Impact of National Omicron Outbreak at the end of 2022 on the future outlook of COVID-19 in China

Zheng, Liwei; Liu, Shuying; Lu, Fengmin

doi:10.1080/22221751.2023.2191738

Cited by 41 publications

(30 citation statements)

References 22 publications

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“…The first participant was enrolled on December 20, 2022, during a wave of infection with the Omicron variant in Shanghai starting from early December. 10 This wave of infection peaked at the end of December, Three data analysis sets, including the full analysis set, the per protocol set, and the safety analysis set, were defined in the trial protocol in Supplement 1. The primary outcome and secondary outcomes were analyzed using the full analysis set.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 Rebound After VV116 vs Nirmatrelvir-Ritonavir Treatment

Yang,

Xu,

Zheng

et al. 2024

JAMA Netw Open

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ImportanceWith the widespread use of anti–SARS-CoV-2 drugs, accumulating data have revealed potential viral load rebound after treatment.ObjectiveTo compare COVID-19 rebound after a standard 5-day course of antiviral treatment with VV116 vs nirmatrelvir-ritonavir.Design, Setting, and ParticipantsThis is a single-center, investigator-blinded, randomized clinical trial conducted in Shanghai, China. Adult patients with mild-to-moderate COVID-19 and within 5 days of SARS-CoV-2 infection were enrolled between December 20, 2022, and January 19, 2023, and randomly allocated to receive either VV116 or nirmatrelvir-ritonavir.InterventionsParticipants in the VV116 treatment group received oral 600-mg VV116 tablets every 12 hours on day 1 and 300 mg every 12 hours on days 2 through 5. Participants in the nirmatrelvir-ritonavir treatment group received oral nirmatrelvir-ritonavir tablets with 300 mg of nirmatrelvir plus 100 mg of ritonavir every 12 hours for 5 days. Participants were followed up every other day until day 28 and every week until day 60.Main Outcomes and MeasuresThe primary outcome was viral load rebound (VLR), defined as a half-log increase in viral RNA copies per milliliter compared with treatment completion. Secondary outcomes included a reduction in the cycle threshold value of 1.5 or more, time until VLR, and symptom rebound, defined as an increase of more than 2 points in symptom score compared with treatment completion. The primary outcome and secondary outcomes were analyzed using the full analysis set. Sensitivity analyses were conducted using the per protocol set. Adverse events were analyzed using the safety analysis set.ResultsThe full analysis set included 345 participants (mean [SD] age, 53.2 [16.8] years; 175 [50.7%] were men) who received VV116 (n = 165) or nirmatrelvir-ritonavir (n = 180). Viral load rebound occurred in 33 patients (20.0%) in the VV116 group and 39 patients (21.7%) in the nirmatrelvir-ritonavir group (P = .70). Symptom rebound occurred in 41 of 160 patients (25.6%) in the VV116 group and 40 of 163 patients (24.5%) in the nirmatrelvir-ritonavir group (P = .82). Viral whole-genome sequencing of 24 rebound cases revealed the same lineage at baseline and at viral load rebound in each case.Conclusions and RelevanceIn this randomized clinical trial of patients with mild-to-moderate COVID-19, viral load rebound and symptom rebound were both common after a standard 5-day course of treatment with either VV116 or nirmatrelvir-ritonavir. Prolongation of treatment duration might be investigated to reduce COVID-19 rebound.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR2200066811

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Section: Discussionmentioning

confidence: 99%

“…A total of 478 participants were needed, with 239 participants in each group. The first participant was enrolled on December 20, 2022, during a wave of infection with the Omicron variant in Shanghai starting from early December . This wave of infection peaked at the end of December, followed by a rapid decline in January.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Rebound After VV116 vs Nirmatrelvir-Ritonavir Treatment

Yang,

Xu,

Zheng

et al. 2024

JAMA Netw Open

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“…In December 2022, Hubei experienced a population-wide omicron outbreak driven by BF.7 sub-variant and its derivates, with estimated infection rates as high as 90%. 7 This sweeping outbreak thus provides a unique opportunity to assess immune imprinting in re-infected participants with minimal selection bias that favors immunocompromised individuals.…”

