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- Seroprevalence of Specific SARS-CoV-2 Antibodies during Omicron BA.5 Wave, Portugal, April-June 2022Publication . Kislaya, Irina; Melo, Aryse; Barreto, Marta; Henriques, Camila; Aniceto, Carlos; Manita, Carla; Ramalhete, Sara; Santos, João Almeida; Soeiro, Sofia; Rodrigues, Ana PaulaAfter the rapid spread of SARS-CoV-2 BA.5 Omicron lineage in Portugal, we developed a seroepidemiologic survey based on a sample of 3,825 residents. Results indicated that from April 27 through June 8, 2022, the estimated seroprevalence of SARS-CoV-2 nucleocapsid or spike IgG was 95.8%, which indicates a high level of protection.
- COVID-19 Vaccine Effectiveness in Autumn and Winter 2022 to 2023 Among Older EuropeansPublication . Laniece Delaunay, Charlotte; Mazagatos, Clara; Martínez-Baz, Iván; Túri, Gergő; Goerlitz, Luise; Domegan, Lisa; Meijer, Adam; Rodrigues, Ana Paula; Sève, Noémie; Ilić, Maja; Latorre-Margalef, Neus; Lazar, Mihaela; Maurel, Marine; Melo, Aryse; Andreu Ivorra, Blanca; Casado, Itziar; Horváth, Judit Krisztina; Buda, Silke; Bennett, Charlene; de Lange, Marit; Guiomar, Raquel; Enouf, Vincent; Mlinarić, Ivan; Samuelsson Hagey, Tove; Dinu, Sorin; Rumayor, Mercedes; Castilla, Jesús; Oroszi, Beatrix; Dürrwald, Ralf; O’Donnell, Joan; Hooiveld, Mariëtte; Gómez, Verónica; Falchi, Alessandra; Kurečić Filipović, Sanja; Dillner, Lena; Popescu, Rodica; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, Esther; Gallardo García, Virtudes; Perez Morilla, Esteban; Pedrosa Corral, Irene; García Vázquez, Miriam; Milagro-Beamonte, Ana; Fernandez Ibañez, Ana; Margolles Martins, Mario; Giménez Duran, Jaume; Sastre Palou, Bartolomé; López Causapé, Carla; Viloria Raymundo, Luis Javier; Vega Alonso, Tomás; Ordax Díez, Ana; Lozano Alonso, Jose Eugenio; Rojo Bello, Silvia; Mendioroz, Jacobo; Basile, Luca; Martínez Mateo, Ana Isabel; Ruiz de Porras, Carlota; Moya Garcés, Alba; Marcos, Mª Ángeles; López Maside, Aurora; Botella Quijal, Francesc; Miralles Espi, Maite; Andreu Salete, Cristina; García Rodríguez, María del Carmen; Linares, Juan Antonio; García Comas, Luis; Barranco, Mª Isabel; Chirlaque, María-Dolores; Moreno Docón, Antonio; Ramos Marín, Violeta; Castrillejo, Daniel; Gómez Anés, Atanasio; Larrauro, Amparo; Pérez-Gimeno, Gloria; Lozano Álvarez, Marcos; Vega, Lorena; Galindo, Silvia; Puma, Tania; Monge, Susana; Pozo, Francisco; Casas, Inmaculada; Sandonis, Virginia; Vázquez-Morón, Sonia; Echeverría, Aitziber; Trobajo-Sanmartín, Camino; García Cenoz, Manuel; Ezpeleta, Guillermo; Ezpeleta, Carmen; Navascués, Ana; Krisztalovics, Katalin; Mucsányiné Juhász, Krisztina; Kristóf, Katalin; Preuss, Ute; Wedde, Marianne; Biere, Barbara; Reiche, Janine; Oh, Djin-Ye; McKenna, Adele; Connell, Jeff; Joyce, Michael; Bagheri, Mariam; Bos, Sanne; van den Brink, Sharon; Dijkstra, Frederika; Eggink, Dirk; van Gageldonk-Lafeber, Rianne; Goderski, Gabriel; Herrebrugh, Chantal; Jenniskens, Liz; Reukers, Daphne; Sluimer, John; Sprong, Tara; Teirlinck, Anne; Veldhijzen, Nienke; van der Burgh, Ruben; Kager, Cathrien; Klinkhamer, Mayra; Knottnerus, Bart; Riethof, Marloes; van den Broek, Ruud; Wortel, Safira; Machado, Ausenda; Kislaya, Irina; Aniceto, Carlos; Gomes, Licínia; Verdasca, Nuno; Henriques, Camila; Dias, Daniela; Lança, Miguel; Blanchon, Thierry; Guerrisi, Caroline; Renard, Aubane; Launay, Titouan; Masse, Shirley; Chazelle, Marie; Ferenčak, Ivana; Kaić, Bernard; Višekruna Vučina, Vesna; Čusek Adamić, Katica; Kosanović Ličina, Mirjana Lana; Lakošeljac, Danijela; Mihin Huskić, Ivana; Nonković, Diana; Carnahan, Annasara; Hansson-Pihlainen, Eva; Arvesen, Elin; Nid, Nora; Hansen, Anna-Lena; Andersson, Emmi; Dillner, Lena; Jidovu, Adrian; Timnea, Olivia Carmen; Pascu, Cătălina; Oprea, Mihaela; Bistriceanu, Iulia; Ivanciuc, Alina; Mihai, Maria Elena; VEBIS Primary Care Vaccine Effectiveness GroupKey Points: - Question: What was the effectiveness of COVID-19 vaccines administered in autumn and winter 2022 to 2023 against symptomatic SARS-CoV-2 infection among people aged 60 years or older in Europe, and how did different exposed or reference groups affect effectiveness? - Findings: In this case-control study of 9308 primary care patients at 11 European sites, within 3 months of vaccination, all COVID-19 vaccine effectiveness (CVE) estimates were 29% to 39% against SARS-CoV-2 viruses and 44% to 52% against the XBB variants. All point estimates decreased by time after vaccination, with no vaccine protection after 6 months. - Meaning: Findings of this study suggest that COVID-19 vaccination campaigns should precede peaks in SARS-CoV-2 incidence and that effectiveness of new vaccines against emerging variants should be continually monitored using seasonal CVE approaches.
