Age-stratified infection fatality rate of COVID-19 in the non-elderly population

Pezzullo, Angelo Maria; Axfors, Cathrine; Contopoulos‐Ioannidis, Despina G.; Apostolatos, Alexandre; Ioannidis, John P. A.

doi:10.1016/j.envres.2022.114655

Cited by 79 publications

(75 citation statements)

References 58 publications

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“…Despite these limitations, we can conclude that precision shielding was feasible in several high-income countries in the first year of the pandemic, but most countries had no major differences in infection rates across age groups. Precision shielding remains an attractive concept given the extreme variability of fatality risk of SARS-CoV-2 infection across age groups [ 17 , 71 ], but when it is not achieved (or worse, when vulnerable individuals, such as elderly and nursing home residents are even more frequently infected than the non-vulnerable) the death toll and excess deaths become high [ 72 ]. These observations may be useful for future pandemic preparedness, especially for pathogens exhibiting large fatality rate variability across different population groups.…”

Section: Discussionmentioning

confidence: 99%

Differential COVID-19 infection rates in children, adults, and elderly: Systematic review and meta-analysis of 38 pre-vaccination national seroprevalence studies

Axfors

Pezzullo

Contopoulos‐Ioannidis

et al. 2023

J Glob Health

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Background Debate exists about whether extra protection of elderly and other vulnerable individuals is feasible in COVID-19. We aimed to assess the relative infection rates in the elderly vs the non-elderly and, secondarily, in children vs adults. Methods We performed a systematic review and meta-analysis of seroprevalence studies conducted in the pre-vaccination era. We identified representative national studies without high risk of bias through SeroTracker and PubMed searches (last updated May 17, 2022). We noted seroprevalence estimates for children, non-elderly adults, and elderly adults, using cut-offs of 20 and 60 years (or as close to these ages, if they were unavailable) and compared them between different age groups. Results We included 38 national seroprevalence studies from 36 different countries comprising 826 963 participants. Twenty-six of these studies also included pediatric populations and twenty-five were from high-income countries. The median ratio of seroprevalence in elderly vs non-elderly adults (or non-elderly in general, if pediatric and adult population data were not offered separately) was 0.90-0.95 in different analyses, with large variability across studies. In five studies (all in high-income countries), we observed significant protection of the elderly with a ratio of <0.40, with a median of 0.83 in high-income countries and 1.02 elsewhere. The median ratio of seroprevalence in children vs adults was 0.89 and only one study showed a significant ratio of <0.40. The main limitation of our study is the inaccuracies and biases in seroprevalence studies. Conclusions Precision shielding of elderly community-dwelling populations before the availability of vaccines was indicated in some high-income countries, but most countries failed to achieve any substantial focused protection. Registration Open Science Framework (available at: https://osf.io/xvupr )

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Section: Discussionmentioning

confidence: 99%

Differential COVID-19 infection rates in children, adults, and elderly: Systematic review and meta-analysis of 38 pre-vaccination national seroprevalence studies

Axfors

Pezzullo

Contopoulos‐Ioannidis

et al. 2023

J Glob Health

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“…While high levels can be expected for trials of a novel technology where dosage levels must be determined (many of these trials are phase I) [163], these findings showcase the relative immaturity of mRNA vaccination as a strategy. Given the low efficacy and short duration of protection of SARS-CoV-2 mRNA products [164,165], and the low risk of many populations from COVID-19 complications [166], it may be advisable for the suspension of mRNA vaccines in certain risk cohorts.…”

Section: Discussionmentioning

confidence: 99%

The Novelty of mRNA Vaccines and Potential Harms: A Scoping Review

Halma¹,

Rose²,

Lawrie³

2023

Preprint

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Pharmacovigilance databases are showing evidence of injury in the context of the COVID-19 modified mRNA shots. According to recent publications, adverse event reports linked to the mRNA COVID-19 products largely point to the spike protein as an aetiological agent of adverse events, but we propose that the platform itself may be culpable. To assess the safety of current and future mRNA vaccines, further analysis on the risks due to the platform itself, and not specifically the expressed antigen. If harm can be exclusively and conclusively attributed to the spike protein, then it is possible that future mRNA vaccines expressing other antigens will be safe. If harms are attributable to the platform itself, then regardless of the toxicity, or lack thereof, of the chosen payload therein, the platform may be inherently unsafe, pending modification. In this work, we examine previous studies of RNA-based delivery by a lipid nanoparticle and break down the possible etiological elements of harm.

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“…Under the precautionary principle, our findings warrant avoiding the recommendation of repeated testing, particularly of individuals who have no symptoms of COVID, given that, contrary to what was believed at the start of the pandemic, they play a minor epidemiological role, [81][82][83][84] particularly at this stage of the pandemic, characterized by markedly lower morbidity and mortality. 85 Having detected these unexpected and potentially toxic chemical elements leads us to propose that, rather than aiding in public health measures, unnecessary frequent swabbing of healthy individuals, could jeopardise their health. We are aware that our conclusion can be considered provocative, but we urge public health officials to consider our findings as a justification for urgent studies on the safety of repeated nasopharyngeal swabbing to be conducted, and to recommend against mandatory testing, often required for travelling, attending universities, or as mandatory work policies.…”

Section: Discussionmentioning

confidence: 99%

Scanning electron microscopy and EDX spectroscopy of commercial swabs used for COVID-19 lateral flow testing

Aparicio-Alonso

Torres-Solórzano

Contreras

et al. 2023

Preprint

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The chemical composition of COVID test swabs has not been examined beyond the manufacturers' datasheets. Given the unprecedented demand for swabs to conduct rapid lateral flow tests and nucleic acid amplification tests, which led to mass production, including 3-D printing platforms, it is plausible that manufacturing impurities could be present in the swabs and, if so, could pose a risk for human health. We used scanning electron microscopy and energy dispersive X-ray (EDX) spectroscopy to examine the ultrastructure of five assorted brands of COVID test swabs, and to identify and quantify their chemical elements. We detected unexpected elements, including transition metals, such as titanium and zirconium, as well as aluminium, silicon, and fluorine. The amount of some of the detected elements is close to reported toxicological thresholds for inhalation routes. Experimental studies have shown that detrimental effects of the unexpected chemical elements include moderate to severe inflammatory states in the exposed epithelium as well as proliferative changes. Given the massive testing still being used in the context of the COVID pandemic, often as requisites for travelling, attending universities, or as mandatory work policies, we urge caution in continuing to recommend repeated and frequent testing, particularly of healthy, non-symptomatic, individuals.

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Age-stratified infection fatality rate of COVID-19 in the non-elderly population

Cited by 79 publications

References 58 publications

Differential COVID-19 infection rates in children, adults, and elderly: Systematic review and meta-analysis of 38 pre-vaccination national seroprevalence studies

Differential COVID-19 infection rates in children, adults, and elderly: Systematic review and meta-analysis of 38 pre-vaccination national seroprevalence studies

The Novelty of mRNA Vaccines and Potential Harms: A Scoping Review

Scanning electron microscopy and EDX spectroscopy of commercial swabs used for COVID-19 lateral flow testing

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