Publications by authors named "Melissa Hagen"

SARS-CoV-2 antibody kinetics based on immunologic history is not fully understood. We analyzed anti-spike and anti-nucleocapsid antibody responses following acute infection in a cohort of Indigenous persons. The models of peak concentrations and decay rates estimated that one year after infection, participants would serorevert for anti-nucleocapsid antibodies and remain seropositive for anti-spike antibodies.

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  • Health disparities leading to higher COVID-19 death rates are caused by social and structural factors, significantly affecting lower socioeconomic groups and socially vulnerable communities.
  • The study analyzed data from over a million COVID-19 deaths in the U.S., using the Minority Health Social Vulnerability Index (MHSVI) to categorize counties based on their social vulnerability.
  • Results showed that higher vulnerability correlated with increased death rates, except for those counties with better healthcare access, which saw lower death rates.
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  • * A study found that as age increases, the likelihood of older adults receiving antiviral treatment decreases, with only 35.2% of those aged 90 and above receiving it.
  • * Among patients aged 65 and older, those who did not receive antiviral treatment were more likely to suffer severe outcomes, indicating a need for improved antiviral access for older populations.
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Unlabelled: Hybrid immunity, as a result of infection and vaccination to SARS-CoV-2, has been well studied in adults but limited evidence is available in children. We evaluated the antibody responses to primary SARS-CoV-2 infection among vaccinated and unvaccinated children aged ≥ 5 years.

Methods: A longitudinal cohort study of children aged ≥ 5 was conducted during August 2021-August 2022, at sites in Arizona, Texas, Utah, and Florida.

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Background: The kinetics and durability of T-cell responses to SARS-CoV-2 in children are not well characterized. We studied a cohort of children aged 6 months to 20 years with COVID-19 in whom peripheral blood mononuclear cells and sera were archived at approximately 1, 6, and 12 months after symptom onset.

Methods: We compared antibody responses (n = 85) and T-cell responses (n = 30) to nucleocapsid (N) and spike (S) glycoprotein over time across 4 age strata: 6 months to 5 years and 5-9, 10-14, and 15-20 years.

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  • Access to timely COVID-19 testing is essential for reducing transmission and aiding early treatment decisions, yet the impact of demographic factors on testing delays remains unclear.
  • The study focused on health care personnel (HCP) who exhibited COVID-19 symptoms and were evaluated for demographic influences on delayed testing from December 2020 to April 2022.
  • The analysis involved 5,551 HCP and examined how demographics like sex, age, and comorbidities correlated with testing delays, revealing insights into the relative risks of delayed testing among different groups.
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Among adults at risk for severe coronavirus disease 2019 (COVID-19), the lowest hospitalization rate was among those who received nirmatrelvir-ritonavir after 3 or more messenger RNA vaccine doses (adjusted hazard ratio, 0.22; 95% confidence interval, .19-.

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Introduction: Since March 2020, Hispanic and Black/African American persons have made up a disproportionate number of COVID-19 cases, hospitalizations, and deaths. However, little is known about whether the prevalence of postacute sequelae or post-COVID conditions differs by race/ethnicity.

Methods: This study used cross-sectional survey data collected by Porter Novelli Public Services to determine the prevalence of ≥1 ongoing symptom lasting ≥4 weeks by SARS-CoV-2 test status and racial/ethnic groups among 2,890 adults in the U.

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Introduction: Data on ethnic and racial differences in symptoms and health-related impacts following SARS-CoV-2 infection are limited. We aimed to estimate the ethnic and racial differences in symptoms and health-related impacts 3 and 6 months after the first SARS-CoV-2 infection.

Methods: Participants included adults with SARS-CoV-2 infection enrolled in a prospective multicenter US study between 12/11/2020 and 7/4/2022 as the primary cohort of interest, as well as a SARS-CoV-2-negative cohort to account for non-SARS-CoV-2-infection impacts, who completed enrollment and 3-month surveys ( = 3,161; 2,402 SARS-CoV-2-positive, 759 SARS-CoV-2-negative).

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  • Protection against COVID-19 is crucial for healthcare workers, especially as vaccine effectiveness has decreased with the rise of the Omicron variant.
  • A study evaluated the effectiveness of a monovalent mRNA booster dose from October 2021 to June 2022, finding that its effectiveness dropped significantly from 86% during Delta prevalence to 65% during Omicron prevalence.
  • The results indicated that while a booster dose provides strong protection initially, its effectiveness wanes over time, dropping to 32% at least 120 days after vaccination, highlighting the importance of staying current with COVID-19 vaccinations.
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  • Reinfections of SARS-CoV-2 in the U.S. have become more common, especially during the Omicron variant period, rising from 2.7% during Delta to 28.8% in Omicron BQ.1/BQ.1.1.
  • Hospitalizations and deaths linked to reinfections also increased significantly, going from 1.9% and 1.2% of COVID-19-related cases during Delta, to 17.0% and 12.3% during Omicron BQ.1/BQ.1.1.
  • Younger adults (18-49 years) had higher rates of reinfections compared to older adults (≥50 years), and it's crucial to stay updated on vaccinations
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From 2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission studies (enrolling April 2020 to January 2022) with rapid enrollment and specimen collection for 14 days, 61% (43/70) of primary cases had culturable virus detected ≥6 days post-onset. Risk of secondary infection among household contacts tended to be greater when primary cases had culturable virus detected after onset. Regardless of duration of culturable virus, most secondary infections (70%, 28/40) had serial intervals <6 days, suggesting early transmission.

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Nirmatrelvir-ritonavir (Paxlovid), an oral antiviral treatment, is authorized for adults with mild-to-moderate COVID-19 who are at increased risk for progression to severe illness. However, real-world evidence on the benefit of Paxlovid, according to vaccination status, age group, and underlying health conditions, is limited. To examine the benefit of Paxlovid in adults aged ≥18 years in the United States, a large electronic health record (EHR) data set (Cosmos) was analyzed to assess the association between receiving a prescription for Paxlovid and hospitalization with a COVID-19 diagnosis in the ensuing 30 days.

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Previous infection with SARS-CoV-2, the virus that causes COVID-19, has been estimated to confer up to 90% protection against reinfection, although this protection was lower against the Omicron variant compared with that against other SARS-CoV-2 variants (1-3). A test-negative design was used to estimate effectiveness of COVID-19 mRNA vaccines in preventing subsequent COVID-19-associated hospitalization among adults aged ≥18 years with a previous positive nucleic acid amplification test (NAAT) or diagnosis of COVID-19. The analysis used data from Cosmos, an electronic health record (EHR)-aggregated data set (4), and compared vaccination status of 3,761 case-patients (positive NAAT result associated with hospitalization) with 7,522 matched control-patients (negative NAAT result).

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Isolation is recommended during acute infection with SARS-CoV-2, the virus that causes COVID-19, but the duration of infectiousness varies among individual persons. Rapid antigen test results have been correlated with detection of viable virus (1-3) and might inform isolation guidance, but data are limited for the recently emerged SARS-CoV-2 B.1.

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Background: Introduction of tenofovir (TDF) plus lamivudine (3TC) and dolutegravir (DTG) in first- and second-line HIV treatment regimens in South Africa warrants characterization of acquired HIV-1 drug resistance (ADR) mutations that could impact DTG-based antiretroviral therapy (ART). In this study, we sought to determine prevalence of ADR mutations and their potential impact on susceptibility to drugs used in combination with DTG among HIV-positive adults (≥ 18 years) accessing routine care at a selected ART facility in KwaZulu-Natal, South Africa.

Methods: We enrolled adult participants in a cross-sectional study between May and September 2019.

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