- Nirsevimab effectiveness against hospitalised Respiratory Syncytial Virus infection in Portugal, 2024/25 seasonPublication . Gaio, Vânia; Valadas Henriques, Camila; Lança, Miguel; Machado, Ausenda; Guiomar, Raquel; Rodrigues, Ana PaulaBackground: Respiratory Syncytial Virus (RSV) is one of the leading causes of lower respiratory tract infections in younger children. In mainland Portugal, in order to reduce the risk of severe RSV post-infection complications, an immunisation strategy using Nirsevimab was implemented starting in October 2024, targeting all children aged less than 3 months, and those with high-risk conditions less than 24 months. We conducted a test-negative case-control study using the national hospital-based RSV surveillance network to estimate Nirsevimab effectiveness (NE). Methods: This multicentre study included children aged under 24 months hospitalised with severe acute respiratory infection in 14 hospitals. Cases were defined as children testing positive for RSV by RT-PCR or rapid antigen test (RAT), while controls tested negative. Immunisation status was obtained from electronic medical records. NE was estimated using logistic regression and estimated as (1 – adjusted odds ratio of immunisation) × 100, adjusting for age group, sex, month of symptom onset date, low birth weight, prematurity, and chronic conditions. Results: Between weeks 40/2024 and 12/2025, we included 111 cases and 110 controls. The median age for both groups was 2 months (IQR: 1–4). 44 (39.6%) RSV-positive and 80 (72.7%) RSV-negative infants received Nirsevimab at least 2 days before symptom onset. No significant differences were observed between cases and controls regarding sex or medical conditions. NE against RSV-associated hospitalisation was 85% (95% CI: 66–94) in the target population. Sensitivity analysis restricted to RT-PCR-confirmed cases yielded similar results. Conclusions: During the first immunisation season in mainland Portugal, Nirsevimab conferred good protection against the most severe presentation of RSV infection in young children. Our results are aligned with those reported in other countries. Given the potential for viral evolution following the introduction of universal immunisation programmes, ongoing monitoring of NE is warranted.
- SARS-CoV-2 Seroprevalence among hospital healthcare workers in comparison with the general population, 2021-2022Publication . Gaio, Vânia; Amaral, Palmira; Santos, Ana João; Henriques, Camila; Valadas Henriques, Camila; Guiomar, Raquel; Rodrigues, Ana Paula; Machado, AusendaBackground/Objectives: Healthcare workers (HCWs) are essential as frontline responders during infectious disease health emergencies. Protecting them is crucial to ensure their health, maintain continuous patient care, and prevent transmission to patients. This study aimed to estimate the SARS-CoV-2 seroprevalence trend among HCWs from a Portuguese hospital cohort between May 2021 and June 2022. It also aimed to compare it with the seroprevalence trend in the general population aged 40-49. Additionally, the characterization of HCWs with seroconversion was performed based on their positivity for anti-nucleocapsid (Anti-N) IgG antibodies. Methods: As part of a vaccine effectiveness study, HCWs were screened for anti-RBD/Spike IgG antibodies against SARS-CoV-2 in three time points: May–July 2021, September-November 2021, and May–June 2022. At the last moment, Anti-N IgG antibodies were also assessed. To compare with data on the general population, we used results from three National Serological Surveys (NSS) phases (February–March 2021, September–November 2021, and April–June 2022) focusing on the 40–49 age group, the most representative among HCW. HCW characteristics were compared according to anti-N IgG seropositivity using the Chi-square and Mann-Whitney tests, assuming a significance level of 0.05. Results: HCWs screening at the 3 moments included 909, 474, and 67 individuals respectively with SARS-CoV-2 seroprevalence was 86%, 90%, and 100%, respectively. These seroprevalences were similar to those found in the Portuguese general population, except for the first period (86% versus 18.8% in the general population, age group 40-49 years). At the last moment, the post-infection seroprevalence (anti-N IgG antibodies) was higher among HCWs than in the general population (41% versus 27%). A lower age and direct contact with COVID-19 patients were associated with anti-N IgG antibody positivity. Conclusions/Recommendations: The increasing trend of seroprevalence among HCWs follows the same trend in the general population. Although the time points differ, in the first moment, higher SARS-CoV-2 seroprevalence was probably linked to priority vaccine uptake. In the third moment, the higher post-infection seroprevalence among HCWs suggests a raised exposure and infection incidence in HCWs following the Omicron wave. Given the decline in COVID-19 vaccination coverage among HCWs in the post-pandemic period, ongoing monitoring of seroprevalence and COVID-19 infection rates in this group remains crucial.