Section: Methodsmentioning

confidence: 99%

Humoral immune response to omicron infection in long-term Wuhan-Hu-1-imprinted population

Lǚ

Zhu

Zheng

et al. 2023

Preprint

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Recent WHO vaccination guidance no longer recommends COVID-19 vaccination beyond the first booster in low risk population, citing high population-level hybrid immunity due to widespread omicron infections.1 Although SARS-CoV-2 infection confers durable protection against reinfection,2-4 it may also produce immune imprinting, which skews subsequent immune response to variant antigens toward the first-exposed antigen based on the antigenic distance.5,6 China has the earliest and exclusively Wuhan-Hu-1(WH1)-imprinted population before the 2022 nation-wide omicron outbreak,7 which offers a unique opportunity to study long-term immune imprinting between most antigenically distant strains. Here, we assessed pseudovirus neutralization activity and anti-WH1 receptor binding domain (RBD) antibodies in 4 Chinese cohorts with hybrid or vaccine-only imprinting, or naïve to SARS-CoV-2 prior to omicron BF.7 infection. Both hybrid and vaccine-only imprinting augmented post-infection serum neutralization of WH1 and omicron sub-variants BF.7/BQ.1.1/XBB.1.5 comparing to naïve background. Feedback from pre-existing high-affinity antibodies limited the magnitude of humoral immune response to omicron infection without compromising protection, while antigenic seniority of pre-existing cross-reactive B cells only slightly reduces forward neutralization breadth in hybrid- and RBD vaccine-imprinted participants. Our results support the effectiveness of hybrid immunity against omicron reinfection in long-term imprinted population and provide immunological basis for similar epidemiological findings.8-10

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“…Yanlin Li 1 Tongfei Wang 2 Yamin Zhang 3 Miao Li 4 Xiemin Feng 5 Rui Xu 6 Hong Xu 2 Weihu Xia 3 Yaning Zhao 7 Xinli Hou 8 Hui Wei 9 Zhiyan Liu 10 Ying Zan 11 Bing Zhao 12 Chunling Liu 12 Xiaopeng He 13 Xuan Liang 1 Mengjie Liu 1 Lili Jiang 1 Wenjuan Wang 1 Yuan Shen 14 Duolao Wang 15 Baibing Mi 14 Yixue Bai 1 Xin Yu 1 Xubo Huang 1 Xiaohui Jia 1 Xiaolan Fu 1 Hui Guo 11,16,17 Min Jiao…”

Section: A U T H O R C O N T R I B U T I O N Smentioning

confidence: 99%

“…In spite of the epidemic reduction, low-level Omicron infections may persist worldwide, necessitating increased attention to high-risk patients with poor prognoses and the provision of detailed health education and better medical resources. 3 Our study included solid cancer patients with positive SARS-CoV-2 tests between December 1, 2022, and February 28, 2023, in 10 medical centres in China 3 (Table S1). Previous lung diseases, including cancer in the lung (primary and metastatic), ILD, pneumonia, atelectasis and chronic bronchitis/chronic obstructive pulmonary disease (COPD), were evaluated.…”

mentioning

confidence: 99%

Association of lung diseases with coronavirus disease 2019 in cancer patients receiving immune checkpoint inhibitors: A multicenter study during national Omicron outbreak in China

Li,

Wang,

Zhang

et al. 2023

Clinical & Translational Med

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Impact of National Omicron Outbreak at the end of 2022 on the future outlook of COVID-19 in China

Cited by 41 publications

References 22 publications

COVID-19 Rebound After VV116 vs Nirmatrelvir-Ritonavir Treatment

COVID-19 Rebound After VV116 vs Nirmatrelvir-Ritonavir Treatment

Humoral immune response to omicron infection in long-term Wuhan-Hu-1-imprinted population

Association of lung diseases with coronavirus disease 2019 in cancer patients receiving immune checkpoint inhibitors: A multicenter study during national Omicron outbreak in China

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