Risk Factors for Severe Outcomes of Respiratory Syncytial Virus Infection in Children: A Nationwide Cohort Study in Sweden
Authors investigated risk factors for RSV-associated severe disease outcomes in children 0–18 years. Among 2,354,302 children, 38,919 (1·7%) had an RSV diagnosis. Of these, 4621 (11·9%) had severe disease outcomes. The median age of children admitted to ICU were 1·9 months and 500 (41·3%) had an underlying comorbidity. Birth in winter (HR 2·96, 95% CI: 2·53–3·46), small for gestational age (aHR 3·91, 95% CI: 3·08–4·97), multiple birth (aHR 3·43, 95% CI: 2·80–4·21), having siblings 0–3 years (aHR 2·92, 95% CI: 2·57–3·31), and comorbidities (aHRs > 4) were the factors most strongly associated with ICU admission or death in the full cohort. Similar, but attenuated, associations were seen among children with an RSV diagnosis. Comorbidities were less common in severe cases under 3 months of age than in older children (40·3% vs 71·6%, p < 0·0001). So, the majority, or 60% of these kids had no identified comorbidities that would put them at risk for severe disease.
Spillover of SARS-CoV-2 to Domestic Dogs in COVID-19–Positive Households: A One Health Surveillance Study
Researchers analyzed serum samples from dogs (n=196) from Pennsylvania during 2021-2022 for the presence of SARS-CoV-2 specific antibodies. The dogs in this analysis included those that were exposed to individuals of the household, who had history of recent SARS-CoV-2 infection, and from dogs with no known history of potential exposure to SARS-CoV-2. They found a significantly higher seroprevalence (68%) among the dogs with exposure to SARS-CoV-2 infection from individuals from COVID-19 positive household compared to other dogs. Our study found the overall seroprevalence of 12.24% among dogs
Patient-Reported Outcomes of Nirmatrelvir Treatment for High-Risk, Nonhospitalized Adults With Symptomatic COVID-19
Compared with placebo, patients receiving NMV/r had a significant three-day reduction in median time to return to usual health (hazard ratio [HR], 1.3; 95% confidence interval [CI], 1.2‒1.4; P < .0001), one-day reduction in median time to return to usual activities (HR, 1.2; 95% CI, 1.1‒1.4; P < .0001), and significantly shorter times to sustained resolution of any overall symptoms (HR, 1.2; 95% CI, 1.1‒1.3; P = .0002) and sustained alleviation of any overall symptoms (HR, 1.2; 95% CI, 1.1‒1.3; P < .0001).
These results are from a phase 2/3 double-blind study, of 2,091 patients (NMV/r = 1,038, placebo = 1,053 high-risk adults with SARS-CoV-2 and ≤5 days of symptoms randomized 1:1 to receive NMV/r or placebo twice daily for five days. Patients recorded responses to 3 Global Impression Questions (GIQs) daily through day 28 to assess return to usual health, return to usual activities, and overall severity of COVID-19-related symptoms.
Real-world effectiveness of nirmatrelvir-ritonavir against severe outcomes of COVID-19 in Taiwan: A nationwide population-based cohort study
This retrospective observational cohort study involved outpatient COVID-19 patients diagnosed between January 1, 2022, and December 1, 2022, within Taiwan’s National Health Insurance Research Database (NHIRD). Patients who received nirmatrelvirritonavir were compared with untreated patients. Primary outcomes include COVID-19-related hospitalization, ICU admission, invasive ventilatory support, death, and the composite outcome of hospital admission or death. They looked at a total of 2,300,131 non-hospitalized patients with confirmed COVID-19 , including 530,807 patients treated with nirmatrelvir-ritonavir and 1,769,324 untreated patients. Treatment with nirmatrelvir-ritonavir was associated with a significantly lower risk of COVID-19-related hospitalization (HR 0.32 [95% CI 0.31 to 0.34]), ICU admission (0.41 [0.38 to 0.45]), invasive ventilatory support (0.38 [0.33 to 0.43]), death (0.42 [0.40 to 0.45]), and the composite outcome of hospital admission or death (0.34 [0.33 to 0.35]). Effectiveness was consistent across subgroups, with the greatest benefit observed in unvaccinated individuals and those aged ≥65 years with additional risk factors.
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