(s) 5470–5487

Abstract: Recent outbreaks of emerging and re-emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that emergent JEV genotype V (GV) is circulating in ... ...

Abstract	Recent outbreaks of emerging and re-emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that emergent JEV genotype V (GV) is circulating in Asia, against which current vaccines may not be efficacious. To ascertain if JEV GV and other arboviruses are circulating in East Asia, we conducted next-generation sequencing on 260 pools of Culex tritaeniorhynchus and Culex bitaeniorhynchus mosquitoes (6540 specimens) collected at Camp Humphreys, Republic of Korea (ROK) in 2018. Interrogation of our data revealed a highly abundant and diverse virosphere that contained sequences from 122 distinct virus species. Our statistical and hierarchical analysis uncovered correlates of potential health, virological, and ecological relevance. Furthermore, we obtained evidence that JEV GV was circulating in Pyeongtaek and, retrospectively, in Seoul in 2016 and placed these findings within the context of human and fowl reservoir activity. Sequence-based analysis of JEV GV showed a divergent genotype that is the most distant from the GIII-derived live attenuated SA14-14-2 vaccine strain and indicated regions probably responsible for reduced antibody affinity. These results emphasize recent concerns of shifting JEV genotype in East Asia and highlight the critical need for a vaccine proven efficacious against this re-emergent virus. Together, our one-health approach to Culex viral metagenomics uncovered novel insights into virus ecology and human health.
MeSH term(s)	Animals ; Culex ; Culicidae ; Encephalitis Virus, Japanese/genetics ; Encephalitis, Japanese/epidemiology ; Genotype ; Humans ; Metagenomics ; Phylogeny ; Retrospective Studies ; Virome
Language	English
Publishing date	2021-08-31
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1126687-9
ISSN	1365-294X ; 0962-1083
ISSN (online)	1365-294X
ISSN	0962-1083
DOI	10.1111/mec.16133
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Article ; Online: Evaluating SARS-CoV-2 Saliva and Dried Blood Spot Surveillance Strategies in a Congregate Population.

Andronescu, Liana R / Richard, Stephanie A / Laing, Eric D / Pisanic, Nora / Coggins, Si'Ana A / Rivera, Magdielis Gregory / Kruczynski, Kate / Saperstein, Adam K / Modi, Jitendrakumar / Fraser, Jamie A / Shaikh, Saira / Broder, Christopher C / Burgess, Timothy H / Heaney, Christopher D / Pollett, Simon D / Millar, Eugene / Coles, Christian L / Simons, Mark P

Emerging infectious diseases

2023 Volume 29, Issue 9, Page(s) 1925–1928

Abstract: The optimal approach to COVID-19 surveillance in congregate populations remains unclear. Our study at the US Naval Academy in Annapolis, Maryland, USA, assessed the concordance of antibody prevalence in longitudinally collected dried blood spots and ... ...

Abstract	The optimal approach to COVID-19 surveillance in congregate populations remains unclear. Our study at the US Naval Academy in Annapolis, Maryland, USA, assessed the concordance of antibody prevalence in longitudinally collected dried blood spots and saliva in a setting of frequent PCR-based testing. Our findings highlight the utility of salivary-based surveillance.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19/diagnosis ; COVID-19/epidemiology ; Saliva ; COVID-19 Testing ; Clinical Laboratory Techniques
Language	English
Publishing date	2023-08-14
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2909.230417
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Article: Metagenomic analysis reveals Culex mosquito virome diversity and Japanese encephalitis genotype V in the Republic of Korea

Sanborn, Mark A. / Wuertz, Kathryn McGuckin / Kim, Heung‐Chul / Yang, Yu / Li, Tao / Pollett, Simon D. / Jarman, Richard G. / Berry, Irina Maljkovic / Klein, Terry A. / Hang, Jun

Molecular ecology. 2021 Nov., v. 30, no. 21

2021

Abstract: Recent outbreaks of emerging and re‐emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that emergent JEV genotype V (GV) is circulating in ... ...