- SARS-CoV-2 serological 6-months follow-up study of a hospital-based cohort of healthcare workers following 2023 COVID-19 vaccination programPublication . Santos, João Almeida; Gaio, Vânia; Amaral, Palmira; Henriques, Camila; Guiomar, Raquel; Machado, AusendaObjective: Healthcare workers (HCWs) have a higher risk of SARS-CoV-2 infection due to their direct contact with patients. On the other hand, they can also act as a source of in-hospital transmission. We assessed SARS-CoV-2 serological status of HCWs at a Portuguese central hospital before vaccination, three and six months after the 2023 COVID-19 booster vaccination program. Methods: We conducted a serological follow-up study among a cohort of HCWs from a Portuguese central hospital, with three rounds of testing: pre-COVID-19 vaccination (September/October 2023), three months (January/February 2024), and six months (April/May 2024) post-vaccination. During follow-up, only participants who underwent pre-vaccination serology and were vaccinated were included. SARS-CoV-2 spike receptor-binding domain (anti-RBD/S) protein-specific IgG antibodies were measured (upper limit of detection 40000 AU/mL). Descriptive statistics and Pearson Chi-Square test analysis were performed. Results: All participants (n=177, median age: 47 years, 77,4% females) had the complete primary COVID-19 vaccination with 78,0% having received 2 additional booster doses prior to 2023 vaccination program. At pre-vaccination, all HCWs had anti-RBD/S IgG antibodies with 11,9% (n=21) presenting a concentration >40000 AU/mL. Three months later, 35,0% HCWs (n=62) underwent retesting, with 40,3% presenting anti-RBD/S IgG antibody concentrations >40000 AU/mL. After six months, 26,6% HCWs (n=47) repeated testing, with 21,3% (n=10) having antibody concentrations >40000 AU/mL. The differences in anti-RBD/S IgG antibody concentrations between the three rounds of testing were significant. Conclusions: Three months post-COVID-19 2023 autumn vaccination, an increase in the concentration of anti-RBD/S antibodies was identified among HCW, but after six months this concentration decreased. These results are in line with the expected decay of antibodies over time after 3 months of vaccination and reinforce the importance of revaccination in HCWs.
- Serological evidence of SARS-CoV-2 infection in a hospital based cohort study of healthcare workers following the 2023 COVID-19 vaccination programPublication . Almeida Santos, João; Gaio, Vânia; Amaral, Palmira; Henriques, Camila; Guiomar, Raquel; Machado, AusendaObjective: Healthcare workers (HCWs) are a high-risk population to acquire SARS-CoV-2 infection and becoming a focus of transmission. It is therefore important to monitor these professionals, especially due to asymptomatic infections. The objective the study was to assess SARS-CoV-2 infection rates in healthcare professionals at a central Portuguese hospital using serological tests, three and six months after the 2023 COVID-19 booster vaccination program. Methods: A prospective cohort study was established through serological follow-up in a cohort of healthcare professionals from a central Portuguese hospital, with three rounds of tests: pre-COVID-19 vaccination (September/October 2023), 3 months (January/February 2024) and 6 months (April/May 2024) post-vaccination. IgG antibodies specific to the SARS-CoV-2 nucleocapsid protein (anti-N) were measured. Data was analyzed trough descriptive statistics (frequency, mean, percentages) and infection rates at each testing moment (0, 3 and 6 months). Results: At baseline, all participants (n=177, median age: 47years, 77,4% females) had the complete primary COVID-19 vaccination, with 78% having received 2 additional booster doses prior to 2023 vaccination program. Pre vaccination, 48,6% (86/177) of HCWs had detectable anti-N IgG antibodies, of which 24,4% (21/86) self-reported having had a SARS-Cov-2 infection in 2022/2023. After 3 months, 17,7% (n=11/62) had detectable anti-N IgG antibodies although being negative in the pre-vaccination testing. After 6 months, 4,3% (n=2/47) had detectable anti-N IgG antibodies but were negative in the previous two rounds. Conclusions: During the study period, several cases of SAR-CoV-2 infection (n=13) were identified serologically among the HCW monitored, without concomitant signs and symptoms that would allow the identification of a potential infection. These results support that monitoring the infection among HCW (regardless of history of symptoms) can provide valuable information for assessing the level of exposure among hospital personnel and identifying high-risk departments. This information could allow early intervention by, for example, reminding and reinforcing the importance of personal protection standards for HCWs.