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Shapiro, N. I.

Publications and source records attributed to Shapiro, N. I..

3 recordsLinked to original sources

Bivalent mRNA vaccine improves antibody-mediated neutralization of many SARS-CoV-2 Omicron lineage variants

The early Omicron lineage variants evolved and gave rise to diverging lineages that fueled the COVID-19 pandemic in 2022. Bivalent mRNA vaccines, designed to broaden protection against circulating and future variants, were authorized by the U.S. Food and Drug Administration (FDA) in August 2022 and recommended by the U.S. Centers for Disease Control and Prevention (CDC) in September 2022. The impact of bivalent vaccination on eliciting neutralizing antibodies against homologous BA.4/BA.5 viruses as well as emerging heterologous viruses needs to be analyzed. In this study, we analyze the neutralizing activity of sera collected after a third dose of vaccination (2-6 weeks post monovalent booster) or a fourth dose of vaccination (2-7 weeks post bivalent booster) against 10 predominant/recent Omicron lineage viruses including BA.1, BA.2, BA.5, BA.2.75, BA.2.75.2, BN.1, BQ.1, BQ.1.1, XBB, and XBB.1. The bivalent booster vaccination enhanced neutralizing antibody titers against all Omicron lineage viruses tested, including a 10-fold increase in neutralization of BQ.1 and BQ.1.1 viruses that predominated in the U.S. during the last two months of 2022. Overall, the data indicate the bivalent vaccine booster strengthens protection against Omicron lineage variants that evolved from BA.5 and BA.2 progenitors.

microbiology↗

Differential neutralization and inhibition of SARS-CoV-2 variants by antibodies elicited by COVID-19 mRNA vaccines

IntroductoryThe evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the emergence of many new variant lineages that have exacerbated the COVID-19 pandemic. Some of those variants were designated as variants of concern/interest (VOC/VOI) by national or international authorities based on many factors including their potential impact on vaccines. To ascertain and rank the risk of VOCs and VOIs, we analyzed their ability to escape from vaccine-induced antibodies. The variants showed differential reductions in neutralization and replication titers by post-vaccination sera. Although the Omicron variant showed the most escape from neutralization, sera collected after a third dose of vaccine (booster sera) retained moderate neutralizing activity against that variant. Therefore, vaccination remains the most effective strategy to combat the COVID-19 pandemic.

microbiology↗

Evaluation of the Angus ICD9-CM Sepsis Abstraction Criteria

ObjectiveValidate the infection component of the Angus International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9-CM) sepsis abstraction criteria\n\nDesignObservational cohort study\n\nSetting55,000 visits/year Adult Emergency Department (ED)\n\nPatientsAll consecutive ED patient visits between 12/16/2011 and 08/13/2012 were included in the study. Patients were excluded if there was a missing outcome measure.\n\nInterventionsNone.\n\nMeasurements and Main ResultsThe primary outcome measure was suspected infection at conclusion of the ED work-up as judged by the physician. There were 34,796 patients who presented to the ED between 12/16/11 and 8/13/12, of which 31,755 (91%) patients were included and analyzed. The original Angus sepsis abstraction criteria had a sensitivity of 55%, specificity of 97%, PPV of 82%, NPV of 88%, accuracy of 87%, and a F1 score of 0.66. The modified Angus sepsis abstraction criteria which includes codes added after the original publication had a sensitivity of 65%, specificity of 96%, PPV of 81%, NPV of 91%, accuracy of 89%, and F1 score of 0.72.\n\nConclusionsIn our study, the Angus abstraction criteria have high specificity (97%), but moderate sensitivity (55%) in identifying patients with suspected infection as defined by physician at the time of disposition from the emergency department. Given these findings, it is likely that we are underestimating the true incidence of sepsis in the United States and worldwide.

bioinformatics↗