Abstract	Recent outbreaks of emerging and re‐emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that emergent JEV genotype V (GV) is circulating in Asia, against which current vaccines may not be efficacious. To ascertain if JEV GV and other arboviruses are circulating in East Asia, we conducted next‐generation sequencing on 260 pools of Culex tritaeniorhynchus and Culex bitaeniorhynchus mosquitoes (6540 specimens) collected at Camp Humphreys, Republic of Korea (ROK) in 2018. Interrogation of our data revealed a highly abundant and diverse virosphere that contained sequences from 122 distinct virus species. Our statistical and hierarchical analysis uncovered correlates of potential health, virological, and ecological relevance. Furthermore, we obtained evidence that JEV GV was circulating in Pyeongtaek and, retrospectively, in Seoul in 2016 and placed these findings within the context of human and fowl reservoir activity. Sequence‐based analysis of JEV GV showed a divergent genotype that is the most distant from the GIII‐derived live attenuated SA14‐14‐2 vaccine strain and indicated regions probably responsible for reduced antibody affinity. These results emphasize recent concerns of shifting JEV genotype in East Asia and highlight the critical need for a vaccine proven efficacious against this re‐emergent virus. Together, our one‐health approach to Culex viral metagenomics uncovered novel insights into virus ecology and human health.
Keywords	Culex tritaeniorhynchus ; One Health initiative ; antibody affinity ; arboviruses ; ecology ; encephalitis ; genotype ; human health ; humans ; live vaccines ; metagenomics ; South Korea
Language	English
Dates of publication	2021-11
Size	p. 5470-5487.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	1126687-9
ISSN	1365-294X ; 0962-1083
ISSN (online)	1365-294X
ISSN	0962-1083
DOI	10.1111/mec.16133
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Antigenic cartography using hamster sera identifies SARS-CoV-2 JN.1 evasion seen in human XBB.1.5 booster sera

Wang, Wei / Bhushan, Gitanjali L. / Paz, Stephanie / Stauft, Charles B. / Selvaraj, Prabhu / Goguet, Emilie / Bishop-Lilly, Kimberly A. / Subramanian, Rahul / Vassell, Russell / Lusvarghi, Sabrina / Cong, Yu / Agan, Brian / Richard, Stephanie A. / Epsi, Nusrat J. / Fries, Anthony / Fung, Christian K. / Conte, Matthew A. / Holbrook, Michael R. / Wang, Tony T. /

Burgess, Timothy H. / Mitre, Edward / Pollett, Simon D. / Katzelnick, Leah C. / Weiss, Carol D.

bioRxiv

Abstract: Antigenic assessments of SARS-CoV-2 variants inform decisions to update COVID-19 vaccines. Primary infection sera are often used for assessments, but such sera are rare due to population immunity from SARS-CoV-2 infections and COVID-19 vaccinations. Here, ...

Abstract	Antigenic assessments of SARS-CoV-2 variants inform decisions to update COVID-19 vaccines. Primary infection sera are often used for assessments, but such sera are rare due to population immunity from SARS-CoV-2 infections and COVID-19 vaccinations. Here, we show that neutralization titers and breadth of matched human and hamster pre-Omicron variant primary infection sera correlate well and generate similar antigenic maps. The hamster antigenic map shows modest antigenic drift among XBB sub-lineage variants, with JN.1 and BA.4/BA.5 variants within the XBB cluster, but with five to six-fold antigenic differences between these variants and XBB.1.5. Compared to sera following only ancestral or bivalent COVID-19 vaccinations, or with post-vaccination infections, XBB.1.5 booster sera had the broadest neutralization against XBB sub-lineage variants, although a five-fold titer difference was still observed between JN.1 and XBB.1.5 variants. These findings suggest that antibody coverage of antigenically divergent JN.1 could be improved with a matched vaccine antigen.
Keywords	covid19
Language	English
Publishing date	2024-04-06
Publisher	Cold Spring Harbor Laboratory
Document type	Article ; Online
DOI	10.1101/2024.04.05.588359
Database	COVID19

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Article ; Online: A machine learning approach identifies distinct early-symptom cluster phenotypes which correlate with hospitalization, failure to return to activities, and prolonged COVID-19 symptoms.

Epsi, Nusrat J / Powers, John H / Lindholm, David A / Mende, Katrin / Malloy, Allison / Ganesan, Anuradha / Huprikar, Nikhil / Lalani, Tahaniyat / Smith, Alfred / Mody, Rupal M / Jones, Milissa U / Bazan, Samantha E / Colombo, Rhonda E / Colombo, Christopher J / Ewers, Evan C / Larson, Derek T / Berjohn, Catherine M / Maldonado, Carlos J / Blair, Paul W /

Chenoweth, Josh / Saunders, David L / Livezey, Jeffrey / Maves, Ryan C / Sanchez Edwards, Margaret / Rozman, Julia S / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Pollett, Simon D

PloS one

2023 Volume 18, Issue 2, Page(s) e0281272

Abstract: Background: Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of ... ...

