Efficacy of first dose of covid-19 vaccine versus no vaccination on symptoms of patients with long covid: target trial emulation based on ComPaRe e-cohort

Tran, Viet-Thi; Perrodeau, Élodie; Saldanha, Júlia Schirmer; Pane, Isabelle; Ravaud, Philippe

doi:10.1136/bmjmed-2022-000229

Cited by 54 publications

(30 citation statements)

References 25 publications

(23 reference statements)

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“…On the other hand, it is also possible that COVID-19 was less functionally significant during Wave 2, and patients did not require extensive rehabilitation and care services. Vaccination likely contributed to the relatively milder presentations in Wave 2 [22], [23]. However, this data was not routinely available for analysis in this study.…”

Section: Discussionmentioning

confidence: 93%

Comparing care pathways between COVID-19 pandemic waves using electronic health records: a process mining case study

Georgiev,

Fleuriot,

Papapanagiotou

et al. 2024

Preprint

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Purpose: The COVID-19 pandemic caused rapid shifts in the workflow of many health services, but evidence of how this affected multidisciplinary care settings is limited. We propose a Process Mining approach that utilises timestamped data from Electronic Health Records to compare care provider patterns across pandemic waves. Methods: We collected routine events from Scottish hospital episodes in adults with COVID-19 status and linked health provider inputs to generate standardised treatment logs. Conformance checking metrics were used to select the optimal model (Inductive Miner infrequent [IMi]) for downstream analysis. Visual diagrams from the discovered Petri Nets indicated the interactions on pre-coded provider and activity-level subsets. We used cross-log conformance checking and graph similarity to measure distances between adverse and less adverse groups across pandemic waves. Results: We included 1,153 patients with COVID-19 (302 [26%] in Wave 1 and 851 [74%] in Wave 2) with 55,212 relevant care provider events. At the conformance checking stage, the IMi model, achieved good log fitness (LF=0.95) and generalisation (G=0.89), but limited precision (PR=0.27) across all granularity levels. More structured care procedures in Wave 1 were present, compared to mixed multidisciplinary patterns in Wave 2. Care activities differed in patients with extended stay (GED=348, PR=0.231 vs GED=197, PR=0.429 in shorter stays). Patients in out-of-hours care and intensive therapy were linked with more standardised patterns. Conclusion: Process Mining can be incorporated alongside clinical oversight to provide visual and quantitative comparisons of care interactions in COVID-19 episodes and enhance further research in complex cases.

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Section: Discussionmentioning

confidence: 93%

Comparing care pathways between COVID-19 pandemic waves using electronic health records: a process mining case study

Georgiev,

Fleuriot,

Papapanagiotou

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…This would not only have knock-on benefits for other children, thereby further reducing risk of infection and adverse events, but would also break transmission chains which could result in older or otherwise vulnerable individuals contracting COVID-19, for whom there is a much higher risk of severe outcomes [ 55 ]. Furthermore, there are additional indirect benefits to the vaccinated individuals that have not been considered, including shorter or less severe Long Covid if it occurs [ 56 ] and reduced school-related absenteeism [ 57 ] as a consequence of reduced infection and Long Covid rates, that can have longer term health-related and socio-economic impacts [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

A Methodological Framework for Assessing the Benefit of SARS-CoV-2 Vaccination following Previous Infection: Case Study of Five- to Eleven-Year-Olds

et al. 2023

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Vaccination rates against SARS-CoV-2 in children aged five to eleven years remain low in many countries. The current benefit of vaccination in this age group has been questioned given that the large majority of children have now experienced at least one SARS-CoV-2 infection. However, protection from infection, vaccination or both wanes over time. National decisions on offering vaccines to this age group have tended to be made without considering time since infection. There is an urgent need to evaluate the additional benefits of vaccination in previously infected children and under what circumstances those benefits accrue. We present a novel methodological framework for estimating the potential benefits of COVID-19 vaccination in previously infected children aged five to eleven, accounting for waning. We apply this framework to the UK context and for two adverse outcomes: hospitalisation related to SARS-CoV-2 infection and Long Covid. We show that the most important drivers of benefit are: the degree of protection provided by previous infection; the protection provided by vaccination; the time since previous infection; and future attack rates. Vaccination can be very beneficial for previously infected children if future attack rates are high and several months have elapsed since the previous major wave in this group. Benefits are generally larger for Long Covid than hospitalisation, because Long Covid is both more common than hospitalisation and previous infection offers less protection against it. Our framework provides a structure for policy makers to explore the additional benefit of vaccination across a range of adverse outcomes and different parameter assumptions. It can be easily updated as new evidence emerges.

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“…Among seven studies that compared vaccinated and unvaccinated individuals with established PCC [44][45][46][47][48][49][50], three studies addressed the main outcome of PCC resolution following one dose, two of which did not demonstrate an association [46,49] and the third reported double the remission rate among vaccinated individuals [45] (Table 2). Three studies compared self-reported outcome data pre-and post-vaccination, all of which found beneficial outcomes after the first dose [42,51,52].…”

Section: (Q3) Changes In Pcc Following Vaccination Among Individuals ...mentioning

confidence: 99%

A systematic review of the evidence on the associations and safety of COVID-19 vaccination and post COVID-19 condition

Jennings,

Corrin,

Waddell

2023

Epidemiol. Infect.

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Post COVID-19 condition (PCC) refers to persistent or recurring symptoms (>8 weeks) occurring ≤12 weeks following acute COVID-19. The objective of this systematic review was to assess the evidence on the risk of PCC with vaccination before or after COVID-19 or after developing PCC, and the safety of vaccination among those already experiencing PCC. A search was conducted up to 13 December 2022 and standard systematic review methodology was followed. Thirty-one observational studies were included. There is moderate confidence that two doses of vaccine given pre-infection reduced the odds of PCC (pooled OR (pOR) 0.67, 95% CI 0.60-0.74, I2 = 59.9%), but low confidence that one dose may not reduce the odds (pOR 0.64, 95% CI 0.31#x2013;1.31, I2 = 99.2%), and the evidence is very uncertain about the effect of three doses (pOR 0.45, 95% CI 0.10#x2013;1.99, I2 = 30.9%). One of three studies suggested vaccination shortly after COVID-19 may offer additional protection from developing PCC compared to unvaccinated individuals, but this evidence was very uncertain. For those with PCC, vaccination was not associated with worsening PCC symptoms (10 studies) and appears safe (3 studies), but it is unclear if vaccination may change established PCC symptoms.

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Efficacy of first dose of covid-19 vaccine versus no vaccination on symptoms of patients with long covid: target trial emulation based on ComPaRe e-cohort

Cited by 54 publications

References 25 publications

Comparing care pathways between COVID-19 pandemic waves using electronic health records: a process mining case study

Comparing care pathways between COVID-19 pandemic waves using electronic health records: a process mining case study

A Methodological Framework for Assessing the Benefit of SARS-CoV-2 Vaccination following Previous Infection: Case Study of Five- to Eleven-Year-Olds

A systematic review of the evidence on the associations and safety of COVID-19 vaccination and post COVID-19 condition

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