These findings support the hypothesis that there is an association between Borrelia burgdorferi infection and psychiatric morbidity. In countries where this infection is endemic, a proportion of psychiatric inpatients may be suffering from neuropathogenic effects of Borrelia burgdorferi.
Background
Observational studies made it possible to assess the impact of risk factors on the long-term effectiveness of mRNA and adenoviral vector (AdV) vaccines against COVID-19.
Methods
A computerized literature search was undertaken using the MEDLINE, EMBASE, and MedRxiv databases to identify eligible studies, with no language restrictions, published up to 28 February 2022. Eligible were observational studies assessing vaccine effectiveness (VE) by disease severity with reference groups of unvaccinated participants or participants immunized with one, two, or three vaccine doses. Our study was carried out in compliance with the PRISMA and MOOSE guidelines. The risk of study bias was identified using the Newcastle–Ottawa Quality Assessment Scale. The GRADE guidelines were applied to assess the strength of evidence for the primary outcome. The synthesis was conducted using a meta-analysis and meta-regression.
Results
Out of a total of 14,155 publications, 290 studies were included. Early VE of full vaccination against COVID-19 of any symptomatology and severity decreased from 96% (95% CI, 95–96%) for mRNA and from 86% (95% CI, 83–89%) for AdV vaccines to 67% for both vaccine types in the last 2 months of 2021. A similar 1-year decline from 98 to 86% was found for severe COVID-19 after full immunization with mRNA, but not with AdV vaccines providing persistent 82–87% effectiveness. Variant-reduced VE was only associated with Omicron regardless of disease severity, vaccine type, or vaccination completeness. The level of protection was reduced in participants aged >65 years, with a comorbidity or those in long-term care or residential homes independently of the number of doses received. The booster effect of the third mRNA dose was unclear because incompletely restored effectiveness, regardless of disease severity, declined within a short-term interval of 4 months.
Conclusions
Full vaccination provided an early high, yet waning level of protection against COVID-19 of any severity with a strong impact on the high-risk population. Moreover, the potential risk of new antigenically distinct variants should not be underestimated, and any future immunization strategy should include variant-updated vaccines.
These findings elaborate on potential association between Bb infection and psychiatric morbidity, but fail to identify any specific clinical 'signature' of Bb infection.
ResumenPropósito.La infección por Borrelia burgdorferi (Bb) puede afectar al sistema nervioso central y llevar posiblemente a trastornos psiquiátricos. Comparamos variables clínicas y demográficas en pacientes psiquiítricos seropositivos y seronegativos para Bb y controles sanos.Método.Se llevó a cabo una detección selectiva para anticuerpos para Bb en 926 pacientes psiquiátricos consecutivos y se los comparó con 884 sujetos sanos seleccionados simultáneamente.Resultados.Contrariamente a los controles sanos, los pacientes psiquiítricos seropositivos eran significativamente más jóvenes que los seronegativos. Ninguna de las categorías diagnósticas psiquiátricas estudiadas mostró una asociación más fuerte con la seropositividad. No hubo diferencias entre los pacientes psiquiátricos seropositivos y seronegativos en la duración de la hospitalización, la proporción de pacientes hospitalizados antes y la proporción de sujetos con antecedentes familiares de trastornos psiquiátricos.Conclusión.Estos hallazgos explican con mayor detalle la asociación potencial entre la infección por Bb y la morbilidad psiquiátrica, pero no identifican ninguna “firma” clínica específica de la infección por Bb.
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