Abstract	Background: Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of developing long-term symptoms and associated inflammatory profiles. Methods: 1,273 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative symptom scores (FLU-PRO Plus) were included in this analysis. We employed machine-learning approaches to identify symptom clusters and compared risk of hospitalization, long-term symptoms, as well as peak CRP and IL-6 concentrations. Results: We identified three distinct clusters of participants based on their FLU-PRO Plus symptoms: cluster 1 ("Nasal cluster") is highly correlated with reporting runny/stuffy nose and sneezing, cluster 2 ("Sensory cluster") is highly correlated with loss of smell or taste, and cluster 3 ("Respiratory/Systemic cluster") is highly correlated with the respiratory (cough, trouble breathing, among others) and systemic (body aches, chills, among others) domain symptoms. Participants in the Respiratory/Systemic cluster were twice as likely as those in the Nasal cluster to have been hospitalized, and 1.5 times as likely to report that they had not returned-to-activities, which remained significant after controlling for confounding covariates (P < 0.01). Respiratory/Systemic and Sensory clusters were more likely to have symptoms at six-months post-symptom-onset (P = 0.03). We observed higher peak CRP and IL-6 in the Respiratory/Systemic cluster (P < 0.01). Conclusions: We identified early symptom profiles potentially associated with hospitalization, return-to-activities, long-term symptoms, and inflammatory profiles. These findings may assist in patient prognosis, including prediction of long COVID risk.
MeSH term(s)	Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Interleukin-6 ; Phenotype ; Hospitalization ; Machine Learning
Chemical Substances	Interleukin-6
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0281272
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Article: Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study.

Richard, Stephanie A / Scher, Ann I / Rusiecki, Jennifer / Byrne, Celia / Berjohn, Catherine M / Fries, Anthony C / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Huprikar, Nikhil / Colombo, Rhonda E / Colombo, Christopher J / Schofield, Christina / Lindholm, David A / Mende, Katrin / Morris, Michael J / Jones, Milissa U / Flanagan, Ryan /

Larson, Derek T / Ewers, Evan C / Bazan, Samantha E / Saunders, David / Maves, Ryan C / Livezey, Jeffrey / Maldonado, Carlos J / Edwards, Margaret Sanchez / Rozman, Julia S / O'Connell, Robert J / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Pollett, Simon D

Open forum infectious diseases

2023 Volume 10, Issue 12, Page(s) ofad579

Abstract: Background: The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain.: Methods: We compared survey responses in a 1-year study of US military service ...

Abstract	Background: The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain. Methods: We compared survey responses in a 1-year study of US military service members with (n = 1923) and without (n = 1591) a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We fit Poisson regression models to estimate the association between history of SARS-CoV-2 infection and fitness impairment, adjusting for time since infection, demographics, and baseline health. Results: The participants in this analysis were primarily young adults aged 18-39 years (75%), and 71.5% were male. Participants with a history of SARS-CoV-2 infection were more likely to report difficulty exercising (38.7% vs 18.4%; Conclusions: In this study of generally young, healthy military service members, SARS-CoV-2 infection was associated with lower self-reported fitness and exercise capacity; vaccination and boosting were associated with lower risk of self-reported fitness loss.
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad579
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Article ; Online: Persistent COVID-19 Symptoms at 6 Months After Onset and the Role of Vaccination Before or After SARS-CoV-2 Infection.

Richard, Stephanie A / Pollett, Simon D / Fries, Anthony C / Berjohn, Catherine M / Maves, Ryan C / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Colombo, Rhonda E / Lindholm, David A / Morris, Michael J / Huprikar, Nikhil / Colombo, Christopher J / Madar, Cristian / Jones, Milissa / Larson, Derek T / Bazan, Samantha E / Mende, Katrin /

Saunders, David / Livezey, Jeffrey / Lanteri, Charlotte A / Scher, Ann I / Byrne, Celia / Rusiecki, Jennifer / Ewers, Evan / Epsi, Nusrat J / Rozman, Julia S / English, Caroline / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H

JAMA network open

2023 Volume 6, Issue 1, Page(s) e2251360

Abstract: Importance: Understanding the factors associated with post-COVID conditions is important for prevention.: Objective: To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters.: ... ...

Abstract	Importance: Understanding the factors associated with post-COVID conditions is important for prevention. Objective: To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters. Design, setting, and participants: This cohort study used data from the Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases With Pandemic Potential (EPICC) study implemented in the US military health system (MHS); MHS beneficiaries aged 18 years or older who tested positive for SARS-CoV-2 from February 28, 2020, through December 31, 2021, were analyzed, with 1-year follow-up. Exposures: SARS-CoV-2 infection. Main outcomes and measures: The outcomes analyzed included survey-reported symptoms through 6 months after SARS-CoV-2 infection and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis categories reported in medical records 6 months following SARS-CoV-2 infection vs 3 months before infection. Results: More than half of the 1832 participants in these analyses were aged 18 to 44 years (1226 [66.9%]; mean [SD] age, 40.5 [13.7] years), were male (1118 [61.0%]), were unvaccinated at the time of their infection (1413 [77.1%]), and had no comorbidities (1290 [70.4%]). A total of 728 participants (39.7%) had illness that lasted 28 days or longer (28-89 days: 364 [19.9%]; ≥90 days: 364 [19.9%]). Participants who were unvaccinated prior to infection (risk ratio [RR], 1.39; 95% CI, 1.04-1.85), reported moderate (RR, 1.80; 95% CI, 1.47-2.22) or severe (RR, 2.25; 95% CI, 1.80-2.81) initial illnesses, had more hospitalized days (RR per each day of hospitalization, 1.02; 95% CI, 1.00-1.03), and had a Charlson Comorbidity Index score of 5 or greater (RR, 1.55; 95% CI, 1.01-2.37) were more likely to report 28 or more days of symptoms. Among unvaccinated participants, postinfection vaccination was associated with a 41% lower risk of reporting symptoms at 6 months (RR, 0.59; 95% CI, 0.40-0.89). Participants had higher risk of pulmonary (RR, 2.00; 95% CI, 1.40-2.84), diabetes (RR, 1.46; 95% CI, 1.00-2.13), neurological (RR, 1.29; 95% CI, 1.02-1.64), and mental health-related medical encounters (RR, 1.28; 95% CI, 1.01-1.62) at 6 months after symptom onset than at baseline (before SARS-CoV-2 infection). Conclusions and relevance: In this cohort study, more severe acute illness, a higher Charlson Comorbidity Index score, and being unvaccinated were associated with a higher risk of reporting COVID-19 symptoms lasting 28 days or more. Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns. These findings may inform the risk-benefit ratio of COVID-19 vaccination policy.
MeSH term(s)	Humans ; Male ; Adult ; Female ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; COVID-19 Vaccines ; Cohort Studies ; Post-Acute COVID-19 Syndrome
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.51360
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Article ; Online: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mRNA Vaccine-Breakthrough Infection Phenotype Includes Significant Symptoms, Live Virus Shedding, and Viral Genetic Diversity.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2021 Volume 74, Issue 5, Page(s) 897–900

Abstract: Little is known about severe acute respiratory syndrome coronavirus 2 "vaccine-breakthrough" infections (VBIs). Here we characterize 24 VBIs in predominantly young healthy persons. While none required hospitalization, a proportion endorsed severe ... ...

Abstract	Little is known about severe acute respiratory syndrome coronavirus 2 "vaccine-breakthrough" infections (VBIs). Here we characterize 24 VBIs in predominantly young healthy persons. While none required hospitalization, a proportion endorsed severe symptoms and shed live virus as high as 4.13 × 103 plaque-forming units/mL. Infecting genotypes included both variant-of-concern (VOC) and non-VOC strains.
MeSH term(s)	COVID-19/prevention & control ; COVID-19 Vaccines ; Genetic Variation ; Humans ; Phenotype ; RNA, Messenger ; SARS-CoV-2/genetics ; Vaccines, Synthetic ; Virus Shedding ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger ; Vaccines, Synthetic ; mRNA Vaccines
Language	English
Publishing date	2021-06-11
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciab543
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